Excess mortality was seen for older adults with Alzheimer disease and related dementias (ADRD) during the COVID-19 pandemic, according to a study published online Feb. 28 in JAMA Neurology.
Lauren Gilstrap, M.D., M.P.H., from the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and colleagues assessed age- and sex-adjusted mortality rates for individuals with ADRD using data from beneficiaries of 100 percent fee-for-service Medicare Parts A and B between Jan. 1, 2019, and Dec. 31, 2020. A total of 53,640,888 Medicare enrollees aged 65 years or older were categorized into four groups: enrollees with or without ADRD and enrollees with or without ADRD residing in nursing homes.
The researchers found that compared with 2019, in 2020, the adjusted mortality was 12.4 and 25.7 percent higher among enrollees without ADRD and among enrollees with ADRD, respectively; the percentages were even higher for Asian, Black, and Hispanic populations with ADRD (36.0, 36.7, and 40.1 percent, respectively). No excess mortality was seen among enrollees without ADRD in the hospital referral region in the lowest quintile for COVID-19 infection in 2020, but community-dwelling enrollees with ADRD and those with ADRD living in nursing homes had 8.8 and 14.2 percent higher mortality, respectively.
“Older adults with ADRD, especially those in racial and ethnic minority groups and those living in nursing homes, may be particularly susceptible to changes in health care delivery and nursing home care during the ‘lockdowns’ and other restrictions during the pandemic,” the authors write.