The effects of the COVID-19 pandemic on people with dementia

Key advances People with dementia are at high risk of SARS-CoV-2 infection because cognitive symptoms cause difficulty with following safeguarding procedures and living arrangements in care homes facilitate viral spread1. Once infected, older adults with dementia are more likely to experience severe virus-related outcomes, including death, than are people without dementia4. A homozygous epsilon 4 genotype is associated with an increased risk of hospitalization for COVID-19 (ref.8), possibly owing to exacerbated inflammation and cytokine production that leads to a cytokine storm. Older adults with dementia, especially those in care homes, are at high risk of worsening psychiatric symptoms and severe behavioural disturbances as a result of social isolation during the pandemic3. The COVID-19 pandemic has posed unique risks to people with Alzheimer disease and dementia. Research from 2020 has shown that these people have a relatively high risk of contracting severe COVID-19, and are also at risk of neuropsychiatric disturbances as a result of lockdown measures and social isolation.