Coronavirus and Dementia Insights: Interview with Dr. Rebecca Edelmayer -Feb.25.2021

Regulation | February 25, 2021 | by Jill Schumann

Rebecca Edelmayer, Ph.D., Director of Scientific Engagement with the Alzheimer’s Association, joined the LeadingAge Coronavirus Update Call on February 25, 2021.

Rebecca Edelmayer, Ph.D., Director of Scientific Engagement with the Alzheimer’s Association, joined the LeadingAge Coronavirus Update Call on February 25, 2021. She responded to questions from Joe Franco and from callers.

Q: Please tell us about the recently published study regarding COVID-19 and dementia.

A: This study by Wang, et al was published on February 9, 2021. Data was collected usin gelectronic health records from all 50 states, representing 20% of the U.S. population. This population included 1,064,960 people who had dementia, 15,770 with COVID‐19, and 810 with both dementia and COVID‐19.

Q: What were the key takeaways?

A: The most important finding is that the risk of contracting COVID-19 was twice as high for people with dementia as for adults without dementia. The mortality risk for people with both dementia and COVID-19 was higher than for people with either condition alone. African Americans had three times the risk of contracting COVID-19 as whites, which highlights both the vulnerabilities of people with dementia and also the risks inherent in health disparities. People with vascular dementia had the highest risk and African Americans have a higher incidence of vascular issues. The study only included people who had interacted with the healthcare system, so these data may be an underestimate of the connection between COVID-19 and dementia and of the health disparities.

Q: Can you tell us more about these disparities?

A: Of the 810 people with both dementia and COVID-19, 480 were hospitalized – higher for Black people (73%) than for Whites (53%). Factors that increase the risk of dementia such as hypertension, diabetes, and cardiovascular issues are also more prevalent among African Americans. There is some hypothesis that the breakdown of the blood brain barrier in dementia may make people with dementia more susceptible to COVID-19.

Q: In light of these risks what might our members do to keep people with dementia safe from COVID-19 but not alone and isolated?

A: We know that people with dementia can have more difficulty wearing masks, maintaining social distance, and practicing the behaviors that would keep them safer. People with dementia may also be living in a congregate setting, which introduces more risk. On the other hand, we need to balance those risks with the negative effects of isolation. People with dementia have more difficulty with things like technologically - mediated virtual visits.

Q: Since people with dementia have more difficulty with masking and social distancing, are there things caregivers should do?

A: The Alzheimer’s Association has resources on our website to assist both professional and family caregivers. We try to reinforce the CDC guideline, but know that it is difficult for people with dementia to follow those. We have released set of long term care recommendations regarding COVID. And we know that vaccinations will be especially important.

Q: Did the study analyze the effects of isolation, depression and anxiety or offer wisdom on how to help people feel connected?

A: No, the study did not delve into this. It focused on hospitalizations, deaths and disparities.

Q: Apart from identifying the COVID-19 -related risks of the various types of dementia, were there other insights about the intersection of the various types of dementia with COVID?

A: There is much se still do not know about COVID-19 (and about dementias). While Alzheimer’s disease is the dementia that occurs most frequently, mixed dementias are quite prevalent. As we learn more about how COVID-19 impacts the brain we will better understand the risks for each type of dementia.

Q: Is there research looking at the long- term impact of COVID-19 on cognitive functioning?

A: Yes, the Alzheimer’s Association is leading a study looking at COVID -19 impacts on the brain. It involves researchers from 25 countries and will track the long term impact of COVID-19.. WE do not yet understand all of the implications of the infection. This study aims to better understand the biology of brain and COVID-19 and also its impact on cognitive function. There are other studies underway as well.