En español | The cruelty of the COVID-19 pandemic has left its mark on all Americans, but few with more catastrophic impact than those suffering from Alzheimer's and other dementias, according to a new report from the Alzheimer's Association.
Deaths from Alzheimer's and other dementias skyrocketed 16 percent — killing at least 42,000 additional vulnerable older Americans in 2020 — compared with the averages over the previous five years, noted the 2021 Alzheimer's Disease Facts and Figures.
Just as alarming: deaths due to Alzheimer's between 2000 and 2019 more than doubled, jumping 145 percent during that period.
Now, even as the nation is being vaccinated entering the second year of the pandemic, the overall Alzheimer's numbers are nothing short of staggering. Some 6.2 million Americans age 65 and older are living with Alzheimer's dementia. That's more than 1 in 9 people over age 65 — and roughly two-thirds of those over age 65 with Alzheimer's dementia are women.
The COVID-dementia connection
"I don't think many people have any idea about the connection between dementia and people dying from COVID-19,” says Sarah Lenz Lock, AARP senior vice president for policy and brain health and executive director of the Global Council on Brain Health. “People are dying not just because they were already sick or old, but also because of the conditions under which they are living."
Sevil Yasar, M.D., an associate professor of medicine and geriatrician at Johns Hopkins University School of Medicine, certainly is aware of that connection. Even then, she is shocked by the deadly impact on her patients. In a more typical month, she says, perhaps one of her Alzheimer's patients dies. But in January alone, she lost five of her Alzheimer's patients to COVID-19.
"All of them were long-term patients who felt like family — it really gets to you,” she says.
What's more, she predicts, even with the COVID-19 vaccinations that many of her patients and their caregivers are starting to receive, she doesn't believe the death rate will improve much in 2021. That's because so many Alzheimer's and dementia patients suffered through so much stress, depression and agitation in 2020 that it will continue to affect their physical and emotional health in 2021.
"There will be a long-term effect on their well-being,” Yasar says — yet another indirect impact of COVID-19.
Beyond the patient
Even before the onset of the deadly virus, Alzheimer's disease was a relentless killer. The Alzheimer's Association says about 1 in 3 older adults die with Alzheimer's or another dementia. .
The pandemic has increased the stakes. But the acute suffering during the pandemic stretches well beyond Alzheimer's patients to families and caregivers, too. In 2020, more than 11 million caregivers of people with Alzheimer's or other dementias provided roughly 15.3 billion hours of unpaid care, according to the report. That's a contribution valued at nearly $257 billion. About two-thirds of these caregivers are women; one-third of dementia caregivers are daughters of the patients.
Potential causes of higher death rates
While it's clear that people with Alzheimer's are dying from COVID-19-related illnesses at a higher rate than the rest of the population, the science on why is not crystal clear, Lock says. But she says some possible reasons include:
- People with dementia may be predisposed to get infections because of cognitive impairments that stop them from taking proper health measures.
- People who are cognitively impaired often are disadvantaged economically and tend to be staying in facilities that are troubled.
- People in nursing facilities tend to be surrounded by lower-income workers who themselves are more susceptible to COVID-19 because of their living conditions.
Also, says Yasar, when Alzheimer's patients get sick, they or their caregivers are often hesitant to go to the emergency room due to what they perceive is the high risk of getting COVID-19, so they delay the urgent care they need.
In addition, many Alzheimer's patients are housed in facilities with many other older patients, so they are simply at greater risk for getting COVID-19, Yasar says.
One solution: Transparent masks
One big problem could be greatly alleviated if those who worked in facilities with Alzheimer's patients wore transparent masks that showed more of their faces, Lock says.
"Health care providers and caregivers wearing transparent masks might not intimidate or frighten the patients as much,” she says. Under that scenario, the patients, too, may be more likely to leave on their own masks and do a better job of social distancing.
In fact, people with Alzheimer's are at a much higher risk for COVID-19 because they have such a hard time following rules about wearing masks and social distancing, Yasar says.
Other ways to prevent deadly infections for Alzheimer's patients: Make certain that caregivers wear masks, wash hands and social distance, Yasar says. And when possible, she suggests, book telemedicine appointments with doctors instead of in-person appointments.
The COVID-19 vaccine will ultimately be very helpful, but many Alzheimer's and dementia patients are hesitant to get it, Yasar says. Only about 50 percent of her dementia patients over age 65 have received the vaccine. If they are hesitant, she says she tries to very specifically address all of their concerns.
"I try to encourage all of [my patients] to get it,” Yasar says.