Dementia as a mortality predictor among older adults with COVID-19: A systematic review and meta-analysis of observational study.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational (cohort and case-control) studies.
PubMed 33824009 · doi:10.1016/j.gerinurse.2021.03.007
What was done
Authors searched 7 databases for observational cohort and case-control studies reporting mortality among older adults with and without dementia who were diagnosed with COVID-19. Pooled odds ratios and mortality rates were synthesized using random-effects meta-analysis models.
What was found
The pooled mortality rate among COVID-19-infected older adults with dementia was 39% (95% CI: 0.23–0.54%, I² = 83.48%) versus 20% (95% CI: 0.16–0.25%, I² = 83.48%) in those without dementia. Dementia was associated with significantly increased mortality (OR 2.96, 95% CI: 2.00–4.38, I² = 29.7%).
Why it matters
This review establishes pre-existing dementia as an indicator for nearly threefold increased mortality in older adults with COVID-19. It reinforces the need for targeted clinical protocols and heightened care vigilance for cognitively impaired geriatric populations during viral outbreaks.
Limits
The abstract omits the number of included studies and the total participant sample size. Because all included designs were observational (cohort and case-control), the analysis cannot prove causation and may be subject to residual confounding by baseline health status, frailty, and care facility settings. Significant heterogeneity was present in the pooled mortality rates (I² = 83.48%).
Cited by
- supports Dementia is strongly associated with poor clinical outcomes in COVID-19.