COVID‐19 associated disruptions in routine health care of people with mild cognitive impairment or dementia

INTRODUCTION: We report the COVID‐19 pandemic's impact on health‐care use disruption among people with mild cognitive impairment or Alzheimer's disease and related dementia (MCI/ADRD). METHODS: We compared the pandemic‐period health‐care use between MCI/ADRD and matched non‐MCI/ADRD patients. Using 4‐year pre‐pandemic data, we modeled three health‐care use types (inpatient, outpatient, emergency encounters) to predict pandemic‐period use, disaggregated for lockdown and post‐lockdown periods. Observed health‐care use was compared to the predicted. Proportional differences (confidence intervals) are reported. RESULTS: Both MCI/ADRD and non‐MCI/ADRD patients (n = 5479 each) experienced pandemic‐related health‐care use disruptions, which were significantly larger for the MCI/ADRD group for outpatient, –13.2% (–16.2%, –10.2%), and inpatient encounters, –12.8% (–18.4%, –7.3%). Large health‐care disruptions during lockdown were similar for both groups. However, post‐lockdown outpatient, –14.4% (–17.3%, –11.5%), and inpatient, –15.2% (–21.0%, –9.5%), disruptions were significantly greater for MCI/ADRD patients. CONCLUSION: MCI/ADRD patients experienced greater and sustained pandemic‐related health‐care use disruptions, highlighting the need for robust strategies to sustain their essential health care during pandemic‐like catastrophes.