Roundup: Dementia Linked to Higher COVID-19 Risks; Mask Mandates Reduce Hospitalizations; and CDC Update on Double Masking

Study: People With Dementia Twice as Likely to Contract COVID-19, More Likely to be Hospitalized

Dementia patients had a significantly increased risk of contracting COVID-19, and higher risk of being hospitalized, compared to those without dementia, according to an analysis of U.S. electronic health record (EHR) data.

The risk of getting infected and seriously ill from COVID-19 was even higher for African-Americans with dementia, according to the research led by Case Western Reserve University in Cleveland. The results were published by the peer-reviewed Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

Researchers adjusted for factors associated with people with dementia that could increase their risk of contracting COVID-19, such as living in a nursing home and underlying conditions like obesity, asthma, diabetes and cardiovascular disease. After modifying for these risk factors, U.S. adults with dementia were still twice as likely to have gotten COVID-19.

Dementia encompasses conditions that impair memory and result in a decline in cognitive function. Alzheimer’s disease, the most common of these conditions, is the 5th leading cause of death among adults aged 65 years or older.

“Our results emphasize how important it is to protect those with dementia from acquiring (COVID-19) for they are at higher risk for severe disease than those without dementia,” said study co-author Pamela Davis, dean emerita of the Case Western Reserve School of Medicine, in a news release. “These patients may constitute another vulnerable category. However, more work is required to understand the mechanism by which this occurs.”

Researchers reviewed electronic health records (stripped of identifying information) from 360 hospitals and 317,000 healthcare providers nationally, “representing 20 percent of the U.S. population.” Of the 61.9 million adults in the study population, more than one million had dementia, 15,770 had COVID-19 and 810 had both.

Overall, the odds of contracting COVID-19 were twice as high for patients with dementia, compared to those without dementia. However, researchers said the risk varied by a specific type of dementia. Patients with vascular dementia had the highest risk — with odds more than three times higher — followed by patients with presenile dementia, senile dementia, Alzheimer’s disease and post-traumatic dementia.

Vascular dementia is considered the second most common cause of dementia after Alzheimer’s disease, accounting for up to 10 percent of cases. It is caused by conditions that damage the blood vessels in the brain, depriving the brain of oxygen.

CDC: States with Mask-Wearing Mandates Saw Declines in Hospitalizations

Research that reviewed hospitalization rates in 10 states during a three-month period in 2020 found that communities with mask mandates saw a significant decline in patients with COVID-19 being admitted to hospitals.

The research, published in the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report, found that the rate of hospitalizations started to decrease slightly in the first three weeks after mask mandates were implemented. More than three weeks following the start of those mandates, hospitalization rates dropped by almost 5 percent.

The study “demonstrates that statewide mask mandates were associated with a reduction in COVID-19–associated hospitalization growth rates among adults aged 18–64 years,” the CDC stated. Hospitalization rates did not decline as much in patients over age 65 — or those who are considered more susceptible to severe illness from COVID-19.

The study looked at hospitalization rates in California, Colorado, Connecticut, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio and Oregon — states that enacted mask mandates between mid-April and mid-July.

Thirty-one states and the District of Columbia have implemented mask mandates to some degree.

Public health officials have emphasized since the beginning of the pandemic that mask-wearing helps reduce the transmission of the coronavirus, and the rates of hospitalizations.

The CDC’s new study says: “At the individual level, the prevention benefit of using a mask increases as more persons use masks consistently and correctly. Studies have confirmed the benefit of masking for (COVID-19) control; each study demonstrated that, after implementation of directives from organizational or political leadership for universal masking, new infections decreased significantly.”

CDC: Double-Masking Offers Better Protecting, But Properly-Fitted, Single Masks are Fine

U.S. public health researchers have found that two masks — a surgical mask underneath a cloth mask — likely protects the wearer from COVID-19 more than one mask. However, the U.S. Centers for Disease Control and Prevention (CDC) stopped short of recommending “double masking.”

The bottom line: It’s more important to wear a single, double-layered mask that fits properly, the CDC said.

In laboratory testing, researchers simulated coughs and breathing between to people, and tested how well different masks worked to block aerosol particles. When both the exhaling and inhaling simulated heads were double-masked, more than 80 percent of the particles were blocked, researchers said. The researchers found that wearing one mask, surgical or cloth, blocked about 40 percent of the particles.

Still, health authorities conceded it’s enough have a challenge to get everyone to properly wear a single mask to move toward making double-masking an official recommendation.

The CDC states: “These experiments highlight the importance of good fit to maximize mask performance. There are multiple simple ways to achieve better fit of masks to more effectively slow the spread of COVID-19.”