Article Text
Abstract
Background Excess deaths from conditions other than COVID-19 have been reported during the pandemic. Difficulty accessing healthcare is a possible explanation. We aimed to assess changes in rates of new diagnoses for common conditions before and during the pandemic.
Methods Participants aged 50 years and older in three waves of the English Longitudinal Study for Ageing were asked whether a doctor had told them that they had newly developed any of 11 medical conditions: hypertension, angina or heart attack, heart failure, diabetes, stroke, chronic lung disease, asthma, arthritis, cancer, dementia, or blood disorder. Responses were compared between pre-COVID Wave 9 (W9) in 2018 to 2019, COVID Wave 1 (CW1) in June and July 2020, and COVID Wave 2 (CW2) in November and December 2020. Multivariate logistic regression on weighted data was performed to assess variation by sex, age group (50 to state pension age (SPA), SPA to 74, 75 and over), and wealth quintile.
Results The overall rate of new diagnoses reported per 1,000 participants per year was 116.76 in W9 (n=7,289), 110.10 in CW1 (n=5,825), and 138.23 in CW2 (n=5,339). Diagnosis rates dropped from W9 to CW1 to CW2 for dementia (9.09 to 4.01 to 2.25 respectively), angina and heart attack (13.50 to 11.67 to 10.86), and stroke (7.05 to 6.18 to 4.12). In contrast, the rate increased for arthritis (29.11 to 37.42 to 44.58) and diabetes (18.83 to 21.06 to 23.60). Multivariate analysis found that increasing age was a predictor for dementia diagnosis in cw2 (odds ratio 2.20; 95% confidence interval 1.12 to 4.30). No other regression analyses were statistically significant.
Conclusion Drops in diagnosis rates for dementia and cardiovascular disease during the pandemic could be contributing to increased deaths from conditions other than COVID-19. Policy initiatives are underway to encourage people to seek healthcare as normal, and it will be important to maintain adequate access to healthcare for major conditions in any future lockdown. The reasons for the reported substantial rise in arthritis and smaller rise in diabetes diagnosis rates are not clear and require further investigation.