Impact of COVID-19 on deaths among people with dementia in 2020

Older people living with dementia are particularly vulnerable during infectious disease outbreaks. Although less than 1 in 10 cases of COVID-19 in Australia in 2020 were among people living in residential aged care, over 7 in 10 COVID-19 deaths were among people living in residential aged care, where it is thought over half of people have dementia (AIHW 2021).

In addition to being exposed to outbreaks in aged care homes, older people living with dementia are at a higher risk of contracting COVID-19 and developing severe COVID-19 for a number of reasons, including that people with dementia often have numerous comorbidities and that they may have difficulties understanding and following public health recommendations. This makes people with dementia a particularly vulnerable group during the COVID-19 pandemic.

To measure changes in mortality patterns during the COVID-19 pandemic and recovery period, the ABS has been publishing provisional mortality statistics for Australia. These statistics indicate that:

  • there were 14,500 deaths in 2020 with an underlying cause of dementia, higher than the average number of deaths due to dementia over 2015–19 (13,500)—this increase is, however, mainly a reflection of Australia’s ageing population
  • once changes in Australia’s population over time are taken into account, the rate of deaths due to dementia remained stable—the age-standardised rate of deaths in 2020 was 40 deaths per 100,000 population, whereas it was 41 deaths per 100,000 population on average over 2015–19 (ABS 2021).

As discussed in Dying due to dementia compared to dying with dementia, incorporating associated causes of death is essential to comprehensively capture deaths among people with dementia as they often die due to other health conditions. In these cases dementia is only recorded as an associated cause of death. The AIHW report Dementia deaths during the COVID-19 pandemic (AIHW 2021) used ABS provisional mortality data to explore the impact of the pandemic on patterns of deaths among people who had dementia recorded anywhere on their death certificate (either as the underlying cause of death or as an associated cause of death, referred to as ‘deaths with dementia’). This report found that during the first 10 months of 2020:

  • the rate of deaths with dementia was lower than the average rate of deaths with dementia over 2015–19
    • Measures introduced to limit the spread of COVID-19 probably led to lower transmission of other infectious respiratory diseases (like influenza or pneumonia), and in turn led to an overall lower rate of deaths among people with dementia
  • 858 people died due to COVID-19, and among them, 257 (30%) also had dementia recorded on their death certificate.

The statistics presented in the report relate only to the first 10 months of the COVID-19 pandemic. Future work will update our understanding of the impact of COVID-19 on deaths of people with dementia as the pandemic continues, including how this may affect the prevalence and incidence of dementia in Australia in coming years.