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Relationship between dementia, COVID‐19 risk, and adherence to COVID‐19 mitigation behaviors among older adults in the United States
Journal Title
International Journal of Geriatric Psychiatry
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Publication Date
2022-05-17
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37
Publication Issue
6
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Abstract
Objectives: To examine how dementia is associated with COVID-19 risk and adherence to COVID-19 mitigation behaviors, and whether mitigation behaviors mediate the relationship between dementia and COVID-19 risk.
Methods/Design: We analyzed 2019 and 2020 data from the National Health and Aging Trends Study, a national prospective cohort study of United States older adults age 65+. Outcomes were COVID-19 diagnosis and adherence to COVID-19 mitigation behaviors (handwashing, mask-wearing, and social distancing).
Results: Among the 3257 older adults in this study, 485 (14.9%) had dementia in 2019 and 98 (3.1%) were COVID-19 positive in 2020. Dementia significantly increased the odds of COVID-19 by 129% (odds ratio [OR] = 2.29, 95% confidence interval [CI] 1.32 to 3.97), and remained elevated after adjusting for sociodemographics and health (OR = 1.67, 95% CI 0.90 to 3.11). Dementia significantly decreased the odds of handwashing by 72% (OR = 0.28, 95% CI 0.17 to 0.44), which remained lower after adjusting for sociodemographics and health (OR = 0.53, 95% CI 0.23 to 1.21). Dementia was not significantly associated with mask-wearing and social distancing. The relationship between dementia and COVID-19 was primarily mediated by functional impairment, income, and residential setting.
Conclusions: Dementia was associated with an increased COVID-19 risk and lower adherence to handwashing among U.S. older adults. Adherence to COVID-19 mitigation behaviors did not mediate COVID-19 risk by dementia status. For older adults with dementia, COVID-19 risk could be decreased by prioritizing health interventions.
Citation
Wong, R., & Lovier, M. A. (2022). Relationship between dementia, COVID-19 risk, and adherence to COVID-19 mitigation behaviors among older adults in the United States. International Journal of Geriatric Psychiatry, 37(6). https://doi.org/10.1002/gps.5735
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Acknowledgements:
This work was supported by funds from the SUNY Upstate College of Medicine and The Research Foundation for The State University of New York. National Health and Aging Trends Study (NHATS) is sponsored by the National Institute on Aging (grant number U01AG32947) and was conducted by the Johns Hopkins University.
Key Points:
● Older adults with dementia have a higher risk for COVID-19.
● Older adults with dementia are less likely to wash their hands to prevent the spread of COVID-19.
● Dementia status is not associated with mask-wearing or social distancing to prevent the spread of COVID-19.
● The relationship between dementia and COVID-19 risk is primarily mediated by functional impairment, income, and residential setting.