# Impact of the COVID-19 Pandemic on Patients with Alzheimer's Disease and Alzheimer's Disease Related Dementias

> **NIH NIH U01** · MASSACHUSETTS GENERAL HOSPITAL · 2021 · $857,976

## Abstract

Abstract
The COVID-19 pandemic has stressed health systems, caregivers, and patients for over a year. Hundreds of
thousands have died, and millions more have been impacted by the threat of infection and efforts to mitigate
disease spread. In response to these challenges, the Medicare program introduced emergency policies that
permitted greater flexibility in the provision of outpatient and inpatient care, including relaxing rules governing
the remote delivery of outpatient care and increasing hospital capacity. Unfortunately, there is limited
information on how the changes in care delivery made possible by these temporary policies have impacted
patient outcomes during times when viral spread and mitigation policies both waxed and waned. In this project,
we will examine the impact of changes in outpatient and inpatient care on clinical event rates and deaths
among older patients with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD) living
in the community. These patients are particularly vulnerable to social isolation or disruptions in their care, and
might not be able to articulate their needs. Those with yet additional disadvantages such as frailty or lower
incomes appear to have been even more susceptible to adverse effects of COVID-19 infections. Some care
delivery changes, however, might have increased the number or quality of clinician interactions with patients,
e.g., more frequent tele-health visits because of less need to travel. Thus, to examine the impact of the
changes in care delivery under the emergency Medicare policies, we will address three aims: 1) To assess and
refine study variable definitions given data collected during the pandemic; 2) To examine the impact of
changes in outpatient care on clinical event rates, e.g., emergency department and hospitalization rates; and
3) To examine the impact of changes in inpatient care on mortality. Notably, changes in visit and referral
patterns during the pandemic could impact information capture; thus, diagnosis-based definitions of AD/ADRD
status, frailty, or delirium developed in the pre-pandemic era could be less accurate when using pandemic era
data. We will examine these care patterns, assess the accuracy of claims-based measures, and develop
prediction models using machine learning methods and linked, overlapping datasets; we also will account for
temporal variation in documented COVID-19 infections and employment at the county level across all aims.
Given these complex data and analytic issues, we will work with NIH’s Social, Behavioral, and Economic
Research on COVID-19 Consortium to improve the data resources and methods for this type of work. The
information from this large natural experiment is critical for preparing for future outbreaks or other shocks to the
health system, to determine which of the emergency policies, if any, should be extended, and to inform
debates concerning the balance between local flexibility and national standards within Medicar...

## Key facts

- **NIH application ID:** 10423845
- **Project number:** 1U01AG076478-01
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** JOHN HSU
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $857,976
- **Award type:** 1
- **Project period:** 2021-09-30 → 2026-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10423845

## Citation

> US National Institutes of Health, RePORTER application 10423845, Impact of the COVID-19 Pandemic on Patients with Alzheimer's Disease and Alzheimer's Disease Related Dementias (1U01AG076478-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10423845. Licensed CC0.

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