COVID-19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US

Introduction: At present, there is limited data on the risks, disparity, and outcomes for COVID-19 in patients with dementia in the United States. Methods: This is a retrospective case-control analysis of patient electronic health records (EHRs) of 61.9 million adult and senior patients (age >= 18 years) in the United States up to August 21, 2020. Results: Patients with dementia were at increased risk for COVID-19 compared to patients without dementia (adjusted odds ratio [AOR]: 2.00 [95% confidence interval (CI), 1.94-2.06], P < .001), with the strongest effect for vascular dementia (AOR: 3.17 [95% CI, 2.97-3.37], P < .001), followed by presenile dementia (AOR: 2.62 [95% CI, 2.28-3.00], P < .001), Alzheimer's disease (AOR: 1.86 [95% CI, 1.77-1.96], P < .001), senile dementia (AOR: 1.99 [95% CI, 1.86-2.13], P < .001) and post-traumatic dementia (AOR: 1.67 [95% CI, 1.51-1.86] P < .001). Blacks with dementia had higher risk of COVID-19 than Whites (AOR: 2.86 [95% CI, 2.67-3.06], P < .001). The 6-month mortality and hospitalization risks in patients with dementia and COVID-19 were 20.99% and 59.26%, respectively. Discussion: These findings highlight the need to protect patients with dementia as part of the strategy to control the COVID-19 pandemic.

Automated summary

Patients with dementia are at increased risk for COVID-19 compared to those without dementia, with vascular dementia carrying the highest risk. Black patients with dementia have a higher risk of COVID-19 compared to White patients.