Pandemic increases dementia deaths in Brazil among blacks, while rate drops among whites – study

RIO DE JANEIRO, BRAZIL – Deaths of black and mixed-race people by dementia increased by approximately 15 percentage points in Brazil in 2020, a new study shows. However, the death rate decreased (-1.4) for whites compared to 2019, a pre-pandemic year, and the following year, which was dominated by the health crisis triggered by the coronavirus.

The researchers point to risk factors the black population is more susceptible to, which have worsened with Covid-19 as potential explanations for this discrepancy.

Conducted by scientists from UFPel (Federal University of Pelotas) and UFRGS (Federal University of Rio Grande do Sul), with cooperation from the University of Queensland in Australia, the research compared data available from the SUS (Unified Health System) on dementia nationwide between 2019 and 2020.

The research focused on three aspects of the occurrence of dementia in Brazil in the context of Covid-19: hospitalizations for the disease, the average costs for its treatment, and the mortality rate. From there, analyses were drawn for the black, mixed-race and white populations.

In terms of hospitalization and treatment costs, a decrease over the past year was found for all Brazilians. However, dementia mortality increased only among black and mixed-race people.

“Some studies, both before and during the pandemic, had warned that the black population, not only in Brazil but particularly in the United States, had an increased risk for cases and deaths from dementia when compared to other ethnic groups,” says Natan Feter, PhD in physical education from UFPel and one of the study’s authors .

Feter believes that a combination of factors may explain the increased mortality rate among black people during the pandemic. One of the reasons would be the fact that this share of the population was more affected economically during the coronavirus outbreak. This tends to increase stress and other mental health problems, considered important risk factors for dementia.

Another hypothesis to explain this increase in deaths is the difficulty in accessing health care systems, particularly with the increase in Covid-19 cases. “People stopped seeking care during the pandemic, even if they needed it,” he says.

Feter also points out that previous studies have shown that people usually only seek emergency services for cases of dementia – which also shows the low adherence to adequate and early treatment of the disease.

This causes dementia to be diagnosed at a later stage. This delay, consequently, hinders the start of treatment and increases the chances of death.

Feter also points out that other risk factors for dementia that don’t necessarily relate to the pandemic, such as diabetes and hypertension, have a higher prevalence among the black population.

“When we have 40% to 50% of dementia cases attributable to modifiable risk factors, and we know that the prevalence of these risk factors is higher in the black population, it’s not that surprising that these people are dying more from this disease,” he points out.

Since these are comorbidities that also increase the chances of dying from Covid-19, “then the black population with dementia have a double burden of risk factors [in the pandemic],” the researcher says.

The study also noted regional particularities. For instance, it was found that in the South region there was an increase in hospitalizations and in the average costs of treating the disease, and a reduction in the mortality rate. In the Northeast, hospitalizations increased, while costs and mortality decreased.

Despite these variations, Fater says that “the racial disparity is quite striking” in the overall context of Brazil.

To address this scenario, the researcher points to the need to implement public policies to decrease the prevalence of these risk factors in the black population and, consequently, reduce dementia mortality.

An example would be the creation of a national plan to fight dementia, which, in Latin America, only exists in Chile.

“Brazil does not have a national plan to fight dementia because it is stalled in the Federal Senate, with no forecast for moving forward. So, in a discussion to structure this plan, we would need to address how to reduce the racial-ethnic disparity,” he says.