The impact of COVID‐19 on the quality of stroke care in people with dementia and stroke: a comparison with stroke‐only controls

Abstract

AbstractBackgroundThe COVID‐19 pandemic has had a significant impact on healthcare systems worldwide, with many hospitals struggling to maintain the same level of care as before the pandemic. As a result, there is concern that the quality of stroke care for patients with dementia diagnoses may have worsened during the pandemic. Therefore, our aim was to study how the COVID‐19 pandemic has affected the quality of stroke care for patients with dementia versus without dementia after suffering a stroke.MethodsWe conducted a register‐based study, retrieving data from the Swedish Stroke Register and The Swedish registry for cognitive/dementia disorders. We included adult patients diagnosed with/without? dementia who had also suffered a stroke between 2017 and 2022. The pre‐pandemic period was defined as January 1, 2017, to February 28, 2020, while the pandemic period was defined as March 1, 2020, to September 19, 2022. The quality indicators of care were defined as care provided at specialized stroke units and assessment for rehabilitation.ResultsThe study included 3205 patients with dementia and 32666 dementia‐free controls, all of whom suffered a stroke. The mean age at onset of stroke was 83 (±6.8) years for those with dementia and 74 (±15.1) years for those without. In addition, the dementia‐stroke group and stroke‐only group had 55% and 48% females, respectively. Compared to the pre‐pandemic period, a lower proportion of patients with dementia were admitted to specialized stroke units and received rehabilitation assessments during the pandemic period, with 64% versus 36% and 65% versus 36%, respectively. Additionally, a lower proportion of patients with dementia compared to stroke‐only controls were admitted to specialized stroke units (36% versus 45%) and received rehabilitation assessments (35% versus 44%) during the pandemic period.ConclusionsOur study indicate that the COVID‐19 pandemic had a negative impact on the quality of stroke care for patients with dementia as compared to stroke‐only controls. This was evidenced by the lower proportion of patients with dementia who were admitted for care to specialized stroke units and assessed for rehabilitation during the pandemic period, compared to the pre‐pandemic period.