Objectives To examine how dementia is associated with COVID‐19 risk and adherence to COVID‐19 mitigation behaviors, and whether mitigation behaviors mediate the relationship between dementia and COVID‐19 risk. Methods/Design We analyzed 2019 and 2020 data from the National Health and Aging Trends Study, a national prospective cohort study of United States older adults age 65+. Outcomes were COVID‐19 diagnosis and adherence to COVID‐19 mitigation behaviors (handwashing, mask‐wearing, and social distancing). Results Among the 3257 older adults in this study, 485 (14.9%) had dementia in 2019 and 98 (3.1%) were COVID‐19 positive in 2020. Dementia significantly increased the odds of COVID‐19 by 129% (odds ratio [OR] = 2.29, 95% confidence interval [CI] 1.32–3.97), and remained elevated after adjusting for sociodemographics and health (OR = 1.67, 95% CI 0.90–3.11). Dementia significantly decreased the odds of handwashing by 72% (OR = 0.28, 95% CI 0.17–0.44), which remained lower after adjusting for sociodemographics and health (OR = 0.53, 95% CI 0.23–1.21). Dementia was not significantly associated with mask‐wearing and social distancing. The relationship between dementia and COVID‐19 was primarily mediated by functional impairment, income, and residential setting. Conclusions Dementia was associated with an increased COVID‐19 risk and lower adherence to handwashing among U.S. older adults. Adherence to COVID‐19 mitigation behaviors did not mediate COVID‐19 risk by dementia status. For older adults with dementia, COVID‐19 risk could be decreased by prioritizing health interventions.

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Annual influenza vaccination is important for older adults to prevent morbidity and mortality from seasonal influenza. Although the United States has had limited success in increasing influenza vaccination, the rise of the COVID-19 pandemic in 2020 may have changed older adults’ approach to vaccination. The objective of this study is to determine factors associated with influenza vaccination in 2019 and 2020 and compare their degree of associations across the two years. Data from the 2019 and 2020 National Health Interview Survey, a nationally representative cross-sectional interview, were collected for variables relating to annual influenza vaccination and possible associated factors. Data were analyzed using chi-square tests and multiple logistic regression. The results show that never having received a vaccination for pneumonia increased the odds of receiving an influenza vaccination by 6.79–7.80 times. Recent specialist care for eye or oral health significantly increased the odds of receiving an influenza vaccination. Being a smoker, identifying as African American, and considering oneself to have excellent overall health were associated with significantly lower odds of receiving a vaccination. Although self-reported feelings of anxiety were not associated with vaccination in 2019, they increased the odds in 2020. Overall, influenza vaccination in older adults may be tied to reliable healthcare access and perceived susceptibility to infectious respiratory diseases.