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.

1 INTRODUCTION

Coronavirus disease 2019 (COVID‐19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) and rapidly escalated into a global pandemic.¹ Severe illness of COVID‐19 predominantly occurs in older people and in individuals with underlying medical comorbidities.² Dementia including Alzheimer disease (AD) is a common cause of morbidity and mortality in the aging population.³ In addition, the majority of people with dementia were living with one or two additional chronic health conditions.^4-6 Currently, there is little if any quantitative analysis of the risks and outcomes for COVID‐19 in individuals with AD or dementia in the United States.