Dementia Increases Risk of COVID-19 Infection, Hospitalization for Older Patients

Investigators found higher risks of COVID-19 infection, hospitalization, and mortality for older patients with dementia compared with those without dementia during the first wave of the COVID-19 pandemic. However, there was not an increased risk for COVID-19 hospitalization in nursing homes, according to the results of the study published in BMC Geriatrics.¹

“Compared to persons aged 18–29, older persons aged 65 years old or above were at 60 to 340 times higher risk of COVID-19 mortality between 2020 and 2022,” the study authors said.¹ “Older persons with dementia were among the most vulnerable groups during the COVID-19 pandemic, potentially due to their cognitive impairment, disability, dependence in activities of daily living, and other comorbidities.”

According to the Alzheimer’s Society, patients with dementia are more likely to get COVID-19, and the organization stated that a patient with dementia in a care home could be at a higher risk because of the closeness of living. Further, for patients who do get COVID-19, they are at a higher risk of worse illness, and most deaths from COVID-19 have been in patients over 60 years.²

In the current study, the investigators aimed to determine the association between dementia and the risks of COVID-19, hospitalization, and mortality in older patients in Sweden. Approximately 5.6% of patients included in the study lived in a nursing home, and 26.7% of patients in nursing homes had a record of dementia compared with 2% of patients who were community dwelling. COVID-19 infections for patients with dementia in community dwellings were prevalent in 3.49 per 1000 person-months compared with 0.97 per 1000 person-months. For nursing homes, investigators found 13.19 per 1000 person-months and 6.31 per 1000 person-months for COVID-19 infections.¹

Further, the investigators reported that the adjusted hazard ratio increased from 2.008 in 1 month to 2.46 in 2 months for community-dwelling adults. However, it decreased to 0.70 in 6 months after the index date. For nursing homes, the adjusted HRs were 1.89 in 1 month to 0.91 in 6 months.¹

“The higher risk of COVID-19 infection in persons with dementia might be explained by patient and health care system factors,” the study authors said. “It was difficult for older persons with dementia to follow recommendations from the public health agency to prevent the transmission of COVID-19, such as hand hygiene, social distancing, or self-isolation by staying at home.”

For hospitalizations, investigators found the rates to be 2.46 per 1000 person-month for patients with dementia in community dwellings compared with 0.78 per 1000 person-month for those without dementia. In nursing homes, the rates for patients with dementia were lower until approximately 2 months after the index date and then higher in the remaining follow-up period, according to the study authors. For mortality, the rates were 1.20 and 6.23 for patients with dementia, respectively, compared with 0.21 and 2.55 for those without dementia, respectively.¹

“A higher risk of COVID-19 hospitalization was seen in persons with dementia living in community dwellings,” the study authors said.¹ “In contrast, among persons living in nursing homes, dementia was not associated with COVID-19 hospitalization.”

READ MORE: COVID-19 Resource Center

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REFERENCES

1. Hoang MT, Wastesson JW, Szilcz M, Maura G, Blotière PO, Johnell K. Impact of dementia on risks of COVID-19 infection and outcomes among older adults in Sweden. BMC Geriatr. 2025;25(1):843. Published 2025 Nov 4. doi:10.1186/s12877-025-06576-3

2. Alzheimer’s Society. Dementia and coronavirus risk. Accessed November 5, 2025. https://www.alzheimers.org.uk/get-support/coronavirus/dementia-risk