TY - JOUR
T1 - Dementia and Parkinson's Disease
T2 - Risk Factors for 30-Day Mortality in Nursing Home Residents with COVID-19
AU - Rutten, Jeanine J. S.
AU - van Kooten, Janine
AU - van Loon, Anouk M.
AU - van Buul, Laura W.
AU - Joling, Karlijn J.
AU - Smalbrugge, Martin
AU - Hertogh, Cees M. P. M.
AU - Malara, Alba
N1 - Funding Information: This work was supported by the Dutch Ministry of Health, Welfare and Sport. Publisher Copyright: © 2021 - The authors. Published by IOS Press.
PY - 2021
Y1 - 2021
N2 - 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.
AB - 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.
KW - Coronavirus
KW - Dementia
KW - Long-term care facilities
KW - Parkinson's disease
KW - SARS-CoV-2
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85120474981&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34542068
UR - http://www.scopus.com/inward/record.url?scp=85120474981&partnerID=8YFLogxK
U2 - https://doi.org/10.3233/JAD-210319
DO - https://doi.org/10.3233/JAD-210319
M3 - Article
C2 - 34542068
SN - 1387-2877
VL - 84
SP - 1173
EP - 1181
JO - Journal of Alzheimer's disease : JAD
JF - Journal of Alzheimer's disease : JAD
IS - 3
ER -