What to Know About Dementia and COVID-19

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Dementia increases the risk of becoming infected with COVID-19. Dementia also raises the likelihood of becoming very ill from the virus and requiring hospitalization. And COVID-19 is more likely to be fatal in people who have dementia. 

Dementia is an independent risk factor for serious illness from the virus that causes COVID-19. According to the Centers for Disease Control and Prevention (CDC), many of the risk factors associated with severity of COVID-19 are also associated with dementia—including advanced age, hypertension, and diabetes.

Based on recent research, the National Institutes of Health (NIH) recommends that adults who have dementia should be protected from exposure to the virus because of the increased risk.

People with dementia cannot have in-person visitors in nursing homes

Hugh R Hastings / Getty Images

Dementia and COVID-19 Risk 

There are many types of dementia. According to research, all types of dementia are associated with an increased risk of COVID-19 illness, including vascular dementia, presenile dementia, Alzheimer’s disease, senile dementia, and post-traumatic dementia.

If you or your loved one has dementia, certain factors increase the risk of COVID-19 exposure. Researchers have also identified several issues that contribute to the increased risk of severe COVID-19 illness among people who have dementia, but suggest that there could be other reasons for this link that have not yet been established.

Factors that increase the risk of COVID-19 illness in people who have dementia include:

Nursing Home Exposure

Since the early days of the COVID-19 pandemic, nursing home residents have been at very high risk of contracting the virus. Common spaces, shared equipment, and caregivers that care for many patients contribute to the rapid spread of the virus from one resident to another.

Nursing homes across the world have employed helpful safety measures to protect residents from COVID-19—including restricting visitors and increased cleaning.

But the reality of contagious spread in shared living spaces and the inherent reliance that people with dementia have on others has made it impossible to fully prevent the virus from spreading.

Cognitive Impairment

People living with dementia, whether with family or in a nursing home, are often unable to tolerate or comply with safety precautions such as handwashing and masks.

Varying degrees of cognitive impairment is a central feature of dementia, and this prevents a person who has dementia from fully understanding the risk and being able to consistently do what is necessary to stay safe from the virus.

Underlying Medical Risk Factors

Dementia is associated with advanced age, diabetes, smoking, hypertension, and frail health. These underlying health issues are known to predispose to severe illness from COVID-19. 

Complications of Dementia and COVID-19

Racial disparities are a significant factor in severe illness with COVID-19, including among those with dementia. The six-month mortality and hospitalization risk in patients with dementia and COVID-19 is 20.99% for White Americans and 59.26% for Black Americans.

The most common complications of the infection among people who have dementia are:

  • Pneumonia: This is a severe lung infection that can lead to a life-threatening inability to breathe, and may require intubation and ventilator support.
  • Blood clots: Blood clotting problems with COVID-19 can lead to blood clots that affect the lungs, brain, extremities, and/or heart, with potentially life-threatening effects.
  • Cognitive decline: COVID-19 often affects thinking and mental status in dementia patients due to factors including direct viral effects on the brain, hypoxia (lack of oxygen to the brain), inflammation, long intensive care unit stay, sedative drugs used in ventilator support, and systemic disease.
  • Prolonged effects: People who have dementia are more vulnerable to lasting neuropsychiatric and cognitive impairments from the infection. Symptoms can include insomnia, depressed mood, anxiety, post-traumatic stress disorder, and cognitive impairment.
  • Depression: The measures that have been implemented to slow the spread of the virus have led to increasing levels of isolation for people with dementia—whether at home or in a nursing home. This contributes to loneliness and depression among people with dementia.

Dementia Treatments and COVID-19

Caregivers of people living with dementia, whether professional or friends and family, face a number of additional challenges due to the COVID-19 pandemic. The need to stay safe can make it especially difficult to seek help and attention for medical issues, including symptoms of COVID-19.  

Access to medical care: If you are taking care of someone who has dementia, given their cognitive and communication issues it can be difficult to know when they are feeling sick. Be sure to contact your loved one’s doctor if you suspect any changes in their health to determine whether they should be medically evaluated and/or treated. 

Access to dementia care: Most memory clinics have had to suspend their in-person care. A lack of ongoing dementia care can impact the symptoms, potentially leading to further impaired cognition, mood changes, and behavioral effects.

Frequently Asked Questions 

Should adults who have dementia be vaccinated to protect from COVID-19?

Yes, it is recommended that adults who have dementia receive the vaccine. There are no negative effects associated with the vaccine in relation to dementia.

Should adults living in a nursing home who have dementia move out of the nursing home?

This is a very difficult decision. If your loved one is living in a nursing home, this means that they require ongoing medical assistance. It would not be safe to move your loved one to your home if this would prevent them from getting the care they need.

What can adults with dementia do if they develop symptoms of the infection?

If you are taking care of someone with dementia and they begin to experience symptoms of COVID-19—cough, fever, stomach upset, or cognitive or behavioral changes—call their doctor so they can be seen either in person or via telehealth.

Who can take care of an adult with dementia if their primary caregiver becomes sick?

It is a good idea to have a backup plan. If you are living with a family member who has dementia and they depend on you for their care, make plans so that someone can take over if you get COVID-19.

How to Stay Safe 

People who have dementia need to take precautions to avoid becoming exposed to the virus that causes COVID-19. Because of their cognitive impairment, staying safe requires assistance from caregivers.

If you are taking care of someone who has dementia, you must also avoid becoming a carrier because you could then expose them to the virus. Things you can do to protect yourself and your loved one from exposure include:

  • Avoiding crowds 
  • Wearing a mask when around other people 
  • Washing hands after potential exposure 

Other things you can do to help your loved one who has dementia include helping them maintain their optimal health. Often, dementia leads to a sedentary lifestyle and lack of self-care, making a person susceptible to a variety of illnesses, including COVID-19.

Steps to keep them healthy include:

  • Promoting a healthy diet 
  • Encouraging them to stay active, such as taking walks 
  • Maintaining contact with friends and family, such as with videoconferencing 
  • Keeping up with personal hygiene, such as brushing teeth and bathing 
  • Keeping regular medical appointments, either in person or via telehealth 

A Word From Verywell

Dementia is a challenge for the person who is experiencing the condition and for loved ones and caregivers. If you or your loved one is living with dementia, the pandemic can be especially stressful.

Since dementia is so variable, a person who has the condition may understand some of the risks but might not fully grasp the implications of the pandemic. Family members and caregivers need to communicate with each other and with the person who has dementia to achieve the best care possible and to avoid problems like isolation and depression.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.

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Article Sources
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