Excess deaths from all causes, involving and with dementia as the underlying cause: Scotland 2020-2022

Main points

• Between 1 March 2020 and 31 March 2022, dementia was the most common pre-existing medical condition mentioned on the death certificate in deaths involving COVID-19.

Deaths registered involving dementia

• In 2020, there were 12,492 deaths involving dementia (as the underlying or a contributory cause of death), representing 2,177 excess deaths.
• In 2021, there were 10,626 deaths involving dementia, representing 311 excess deaths, therefore showing a reduction in excess deaths across the two years.
• The main spike in excess deaths involving dementia was observed during the first wave of the pandemic in April 2020.

Deaths registered involving dementia and COVID-19

• In 2020, there were 2,154 deaths involving dementia and COVID-19, which decreased to 1,000 deaths in 2021.
• In 2020 the number of deaths involving dementia and COVID-19 almost equalled the number of excess deaths involving dementia, but in 2021 there were over three times more deaths involving dementia and COVID-19 than there were excess deaths involving dementia. This may be a result of mortality displacement, offset by continued deaths involving COVID-19.
• Of deaths involving dementia and COVID-19, the proportion with dementia as the underlying cause increased from 3% in 2020 to 12% in 2021, while the proportion with COVID-19 as the underlying cause decreased from 95% to 82%.

Deaths registered by setting of occurrence

• In 2020, 73% of deaths involving dementia and COVID-19 occurred in care homes, compared to 53% in 2021.
• The number of deaths with COVID-19 as the underlying cause decreased between 2020 and 2021, but the proportion occurring in hospital increased.
• In 2020, there were a large number of excess deaths involving dementia in care homes and at home or non-institutional settings. However, in 2021 there were fewer excess deaths involving dementia overall, with only home or non-institutional settings experiencing an excess.
• In 2020, there were a large numberof excess deaths with dementia as the underlying cause at home or non-institutional settings. In 2021, there was an increase in excess deaths with dementia as the underlying cause at home or in non-institutional settings, however deaths with dementia as the underlying cause reduced to below average levels as a whole.