OAXACA CITY, Mexico – Nicolasa Santiago, a 74-year-old Mexican with Alzheimer’s disease who has short-term memory loss, needs to be reminded daily by her caregivers that a new, potentially fatal illness makes it dangerous for her to go outside.
Three years ago, this Zapotec indigenous woman’s mental function began to decline as a result of that degenerative illness. Although she still can fervently recall events from her early childhood, adolescence and adult life, she often has no recollection of things that happened just a few hours earlier.
At the start of the coronavirus pandemic, the Chicago-based Alzheimer’s Association warned that dementia-related behaviors may increase the risk of contracting COVID-19, a disease whose case fatality rate is much higher among the elderly than it is among younger people.
Santiago’s daughter and granddaughter – who care for her at her home in Juchitan de Zaragoza, an indigenous town in the southern state of Oaxaca’s Isthmus of Tehuantepec region – are well aware of the danger and frequently remind her why she should not venture outside.
Even so, Doña Nicolasa often will get up from her chair just a few minutes later and head for the door.
“I’m going out to see my friends,” she tells them, referring to an elderly prayer group that used to meet in the afternoons prior to the onset of the pandemic.
But the younger women immediately stop her halfway to the exit and patiently remind her once again of the disease and the risk it poses to people her age.
Extra precautions must be taken with Santiago considering both her mental health and the fact she was hospitalized for three weeks last November with an infection. Even though she would like to go outside, she spends the majority of her time watching black-and-white movies and reading stories.
According to Mexico’s National Institute of Statistics and Geography (INEGI), there are a total of 1.2 million people in Mexico with some form of dementia and that number is expected to climb by 2050 to 3.7 million, with 70 percent of those individuals projected to have Alzheimer’s.
Agustin Torres, a physician who specializes in psychogeriatrics, told EFE that there is concern among medical professionals over both the high risk of coronavirus infection among Alzheimer’s patients and that group’s enhanced susceptibility to fatal complications from COVID-19.
Firstly, “a patient with this type of dementia is more than 60 years old and very likely has diabetes, high blood pressure or some other chronic degenerative disease that would aggravate their COVID-19 symptoms,” he said.
And secondly, Alzheimer’s patients are not aware of their surroundings nor of the new reality deriving from the pandemic, Torres added.
“They’re not going to frequently wash their hands, so they can easily … become infected. They also won’t understand and heed the confinement (measures) and will develop anxiety or aggressiveness crises.”
Mexico, which has registered more than 390,000 confirmed coronavirus cases (sixth worldwide) and 43,680 deaths attributed to COVID-19 (fourth globally), has been gradually reopening its economy since June even though the number of new infections continues to grow.
The amount of confirmed cases and deaths in Oaxaca, one of Mexico’s poorest states, stands at 9,764 and 884, respectively, with a slight upward trend in recent weeks.
Because of the high number of infections, residents of Juchitan de Zaragoza have been urged to voluntarily shelter in place as much as possible over the next 10 days. That recommendation was largely heeded on Monday, with the streets much emptier than at the start of the month.
Compliance in the Santiago household, meanwhile, is the responsibility of her caregivers, who are taking it upon themselves to convey an instruction to Doña Nicolasa that she no doubt has heard but is unable to retain: “Stay at home.”