Covid Scotland: Virus almost 'wholly responsible' for spike in dementia deaths

Of the 2,154 deaths where both dementia and Covid were listed on the death certificate, 95 per cent had Covid as the main underlying cause.

This contradicts previous suggestions that a rise in dementia deaths early in the pandemic may have been linked indirectly to the virus as a result of “lockdown distress” or an increased use of potentially harmful sedation in elderly people confused by restrictions.

Source: Scottish Government/National Records of Scotland

The report also found that 73% (1,577) of those who died with both Covid and dementia mentioned on their death certificates had passed away in care homes.

Henry Simmons, chief executive of Alzheimer’s Scotland, said their loved ones had been “torn apart by grief and loss” and that the report “raises many more questions as to why so many people with dementia living in care homes quickly became victims of Covid-19”.

He added: “The fact that so many people living in care homes were impacted must make us question the logic and rationale of this form of care for those most vulnerable people in our society.

"The large Care Home Model with, in many cases, some 30 people or more living together and being cared for with a small team of committed care staff is borne out of delivering the best quality of care within an economy of scale.

"Perceived cost effectiveness is at its core, as is the issue of who pays for it. These figures clearly indicate that large group living environments present the greatest risk of virus transmission for people with dementia."

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He added: "In a world where there might be further variants, new pandemics and the need for new methods of preventing transmission, it would be folly to maintain a model of large group living.

"We need to radically transform our approach, develop a smaller scale approach to residential and nursing care."

Early in the pandemic, more than half of elderly hospital patients discharged to nearly 200 Scottish care homes had not been tested for Covid.

A report by Public Health Scotland in April last year found no definitive link between this and subsequent infection outbreaks. However, it did find that larger premises were worst hit.

The new report, commissioned as part of the Scottish Government’s Dementia Covid-19 Action Plan, provides some of the most detailed analysis available anywhere in the world on the relationship between the virus and the degenerative brain disease.

Source: Scottish Government/National Records for Scotland

It notes that 28% of all deaths involving Covid-19 in 2020 had some category of dementia mentioned on the death certificate, and that excess deaths involving dementia in 2020 were 21% higher than the pre-pandemic five-year average.

However, care homes also experienced the "largest reduction in excess deaths over the course of the pandemic", and those involving dementia were below average by summer 2021.

This "may relate to improved measures to reduce infection in care homes and the prioritisation of care home residents and staff in the vaccination programme", states the report, although it also notes that some deaths in people with dementia "may have been hastened"during the first wave of Covid - effectively reducing the pool of elderly people vulnerable to the virus later in the pandemic.

READ MORE: Sedation 'linked' to dementia deaths surge in pandemic

Responding to the findings, Health Secretary Humza Yousaf offered his "heartfelt condolences to all of those affected by the loss of a loved one".

He added: “The findings strongly suggest that excess deaths involving dementia were largely due to Covid-19 infection, rather than the indirect effects of lockdown and other restrictions.

"While it is not possible to conclude from the report’s findings whether those deaths were avoidable, the report will inform the public inquiry and will be useful in helping to inform the clinical response to people with dementia who contract Covid-19 in future.”