A RISE in the use of sedation to manage “lockdown distress” amongst the elderly may have contributed to a stark increase in dementia death rates, a charity has warned.

Alzheimer Scotland said it is very concerned that the pandemic has disproportionately affected people affected by the disease in both Covid-related and excess deaths.

Figures show in all the deaths involving Covid-19 between March and June 2020, 92 per cent had at least one pre-existing condition. The most common main pre-existing condition was dementia and Alzheimer’s disease, representing 31%.

During one week in April the number of deaths of Scots with dementia had doubled, compared to the previous year.

READ MORE: Coronavirus in Scotland: Hundreds more dying from cancer, strokes and dementia 

The charity said there is strong evidence that lockdown measures which were necessary to protect the elderly, led to increased levels of distress, loneliness and isolation for people with dementia and had accelerated the progression of the disease, “beyond what you would normally expect”.

Jim Pearson, director of policy and research for the charity, said that while there is no hard evidence, there is an “anxiety and concern” that sedation with anti-psychotic medication to manage the more challenging symptoms may also have played a role in the higher death rates in care homes and hospitals.

Mr Pearson pointed to “long-standing” research linking psychoactive medication with higher levels of morbidity amongst people with dementia.

Some research has suggested there is up to a nine-fold risk of stroke in the first four weeks of being prescribed medication and almost a doubling in the risk of mortality. There has been a drive to cut their use as part of Scotland’s national dementia strategy.

READ MORE: TV presenter fears window closing for mum to recognise her after lockdown 

Mr Pearson said: “We have some idea without evidence that with the high levels of stress and anxiety affecting people with dementia that there was a potential that they may be being sedated. We don’t know that but we have an anxiety and concern. And how do you verify that because people weren’t getting visitors?”

Figures show that in one week in April there were more than 100 extra deaths from dementia in Scotland than is normal for the time of year.

For the week available, up to April 20, there were 196 deaths attributed to dementia where the average is 113, an extra 86.

The week before the number was even higher when 215 deaths were recorded, an extra 102 above the average.

The Scottish Government said that while there is no evidence of any change to prescribing practice it is working closely with the charity “to establish the facts around these potential issues”.

READ MORE: The Herald launches dementia hub to help families affected by the disease 

Mr Pearson added:  “It is well documented and recognised, not just in Scotland but elsewhere that dementia figures disproportionately in both coronavirus deaths and excess deaths.

“Some of those excess deaths have been attributed to coronavirus that hasn’t been recorded on death certificates.

"We have evidence of the isolation and lockdown measures increasing levels of distress, loneliness and isolation, not just in care homes but in the community as well. 

“There’s been a drive through Scotland’s dementia strategy to reduce the use of anti-psychotic medication. 

“But, of course, in this crisis when they don’t have visitors and they aren’t getting the same level of stimulation and staff are considerably stressed... our anxiety would be that this might lead to an over-reliance on medication.”

According to the Alzheimer’s Society, around 90% of people with dementia experience behavioural and psychological symptoms, such as aggression, agitation, loss of inhibitions and psychosis (delusions and hallucinations).

READ MORE: Coronavirus now causing one death in every 100 in Scotland 

Mr Pearson said: “There is long-standing evidence that psychoactive medication can lead to higher levels of morbidity amongst people with dementia. 

“There is a drive to consider all non-pharmalogical interventions before considering that.

"We are seeing a lot of evidence of physical decline, mental health decline and cognitive decline and the acceleration of the progression of dementia beyond what you would normally expect.

“We don’t think there is any doubt this has contributed to the excess deaths.

“We don’t know is what factors are at play but what we do know from just looking at the statistics is that people with dementia have been disproportionately represented and disproportionately affected not just by coronavirus but by the measures to protect people against coronavirus.”

A government spokesman said: “Work is ongoing to better understand excess deaths during the pandemic. The human-rights based principles on use of psychoactive medications in Scotland’s Dementia Care Standards are underpinned by a legal framework. 

“These principles inform our national work with Alzheimer Scotland and others on supporting expansion of the use of therapeutic alternatives.”

HeraldScotland:

The Herald is backing a campaign by Alzheimer Scotland to ensure people with advanced dementia have access to free NHS care.