COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US
Open accessAbstract
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.
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Even after adjusting for demographic characteristics and other COVID-19 risk factors, individuals with Alzheimer's were at higher risk for contracting and dying from COVID-19.
“Even after adjusting for demographic characteristics and other COVID-19 risk factors (including living in long-term care or other care communities), individuals with Alzheimer's were at higher risk for contracting and dying from COVID-19.799,800”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [800]
The Results (‘Odds of COVID-19 in patients with dementia’; page not provided) report higher odds of COVID-19 for patients with Alzheimer’s disease after adjustment for demographics and known risk factors, including nursing-home stay as described in Methods. The mortality Results report that 19.23% of patients with both Alzheimer’s and COVID-19 died, but do not report an adjusted estimate showing a higher risk of death for that group. The claim’s ‘even after adjusting’ qualifier is therefore supported for contracting COVID-19, not for dying from it. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe COVID-19 pandemic had a significant impact on the health care workforce and especially on the dementia care workforce, given disproportionately high infection and death rates among people with Alzheimer's and other dementias.
“The COVID-19 pandemic had a significant impact on the health care workforce and especially on the dementia care workforce, given the disproportionately high infection and death rates due to COVID-19 among people with Alzheimer's and other forms of dementia.679”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [679]
The Results report higher COVID-19 infection risk among patients with dementia and higher six-month mortality among infected patients with dementia than among infected patients without dementia (20.99% versus 4.81%). The paper does not assess the pandemic’s impact on the health care or dementia care workforce, so it does not support that part of the sentence. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe COVID-19 pandemic has had a significant and enduring impact on the health care workforce and especially on the dementia care workforce, given the disproportionately high infection and death rates due to COVID-19 among people living with Alzheimer's disease and other dementias.
“The COVID‐19 pandemic has had a significant and enduring impact on the health care workforce and especially on the dementia care workforce, given the disproportionately high infection and death rates due to COVID‐19 among people living with Alzheimer's disease and other dementias.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [812]
Split into 2 atoms — 1 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredAfter adjusting for demographic characteristics and other COVID-19 risk factors, individuals with Alzheimer's were at higher risk for dying of COVID-19.
“individuals with Alzheimer's were at higher risk for contracting and dying of COVID‐19. 959 , 960”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [960]
The Results section (page not provided) reports 6-month mortality of 19.23% among patients with both Alzheimer’s disease and COVID-19, versus 4.81% among patients with COVID-19 but no dementia. However, the Discussion says the outcome analysis could not control for medical comorbidities and other factors. The paper’s adjusted Alzheimer’s finding concerns the risk of contracting COVID-19, not the risk of dying from it. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAD patients are more susceptible to COVID-19, with higher risks of hospitalization and mortality.
“AD patients are also more susceptible to COVID-19, with higher risks of hospitalization and mortality in the patients with dementia and COVID-19.604”
From Recent advances in Alzheimer's disease: Mechanisms, clinical trials and new drug development strategies. (2024) · cites this paper as [604]
One study using electronic health records and adjusting for COVID-19 risk factors found that individuals with Alzheimer's had twice the odds of being diagnosed with COVID-19 as individuals without Alzheimer's.
“One study using data from electronic health records and adjusting for COVID-19 risk factors found that individuals with Alzheimer's had twice the odds of being diagnosed with COVID-19 as individuals without Alzheimer's.”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [800]
The risk of contracting COVID-19 was even higher for Black adults with dementia, who had nearly three times the odds compared with White adults with dementia.
“The risk was even higher for Black adults with dementia, who had nearly three times the odds of contracting COVID-19 compared with White adults with dementia.800”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [800]
After adjusting for demographic characteristics and other COVID-19 risk factors, individuals with Alzheimer's were at higher risk for contracting COVID-19.
“Even after adjusting for demographic characteristics and other COVID‐19 risk factors (including living in long‐term care or other care communities), individuals with Alzheimer's were at higher risk for contracting and dying of COVID‐19. 959 , 960”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [960]
Individuals with Alzheimer's had twice the odds of being diagnosed with COVID-19 as individuals without Alzheimer's.
“individuals with Alzheimer's had twice the odds of being diagnosed with COVID‐19 as individuals without Alzheimer's.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [960]
Black adults with dementia had nearly three times the odds of contracting COVID-19 compared with White adults with dementia.
“The risk was even higher for Black adults with dementia, who had nearly three times the odds of contracting COVID‐19 compared with White adults with dementia. 960”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [960]
Individuals with Alzheimer's are more susceptible both to contracting COVID-19 and to developing severe illness due to COVID-19.
“these individuals are more susceptible both to contracting COVID‐19 and developing severe illness due to COVID‐19.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [960]
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Self-citation
- Authors
- Wang, Q., Davis, P. B., Gurney, M. E., & Xu, R.
- Affiliations
- Case Western Reserve University (US)
- Tetra Therapeutics (United States) (US)
- Corresponding author
- Xu, Rong
- Venue
- Alzheimer's & Dementia
- Publisher
- Wiley
- Published
- 2021-02-09
- Volume
- 17
- Issue
- 8
- Pages
- 1297-1306
- ISSN
- 1552-5260 (ISSN-L)
- 1552-5279
- PMC
- PMC8014535
- OpenAlex
- W3127585785
- Cited by
- 257
- References
- 57
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 54 · 2023: 53 · 2022: 81 · 2021: 43
- FWCI
- 18.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Alzheimer s & Dementia (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG057557, AG061388, AG062272)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, dementia
- MeSH terms
- Brain Injuries, Traumatic, COVID-19, Adolescent, Adult, Aged, Aged, 80 and over, Alzheimer Disease, Black or African American, Dementia, Demography, Female, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, United States, Dementia, Vascular, Case-Control Studies, Treatment Outcome, Black People, White People, Healthcare Disparities, Young Adult, Electronic Health Records
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