Dementia and Parkinson’s Disease: Risk Factors for 30-Day Mortality in Nursing Home Residents with COVID-19

Abstract

Background: The COVID-19 pandemic has led to high mortality rates in nursing homes (NHs) in Europe. For adequate risk management and good prognostications, it is essential to identify mortality risk factors. Objective: This study aimed to determine whether previously identified risk factors for 30-day mortality in Dutch NH residents with COVID-19 are unique to COVID-19. Methods: In this cohort study, we included 1,294 NH residents with COVID-19 (cases) and 17,999 NH residents without COVID-19 (controls, from the pre-COVID-19 period). We used descriptive statistics and Cox proportional hazard models to compare mortality rates in residents with and without COVID-19, categorized by risk factors. Results: Cases had a more than 18 times higher hazard of death within 30 days compared to controls (HR 18, 95%CI: 16–20). For residents with COVID-19, being male, having dementia, and having Parkinson’s disease (PD) were all associated with a higher 30-day mortality (HR 1.8 versus 1.3 versus 1.7). Being male was also associated with a higher mortality (HR 1.7) in the control group, whereas having dementia and PD were not. COVID-19 symptomatology was very similar for residents with and without dementia or PD, except for delirium and malaise which was more frequent in residents with dementia. Conclusion: Dementia and PD were significant additional risk factors for mortality in Dutch NH residents with COVID-19, whereas male gender was not unique to residents with COVID-19. The frailty of PD and dementia in NH residents with COVID-19 are relevant to consider in prognostication, communication, and care planning with residents and their families.

Absence of negativization of nasal swab test and frailty as risk factors for mortality in elderly COVID-19 patients admitted in long-term care facilities

“…The mortality rate was 26,9%, with a slight increase, not statistically significant ( p value 0,33), compared to the previous year (24,3%), and higher in female population. This is apparently in contrast with literature [ 13 – 16 ], where mortality is higher among men. But the majority of papers refer to acute or intensive care settings [ 17 , 18 ], while in our paper, we refer to a post-acute setting with a prevalence of female survived patients, burned with greater clinical impairment.…”

Parkinson’s disease related mortality: Long-term trends and impact of COVID-19 pandemic waves

“…A pooled analysis showed that PD was associated with poor in-hospital outcomes, including severe disease (odds ratio 2.61, 95% CI 1.98–3.43) and mortality from COVID-19 (odds ratio 2.63, 95% CI 1.50–4.60), and the risk increased with age [ 7 ]. Furthermore, among Dutch nursing home residents affected by COVID-19, those with PD had a strongly increased risk of death compared to those without PD [ 8 ]. People with PD have also experienced indirect consequences of the pandemic.…”

Secondary Impact of COVID-19 Pandemic on People with Parkinson’s Disease—Results of a Polish Online Survey

“…Our study also showed that more than half of the respondents confirmed being afraid of infection. Fear may also be related to previous data concerning higher mortality rates in the PD population compared to the general population, especially in those who were older, with longer PD duration, hypertension or coexisting dementia [ 34 , 38 , 39 ]. However, other scientific studies showed that the risk of infection, severe disease or death among people with PD was comparable to that of the general population [ 40 , 41 , 42 ].…”