The age-standardised death rate of Australians with dementia fell during the first 10 months of 2020, probably as a result of measures designed to prevent COVID-19 infections also limiting the spread of other infectious respiratory diseases, according to a new report from the Australian Institute of Health and Welfare (AIHW).
The report, Dementia deaths during the COVID-19 pandemic in Australia, uses provisional mortality data collected by the Australian Bureau of Statistics to examine deaths among people who had dementia recorded on their death certificates between January and October 2020.
It shows that 257 (30%) of the 858 people who died due to COVID-19 in the first 10 months of 2020 had dementia.
‘Older people living with dementia are particularly vulnerable during infectious disease outbreaks. Over the past year, Australia has introduced a range of measures to limit the spread of COVID-19 and treat those affected,’ said AIHW spokesperson Dr. Fleur de Crespigny.
‘The death rate for people with dementia was slightly lower over the first 10 months of 2020 compared to the average rate over the same months during 2015–19 (58 and 63 deaths per 100,000 population, respectively). Lower rates of death were particularly apparent during the winter months, when there is usually a seasonal peak in deaths of people with dementia.’
For people with dementia*, the number of deaths due to influenza or pneumonia fell during the first 10 months of the pandemic (13 people in 2020 compared to an average of 187 people over 2015–2019).
‘These results suggest that the measures in place to control the virus indirectly reduced dementia mortality rates in Australia during the first 10 months of 2020, and contrasts with the experience of other developed countries like the United Kingdom where mortality among people with dementia (even when not due to COVID-19) rose during the pandemic,’ Dr. de Crespigny said.
Measures to prevent the spread of COVID-19 included setting up new treatment facilities, contact tracing and quarantine systems, implementing social-distancing measures and, at times, enforcing mask-wearing and lockdowns in areas where outbreaks occurred.
‘While early evidence suggests that these measures have assisted in reducing deaths due to other respiratory conditions, it is important to note the impacts of social isolation and loneliness on overall wellbeing, particularly among those living in residential aged care,’ Dr. de Crespigny said.
Of the 257 people with dementia who died due to COVID-19, more than half (54%) were women, and most deaths occurred among those aged 85 and over. Almost all the people with dementia who died due to COVID-19 were Victorian residents (95%), with many likely living in one of the 61 residential aged care facilities in Greater Melbourne that experienced fatal COVID-19 outbreaks. The remaining 5% of deaths were among NSW residents.
‘The impact of the COVID-19 pandemic in Australia on people with dementia is not yet fully understood. Although they are more likely to develop severe COVID-19 and die from the virus than people without dementia, they often do not present symptoms commonly associated with COVID-19’ Dr. de Crespigny said.
‘In an unknown proportion of cases, people who die with dementia do not have the condition recorded in their death certificates, so mortality data will not capture every person who dies with dementia. More data, over a longer period of time, are required to provide a more comprehensive picture of the impacts COVID-19 has had on people living with dementia.’
Dementia is a collection of symptoms—usually progressive in nature—caused by a range of disorders affecting the brain. The prevalence of dementia increases with age, mainly occurring among those aged 65 and over, and often co-exists with other age-related conditions.
The number of Australians with dementia is projected to more than double between 2020 and 2050. Without a significant breakthrough in prevention or treatment, dementia will have an increasingly major impact on Australia’s health and aged care systems. In its final report, the Royal Commission into Aged Care Quality and Safety identified dementia care as one of four areas requiring immediate attention.
‘With the pandemic still ongoing, people with dementia remain a particularly vulnerable group and it will be important to monitor broader impacts on their health and welfare as other data sources become available over time,’ Dr. de Crespigny said.
An AIHW report scheduled for September, Dementia in Australia, will provide the latest information available on dementia, risk factors, health services, aged care services, carers and Government expenditure on dementia.
* This rate is specific to people who died with dementia recorded as an underlying and/or associated cause of death on their death certificate.
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