Dementia and coronavirus risk

Catching coronavirus

Risks for people with dementia at home

A person living with dementia who has memory problems or confusion may struggle with the guidance and rules around coronavirus. These include frequent handwashing, and social distancing when outside to reduce the risk of catching the virus.

This may mean that, without help to stay safe, someone with dementia may be a bit more likely to become infected with the virus.

If someone has paid carers coming in and out to support them, this may also make the person more likely to catch coronavirus.

The carers should not stop coming, but should use measures like an apron, mask and gloves.

Risks for people with dementia living in residential care

For a person with dementia in a care home, evidence suggests that they are at higher risk of getting coronavirus.

This is partly because frailer older people have weaker immune systems that are less able to fight off infections. It’s also because people in care homes live very closely together.

The person may easily catch coronavirus from another resident, from a care worker or from a communal surface with virus on it.

Talk to the care home about any concerns you have and how you can support the person from a distance.

Severe COVID-19 illness

If a person with dementia does catch coronavirus, they are at higher risk of getting worse COVID-19 illness.

The risk of severe symptoms rises steeply with age, and 9 in 10 deaths have been in people over 60. Most people with dementia and many older carers will fall into a higher risk group on age alone.

Long-term health conditions also significantly raise the risk of severe illness. Some of the more common of these – heart or blood vessel disease and diabetes – are more often seen in people with dementia. 

There is some evidence that dementia itself may add a further risk on top of age and these other health conditions, but this is not certain. 

It is not clear why, but men and people from black and minority ethnic communities, with or without dementia, are also at increased risk. This link is not explained by age or long-term health conditions.

How does the government define vulnerable?

The issue of who the government recognises as vulnerable from coronavirus is complicated but important. It can affect the support available.

People identified as ‘clinically extremely vulnerable’ are those with health conditions that put them at very high risk of severe symptoms if they catch the virus. This will be because they already have a serious lung condition or their immune system is already very weak. These people are those who were ‘shielding’ (staying at home at all times) between March and August 2020.

National advice to shield is no longer being issued to this group of people. Instead, the government will write to anyone separately to advise them to shield again for a time, for example because they live in an area with a particularly high amount of coronavirus in the community.

Everyone in the clinically extremely vulnerable group must still follow the general rules where they live extremely carefully. They can exercise outdoors and shop for essentials (at quieter times if possible), but should limit social contact with anyone outside their household or support bubble.

This ‘clinically extremely vulnerable’ group doesn’t include people with dementia unless they have any of these conditions, including a kidney transplant, severe chronic obstructive pulmonary disease or certain cancers. (See the government’s full list on GOV.UK)

What does this mean for people with dementia?

So for most people with dementia their risk of severe COVID-19 illness is not as high as for the ‘shielded’ group. As explained above, however, people with dementia and many older carers are at higher risk than the general population. Therefore, people with dementia are ‘vulnerable’ on health grounds, but not ‘clinically extremely vulnerable’. This is why they can leave the house to exercise, follow local guidance on who they can meet outdoors or to shop (if they have to), but must follow the social distancing rules very carefully.

Separately, anyone with dementia and many carers are already seen as ‘vulnerable adults’ by the NHS and social care. This term is commonly used when talking about general support needs or a person’s ability to protect themselves from harm. It is not directly linked to coronavirus.

These terms ‘vulnerable’ and ‘clinically extremely vulnerable’ can make a difference, for example when it comes to food shopping.

People with dementia should still be treated as vulnerable customers by supermarkets or other suppliers and so be eligible for arrangements such as dedicated shopping times.