Large impact of COVID-19 on dementia diagnosis and care

Registry-based national data of Sweden demonstrated that the COVID-19 pandemic not only increased mortality of dementia patients in 2020, but also has extensively affected dementia diagnosis and care. This could have severe long-term consequences in terms of underdiagnosis and undertreatment of dementia, particularly amongst elderly women, the researchers warn.

In the Swedish population of 10.4 million people, around 150,000 have dementia, with 24,000 newly diagnosed patients each year. The number of confirmed cases of COVID-19 is now around 2.5 million; 90% of deaths were in people aged >70 years. To explore the impact of the COVID-19 pandemic on dementia diagnosis and care, Prof. Bengt Winblad (Karolinska Institutet, Sweden) and colleagues collected regional and national data on International Classification of Disease version 10 coding (ICD-10), COVID-19 incidence, mortality, and population census from 2015–2020 from the National Institute of Health and Welfare [1,2].

The incidence of dementia diagnosis was relatively stable during 2015–2019, though already slightly declining, with a further decline in many regions during 2020. This decline was especially steep in women >85 years of age (see Figure). A higher COVID-19 incidence was inversely associated with a decrease in dementia diagnosis incidence. Unspecified dementia was however increased, which may be indicative of decreased quality in dementia diagnosis.

Figure: Changes in dementia diagnoses in Sweden during de COVID-19 pandemic [1,2]

Reprinted from Axenhus M, et al. BMC Geriatr. 2022;22(1):365. DOI 10.1186/s12877-022-03070-y under the terms of the Creative Commons Attribution 4.0 license.

During the first 6 months of 2020, mortality was 4.82% higher than would be expected without the COVID-19 pandemic (n=18,940 vs n=18,452). Excess mortality was 8.61% in men and -0.58% in women with dementia. These rates were higher in patients with Alzheimer’s disease.

This study thus showed that the need for dementia diagnosis is crucial and that the COVID-19 pandemic further highlighted this.

1. Winblad B, et al. The COVID-19 pandemic has caused large disruptions to dementia mortality, care, and diagnosis in Sweden during 2020. OPR-036, EAN 2022, 25–28 April, Vienna, Austria.
2. Axenhus M, et al. BMC Geriatr. 2022;22(1):365.

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Posted on 22 August, 2022