Why dementia patients in Latin America are more exposed to COVID-19

Globally, the global prevalence of dementia is 5.2% in people over the age of 60. In Latin America, the prevalence of dementia is 6.54% (Shutterstock)

Two years ago, Zoraida B., 83, began to experience more frequent forgetting, word-finding difficulties, orientation problems in the place, and fixed ideas. Her symptoms have increased since the quarantine began in March. For her relatives, the most difficult thing has been to make her understand the current situation and why she needs to stay inside. Despite the explanations, she does not want to abide by the quarantine restrictions. She asks her son to visit her in the San Isidro neighborhood of Lima, Peru. Despite the restrictions, she leaves her home to go to the market and to church. It needs constant monitoring and urgently requires a cognitive and neurological evaluation, but it has not yet been studied due to the disruptions caused by the pandemic.

Zoraida’s case is not unique in Latin America. The pandemic can affect more than the general population when people have cognitive impairment and dementia. Difficulties in understanding messages with preventive measures – such as the use of masks, physical distancing, frequent hand washing, isolation in their homes – and access to medical care may put them at greater risk of acquiring infection by the coronavirus, according to a group of scientific researchers from Brazil, Chile, Colombia, Peru, Argentina, Ecuador, the United States, Canada and England. Furthermore, only 1% of the population over the age of 60 lives in long-term care homes, and many of them are not systematically monitored.

The group of researchers signed a declaration document (to which they had access Infobae) that will be published soon in the magazine The Lancet Neurology to make a wake-up call for all health authorities in Latin America and for society in general. Globally, the global prevalence of dementia is 5.2% in people over the age of 60. In Latin America, the prevalence of dementia is 6.54%.

Many older adults live alone and only have contact with healthcare personnel (shutterstock)
Many older adults live alone and only have contact with healthcare personnel (shutterstock)

The situation for dementia patients is critical in the context of the pandemic ”, the independent researcher of the Conicet in Argentina, Agustín Ibañez, told Infobae. “The region is doing poorly in economic terms, health systems are already overstretched, and dementias – such as Alzheimer’s disease – are highly prevalent. The coronavirus will unevenly impact the most disadvantaged and at the same time widen the gap for those without adequate assistance.”Warned Dr. Ibañez, who is director of the Center for Cognitive Neuroscience (CNC) at the University of San Andrés, in Argentina, researcher at the Center for Cognitive and Social Neuroscience at the Adolfo Ibáñez University in Chile; and Senior Fellow Atlantic from the University of California, San Francisco Global Brain Health Institute (UCSF).

Dementia patients may have difficulties with changes in habits and with the understanding of information provided by health services. They tend to forget new habits, such as frequent hand washing, the use of a chinstrap and isolation, ”researcher Myriam de la Cruz Puebla, from the Peruvian Neuroscience Institute, in the city of Lima, explained to Infobae. “Many of the patients even forget whether or not they have eaten food. Therefore forgetting the preventive measures for COVID-19 is something that happens and that puts them in a higher risk situation ”.

“Unfortunately, patients with dementias are at high risk of having a severe COVID-19 picture due to age. Many have other diseases such as type 2 diabetes, cardiovascular disease or have suffered strokes. These factors and diseases make them weaker against the virus, ”explained De la Cruz Puebla. “From difficulties in understanding messages to other previous illnesses, they can make the situation of people with dementia a time bomb for patients, their families and the health professionals who care for them,” said Ibañez.

The combination of other factors associated with dementia were underlined by the researchers. The high prevalence of dementias increases year by year in Latin America, while in Europe or in the United States it remains or tends to decrease. There is a significant impact of social determinants of health or modifiable risk factors in Latin America, which explain about 56% of dementia cases, compared to 35% of the world average: These factors undoubtedly also make people infected with coronaviruses more vulnerable, because they impact their general health.

In Argentina, many cases of covid-19 have been detected in nursing homes (Nicolás Stulberg)
In Argentina, many cases of covid-19 have been detected in nursing homes (Nicolás Stulberg)

Many dementia patients live with families that include four generations. This situation exposes them to the spread of the coronavirus. “As there are very few nursing homes, care is generally informal and falls on the family, especially in women, wives or daughters. “There are also limitations for them to be treated through telemedicine and a remote approach to dementia,” said Dr. Ibáñez. Paradoxically, Geriatric hospitals have also detected more confirmed cases of COVID-19 due to the close proximity of many people.

What should be done to better protect dementia patients? Dr. Myriam De la Cruz Puebla replied: “Given the lack of resources intended to provide care to patients with dementia in Latin America, our group of researchers is firmly committed to promoting collaboration between experts. We consider that identify common regional problems, develop work guides applicable throughout the region, and train health professionals about the pillars in the diagnosis, care and treatment of patients with dementia “. In addition, he pointed out three other public health measures: “We must massively spread knowledge about dementias, raise awareness of the disease in the main social actors, and promote the development of health policies in favor of both dementia patients and caregivers ”.

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