The complex health needs of dementia patients have somehow been neglected as COVID-19 took the world by storm. Eight months in, the pandemic is taking a devastating toll on the estimated 5.8 million Americans living with dementia.


These patients require hands-on care and can be sensitive to changes in routine; now both are difficult to navigate. Dementia patients are especially vulnerable with over 65,446 total COVID-19 deaths reported by American nursing homes to the CDC’s National Healthcare Safety Network.


COVID-19 and dementia disproportionately affect Black Americans, Hispanics and women, and addressing the social determinants of health is critical in optimizing equity to regulate dementia care.


The risk factors for dementia — age, obesity, cardiovascular disease, hypertension, and diabetes — are also major risk factors for COVID-19, making this population especially susceptible to the infection. Worse, older African-Americans are approximately twice as likely than their white counterparts to develop dementia, and data from the Centers for Disease Control and Prevention suggests that African-Americans are disproportionately affected by COVID-19.


Altogether, the prevalence of dementia and COVID-19 is greater among minority groups and policy interventions must eliminate these disparities. The pandemic offers an opportunity to improve health equity for older adults by focusing on how we address social determinants of health.


Understanding the conditions in the environment in which people live and how they affect their health outcomes will foster better solutions in post-COVID-19 dementia care. The first step on the road to improvement begins with individual communities.


Kansas nursing homes still lack access to fast COVID-19 testing. As we face another wave of outbreaks at long-term care facilities, advocates point out the virus’ spread is worsened by longstanding issues with staffing regulations and infection control.


KDHE reports 250 clusters associated with long-term care, accounting for over 2,800 positive cases. In Norton County, the Andbe Home reported all 62 residents tested positive for the virus in late October, killing 10. An inspection by the Center for Medicare and Medicaid Services reported the facility’s prevention planning "revealed lack of action and education to prevent the spread of COVID-19" as employees were not mandated to wear masks. CMS deemed five other Kansas facilities inadequate in their response to the pandemic.


We need new strategies to guarantee adequate care in nursing homes. The existing state COVID-19 guidance directs adult care homes to "do everything possible" to notify families of positive cases. While all Kansas nursing homes are expected to create a plan for COVID-19 testing, there are not explicit requirements for infection control.


Required masks and frequent sanitizing of shared spaces must be implemented as a priority and enforced through inspections. Telemedicine and digital technology can also assist in remote monitoring, support an ecological assessment of the individual in their environment, and minimize outpatient visits in crowded hospitals.


For those who are proficient with smartphones, devices can keep patients engaged and connected, potentially mitigating isolation.


Dementia is one of the most common comorbidities among COVID-19 positive deceased patients, yet the multifaceted health needs of dementia patients are largely neglected in the emergency phase of the pandemic.


This crisis has exposed underlying health disparities within dementia care, and we have the power to remind our policymakers of the unheard voices who are especially susceptible to COVID-19.


Let us take this opportunity to foster innovative solutions and work toward a more equitable future.


Lillian Wen is a native Kansan pursuing a degree in medicine, health, and society at Vanderbilt University.