Since the earliest days of the coronavirus outbreak in the LifeCare Center in Kirkland, Washington, it’s been apparent that older adults in nursing homes have been disproportionately impacted by the pandemic. Nationally, older adults in nursing homes and other long-term care facilities account for nearly one-third of all COVID-19 deaths; in Massachusetts, it's close to two-thirds.
But because this population is not homogeneous, Boston-based CarePort Health decided to look at who specifically is dying from the virus within nursing homes.
Using data from 10,000 nursing home residents across the country, their analysts found that even after adjusting for age, residents with dementia were 1.7 times more likely to die from COVID-19 than residents without this diagnosis.
In other words, residents with dementia accounted for 52% of COVID-19 cases, but 72% of deaths.
CarePort CEO Dr. Lissy Hu says this information is important, because underlying health conditions can impact a person’s risk of dying from COVID-19. But so far, the conversation about risk has focused on conditions like asthma, hypertension, diabetes and chronic pulmonary disease.
“A lot of folks think about dementia as just a cognitive disorder, a memory issue. But it affects multiple organ systems, especially in cases of severe dementia,” she says. “So if you're a clinician in a nursing home trying to think about who do you test first and who's at high risk, it's important that you think about dementia.”
The report also found that increasing age is associated with a higher risk of dying from the virus and that women were slightly more likely than men to contract the virus and to die from it. Hu attributes the latter to the fact that older residents in nursing homes tend to skew female.
While the survey was national, CarePort agreed to analyze data on 1,000 residents of Mass. nursing homes for WBUR. Hu cautioned against overgeneralizing given the small sample size, but says the state data mirror national trends.
- Those with dementia accounted for 58% of the surveyed population in the state, but represented 84% of those who died from COVID-19
- About one-third of nursing home residents are over the age of 85, but they account for nearly two-thirds of COVID-19 deaths
- Women — who make up a greater percentage of the over 85 population in nursing homes — were slightly more likely to die from COVID-19 than men
“I think when people think about nursing home populations and the elderly, they tend to think of it as sort of one block of population,” Hu says. “But you can see there's quite a range of folks in these nursing homes and their risk of dying from COVID-19 can be quite different.”