State and territory governments and the federal Department of Health publish daily updates on the number of COVID-19 cases and deaths in Australia, and fortnightly reports on outbreaks in residential aged care homes, and these resources have provided the public with timely data on the impact of the pandemic on older people in Australia (Department of Health 2020; Department of Health 2021). There is, however, less information on how COVID-19 has specifically affected people with dementia (Parliament of Australia 2020). People with dementia are more likely to contract COVID-19 as well as to develop severe COVID-19 than people without dementia due to various reasons, including that:
- there has been a high prevalence and spread of the virus in some aged care homes
- people with dementia tend to have other comorbidities, and these may increase their risk of developing severe COVID-19 symptoms (AIHW 2020a)
- people with dementia may find it more difficult to understand and follow public health recommendations related to reducing the chances of contracting COVID-19
- a gene common in people with dementia (the APOE e4 genotype), is also linked to an increased probability of developing severe COVID-19 (Kuo et al. 2020a; Kuo et al. 2020b; Numbers and Brodaty 2021; Yang et al. 2021).
In Australia, people with dementia are estimated to account for over half of people living in permanent residential aged care (AIHW 2020a). While less than 1 in 10 cases of COVID-19 across Australia have been of people living in residential aged care, they accounted for over 7 in 10 COVID-19 deaths during 2020 (Department of Health 2021). Outbreaks in aged care homes have placed residential aged care homes under strict public scrutiny and pressure, particularly in light of the Royal Commission into Aged Care Quality and Safety’s interim report ‘Neglect’, which found that Australia’s aged care system has failed to consistently provide safe and quality care to Australians, and has called for a fundamental overhaul of Australia’s aged care system (Royal Commission 2020). While most people with dementia are thought to live in the community and not in residential aged care homes, those with more advanced dementia and more frail health tend to live in residential aged care homes due to their higher care needs.
This section presents deaths due to COVID-19 in Australia (that is, where COVID-19 was the underlying cause of death recorded on a person’s death certificate) and compares these deaths by whether or not dementia was also recorded as an associated cause of death.