3 times more likely to develop severe coronavirus

[Alex54]

Article in Wednesday's Telegraph that Dementia patients are three times more likely to develop severe coronavirus, the first study of the issue has shown, with experts saying they should be added to the shielded list.

This is worrying as our hospital said my wife would not be allowed into the ICT ward because of her Alzheimer's, which means if she did get exposed to the virus it would be almost certain death. Guess all I can do is make sure she is isolated as much as possible but is that really the best way?

 

[nae sporran]

I've not heard anything about that, Alex. My partner is shielding anyway as she has diabetes and has had kidney problems in the recent past. It is harder to keep her motivated and stop her from becoming stiff than it is to keep her safe from the virus.
The Dementia Connect helpline should be able to advise you on how to get help and you local social services can certainly arrange help with shopping and collecting medication.
This looked useful from dementia uk too, https://www.dementiauk.org/dementia-uk-coronavirus-advice/ https://www.alzheimers.org.uk/dementiaconnect

 

[karaokePete]

My wife doesn't understand the pandemic and the need for social distancing etc so would be a high risk to both of us.
I've been shielding her as best I can.

Our Local Authority have been checking in on us, even offering food parcels etc at one point, via a weekly phone call since the lockdown began. I would second the advice from @nae sporran.

 

[Lawson58]

I wonder if the risk for dementia patients is that mostly that they have other diseases as well. Most pe inople with dementia are in the older age group when the immune system doesn't function as well anyway. I know that all the additional treatment and change of scene if they are in hospital will also load them up with extra stress which. Can cause a decline in their health.

 

[Weasell]

I wonder if the risk for dementia patients is that mostly that they have other diseases as well. Most pe inople with dementia are in the older age group when the immune system doesn't function as well anyway. I know that all the additional treatment and change of scene if they are in hospital will also load them up with extra stress which. Can cause a decline in their health.

 

[Weasell]

I completely agree, so many people with dementia have other conditions as well.
Also so many of our dementia sufferers are simply very old.
we were interested to as to why not so many people died of covid on Russia, compared to the number of people catching it, a quick look on Wikipedia tells you the average life expectancy of a male in Russia is 66.9 years and a female is 73.34 years.
I have been working with older patients in a rehab setting. Many have dementia and they have all got over covid, other than one who went to A and E and I have no idea what the outcome was, so do not believe the people who make it sound like an automatic death sentence .
A far bigger scandal in my opinion is the lack of desire to discuss what covid does to the obese in out society. With 63 per cent of our adult population fat or obese, who wants to offend that many people. but they should be entitled to be honestly educated about how the virus interacts with their fat cells.

 

[Canadian Joanne]

@lawson, I think you are on target with your comments. Here in Canada although 20% of the cases are in care homes, 80% of the deaths are in care homes. Care homes have extremely vulnerable populations.

Having said that, there are many, many cases of very elderly people surviving COVID-19 - the 113 year old Spanish woman comes to mind. So we should never give up hope.

 

[Lawson58]

I think this disease is very sneaky and if it gets into nursing/care homes and is there for a while before being detected, then it seems to be hard to get control and lives are lost.

Also people can be ill for a very long time which is harder for older people to withstand. A recent death here was an older lady who had been sick for about five weeks and at 82, she was already a little frail.

The largest number of deaths in Australia have been from cruise ships and three nursing homes, a similar environment in many ways, hothouses for all sorts of infections. Long haul flights are not far behind them. But people who are in nursing homes are there because they are already needing a high level of care which sets them apart from older people in the general community.

The greatest number of Covid 19 cases have been in 20s - 40s but the greatest number of deaths has been in 70+.

I don't know any older person still living in the community who has had it and I suspect that in many ways, they find it easier to stay isolated, not having to work and being the generation that didn't grow up with modern technology.

 

[Palerider]

Just wanted to correct the title to this thread, it should read :

3 times more likely to develop severe Covid-19​

​

Sorry to split hairs but its important to distinguish between the virus and the disease it causes which is an immune dysfunction syndrome that is not understood.

 

[Louise7]

Newspaper headlines don’t always show the full picture. The university press release stated: A team based at the University of Exeter and the University of Connecticut in the USA found that older people with dementia were three times more likely to have severe COVID-19 than older people with no dementia. This may have been as a result of greater exposure to the virus, for example in nursing homes, or it may be caused by the dementia disease process itself.

http://www.exeter.ac.uk/dementia/news/articles/dementiaamongoverlookedco.html

For those interested, here is the research paper. It is based on 488 elderly hospital patients who tested positive for covid-19 (3.3% had dementia), and the paper states that information is lacking with regards to the reasons for hospitilisation and the severity of the covid-19 (considered as severe solely by virtue of a covid-19 test being conducted).

https://www.medrxiv.org/content/10.1101/2020.05.06.20092700v1.full.pdf

 

[Alex54]

Sorry to split hairs

Don't mind at all regarding splitting hairs, and you are right one is the virus the other the illness.

Just wish they would lift the lockdown so I could get a decent haircut!?

 

[Palerider]

Just wish they would lift the lockdown so I could get a decent haircut!?

Me too

 

[Palerider]

Newspaper headlines don’t always show the full picture. The university press release stated: A team based at the University of Exeter and the University of Connecticut in the USA found that older people with dementia were three times more likely to have severe COVID-19 than older people with no dementia. This may have been as a result of greater exposure to the virus, for example in nursing homes, or it may be caused by the dementia disease process itself.

http://www.exeter.ac.uk/dementia/news/articles/dementiaamongoverlookedco.html

For those interested, here is the research paper. It is based on 488 elderly hospital patients who tested positive for covid-19 (3.3% had dementia), and the paper states that information is lacking with regards to the reasons for hospitilisation and the severity of the covid-19 (considered as severe solely by virtue of a covid-19 test being conducted).

https://www.medrxiv.org/content/10.1101/2020.05.06.20092700v1.full.pdf

I agree

This paper (not yet peer reviewed) adds to the growing hypothesis that age alone is not sufficient as a marker for why some develop severe forms of Covid-19 and others do not and highlights dementia as an independent risk factor (Atkins et al., 2020). This paper has already been taken out of context in the media and some caution needs to be advised. People with dementia have and are surviving Covid-19 (ITV News (Online), 2020). What is known is that the immunity is altered in dementia and this is now hypothesised to be the main cause, which involves some very complex mechanisms and why those with dementia can be more susceptible to immune deficiencies and inflammatory processes and not dementia par se, which is the end result of those mechanisms (Marsh et al., 2016, Leonard and Myint, 2006). What these studies do show and others is that there is an underlying immune/inflammatory process in dementia, which is exacerbated by infections, demonstrated in a study by Tate et al. (2014). To date these links have not been fully resolved and making a bland statement about severity and linking that to a generalised term ‘dementia’ is unhelpful in the media, because this kind of reporting impacts on how best to manage people living with dementia and the general population of older people without dementia.

Covid-19, the resulting disease from inoculation of coronavirus has added a new twist to an already difficult situation for those with neurodegenerative diseases such as dementia, and as Atkins et al. (2020, p 9) state in their study:

“Future work will need to clarify the mechanisms involved and aim to establish whether this a direct effect of dementia pathologies, or an indirect effect of high rates of infection in nursing homes.”

References

ATKINS, J. L., MASOLI, J. A., DELGADO, J., PILLING, L. C., KUO, C.-L. C., KUCHEL, G. & MELZER, D. (2020). PREEXISTING COMORBIDITIES PREDICTING SEVERE COVID-19 IN OLDER ADULTS IN THE UK BIOBANK COMMUNITY COHORT. medRxiv [Online]. Available: https://www.medrxiv.org/content/medrxiv/early/2020/05/08/2020.05.06.20092700.full.pdf [Accessed 14/05/2020].

ITV NEWS (ONLINE). (2020). 'Unresponsive' great-grandfather, 90, with dementia beats coronavirus. Available: https://www.itv.com/news/wales/2020...andfather-90-with-dementia-beats-coronavirus/ [Accessed 14/05/2020].

LEONARD, B. E. & MYINT, A. (2006). Changes in the immune system in depression and dementia: causal or coincidental effects? Dialogues in clinical neuroscience [Online], 8. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181774/ [Accessed 20/06/2017].

MARSH, S. E., ABUD, E. M., LAKATOS, A., KARIMZADEH, A., YEUNG, S. T., DAVTYAN, H., FOTE, G. M., LAU, L., WEINGER, J. G., LANE, T. E., INLAY, M. A., POON, W. W. & BLURTON-JONES, M. (2016). The adaptive immune system restrains Alzheimer’s disease pathogenesis by modulating microglial function. Proceedings of the National Academy of Sciences [Online], 113. Available: https://www.pnas.org/content/pnas/113/9/E1316.full.pdf [Accessed 13/06/2017].

TATE, J. A., SNITZ, B. E., ALVAREZ, K. A., NAHIN, R. L., WEISSFELD, L. A., LOPEZ, O., ANGUS, D. C., SHAH, F., IVES, D. G., FITZPATRICK, A. L., WILLIAMSON, J. D., ARNOLD, A. M., DEKOSKY, S. T., YENDE, S. & INVESTIGATORS, G. E. M. S. (2014). Infection hospitalization increases risk of dementia in the elderly. Critical care medicine [Online], 42. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4071960/ [Accessed 14/05/2020].