Table 1:

Characteristics of community-dwelling people with dementia who had at least 1 visit to the emergency department in Ontario, by COVID-19 pandemic and historical periods (2019–2021)

CharacteristicNo. (%) of people with dementia*Standardized difference
Historical period
n = 67 611
Pandemic period
n = 58 852
Age, yr
 Mean ± SD81.3 ± 9.781.4 ± 9.7< 0.01
 40–644219 (6.2)3741 (6.4)0.01
 65–749980 (14.8)8676 (14.7)< 0.01
 75–8424 728 (36.6)21 421 (36.4)< 0.01
 ≥ 8528 684 (42.4)25 014 (42.5)< 0.01
Sex, female38 819 (57.4)33 439 (56.8)0.01
Rural residence7082 (10.5)6288 (10.7)0.01
Income quintile§
 1 (lowest)16 368 (24.2)14 061 (23.9)0.01
 214 808 (21.9)13 011 (22.1)0.01
 313 191 (19.5)11 457 (19.5)< 0.01
 411 620 (17.2)10 198 (17.3)< 0.01
 5 (highest)11 244 (16.6)9791 (16.6)0
Time since dementia case ascertainment, yr; mean ± SD4.1 ± 4.14.3 ± 4.20.04
No. of ED visits during the relevant period (includes the first ED visit)
 Mean ± SD2.3 ± 2.92.1 ± 3.30.06
 Median (IQR)2 (1–3)1 (1–2)0.10
 131 895 (47.2)30 253 (51.4)0.09
 216 132 (23.9)13 929 (23.7)0.01
 ≥ 319 584 (29.0)14 670 (24.9)0.09
Time in ED, h
 Mean ± SD9.6 ± 12.29.2 ± 10.70.03
 Median (IQR)6 (3–10)6 (3–10)0.03
Discharge disposition
 Discharged home or to place of residence37 930 (56.1)30 366 (51.6)0.09
 Admitted to inpatient facility20 084 (29.7)20 653 (35.1)0.12
 Transferred to another health care facility1394 (2.1)1292 (2.2)0.01
 Transferred to a congregate living facility6576 (9.7)5681 (9.7)< 0.01
 Left ED1595 (2.4)822 (1.4)0.07
 Died32 (0.0)38 (0.1)0.01
No. of chronic conditions at time of visit
 Mean ± SD6.1 ± 2.86.3 ± 2.70.06
 Median (IQR)6 (5–8)6 (5–8)0.04
 0–15067 (7.5)3147 (5.3)0.09
 21329 (2.0)1203 (2.0)0.01
 33475 (5.1)3077 (5.2)< 0.01
 46553 (9.7)5777 (9.8)< 0.01
 ≥ 551 187 (75.7)45 648 (77.6)0.04
History of specific chronic conditions
 AMI5305 (7.8)4778 (8.1)0.01
 Osteoarthritis49 007 (72.5)43 870 (74.5)0.05
 Rheumatoid arthritis2293 (3.4)2076 (3.5)0.01
 Asthma11 487 (17.0)10 332 (17.6)0.02
 Cancer39 136 (57.9)35 287 (60.0)0.04
 Cardiac arrhythmia15 673 (23.2)13 727 (23.3)< 0.01
 Heart failure13 629 (20.2)12 092 (20.5)0.01
 Chronic obstructive pulmonary disease10 181 (15.1)8778 (14.9)< 0.01
 Coronary syndrome (excluding AMI)23 983 (35.5)20 784 (35.3)< 0.01
 Diabetes23 918 (35.4)21 468 (36.5)0.02
 Hypertension51 564 (76.3)45 728 (77.7)0.03
 Mood, anxiety, depression and other nonpsychotic disorders42 952 (63.5)38 261 (65.0)0.03
 Other mental illnesses26 498 (39.2)24 437 (41.5)0.05
 Osteoporosis12 256 (18.1)10 827 (18.4)0.01
 Renal failure13 205 (19.5)12 387 (21.0)0.04
 Stroke (excluding transient ischemic attack)10 330 (15.3)8976 (15.3)< 0.01
  • Note: AMI = acute myocardial infarction, ED = emergency department, IQR = interquartile range, SD = standard deviation.

  • * Unless indicated otherwise.

  • Historical period: week of Mar. 3, 2019, to the week of Feb. 23, 2020. COVID-19 pandemic period: week of Mar. 1, 2020, to the week of Feb. 21, 2021. For people who visited the ED more than once in a given period, characteristics shown are as of the first visit in each period.

  • We defined rural residence as having a Rurality Index for Ontario value greater than 40.

  • § We defined neighbourhood income quintiles using postal code linkage to Statistics Canada Census data (2016; https://www150.statcan.gc.ca/n1/pub/92-154-g/92-154-g2017001-eng.htm).

  • We used Mondor et al.20 to define a history of chronic conditions. Eligible conditions included AMI, osteoarthritis, rheumatoid arthritis, asthma, cancer, cardiac arrhythmia, heart failure, chronic obstructive pulmonary disease, coronary syndrome (excluding AMI), dementia, diabetes, hypertension, mood, anxiety, depression and other nonpsychotic disorders, other mental illnesses, osteoporosis, renal failure and stroke (excluding transient ischemic attack).