COVID-19 forever changed our world when in March 2020, this novel virus moved to pandemic status. The World Health Organization estimates that over 6.5 million people have lost their lives globally to COVID.
A severe COVID-19 infection may place you at a higher risk of cognitive decline associated with dementia.
COVID-19 may be responsible for damaging the blood-brain barrier causing neurological effects of the disease.
Be alert to the warning signs of cognitive decline, and contact your medical practitioner with concerns.
Protecting yourself from acquiring COVID is the best defense against cognitive decline associated with the disease.
The COVID vaccine still provides the best protection against severe illness and death from COVID.
In the wake of the disease, our older adult population and medically vulnerable people were at the most risk. But for those who survive, the research and data constantly evolve concerning lasting effects, sometimes called “Long COVID.” In addition, the concern of COVID affecting cognitive status is growing for the older adult population.
Fast forward to the advent of the COVID vaccines developed to fight the pandemic. Vaccination is still the best protection against the disease and reduces the risk of severe illness. However, while the numbers have declined, infections remain, and the risk for neurological effects remains a factor in the older adult population. The potential for these neurological effects to produce significant cognitive impairment is being studied.
Are we looking at a sharp uptick in dementia diagnoses in the coming months or years? Did the months of isolation during lockdown affect older adults' cognitive and mental state, regardless of their COVID infection status?
The COVID data
Since the pandemic began, research shows that 90% of people infected with the virus report at least one neurological symptom. More often, these neurological symptoms last longer; suggesting a significant element of the disease affects the nervous system.
One recent research study published in March 2022 in JAMA Neurology revealed some troubling results out of Wuhan, China, the very epicenter of the pandemic. They looked at people aged 60 and older with no cognitive issues or family history of dementia. They also had no existing severe medical illnesses, such as cardiac, liver, or kidney disease. However, at 12 months post-infection, 15% had dementia, and 26% of people with severe COVID had mild cognitive impairment.
Another study from the Journal of the Alzheimer’s Association noted that brain changes found in patients with Alzheimer’s disease were also discovered in the brains of patients with COVID, suggesting an association.
The neurological effect
It is unclear if the neurological symptoms of COVID-19 are from the viral infection or due to a lack of oxygen from respiratory complications. Most viruses do not enter the brain from the bloodstream due to protection from the “blood-brain barrier."
However, recent studies suggest that a severe COVID infection may be responsible for the disruption of the barrier, causing damage to the circulatory and nervous systems in the brain. Research indicates this damage could be due to an excessive systemic response of the immune system, causing inflammation and damage to cells called a cytokine storm.
Additionally, a lack of oxygen, stroke, or delirium can result in cognitive deficits in severe COVID. Still, even in mild COVID infections, the associated “brain fog” is a growing concern regarding future mental status. The National Health Institute has developed a database for clinicians to report the neurological effects of COVID-19, such as problems with cognition, stroke, headaches, fatigue, and sleep disorders.
In older adults with an existing diagnosis of dementia, a COVID infection may further progress cognitive decline. It's found that people with dementia already have a vulnerable brain that places them at risk of developing delirium.
In addition, people with dementia and other comorbidities often have delirium as a presenting sign of a COVID infection. Additional damage to this vulnerable brain can further affect the memory and functional status of someone with an established diagnosis of dementia.
The lockdown factor
Whether you or your loved one contracted COVID or escaped the virus, the isolation during the lockdown also had its hazards. Isolation, loneliness, and depression are risk factors identified for Alzheimer’s disease. Engagement during social activities boosts memory and protects against cognitive decline. Those living alone or with few social supports during the pandemic were at greater risk of developing cognitive decline or worsening existing dementia.
Warning signs of cognitive decline
- Memory loss affecting day-to-day activities.
- Misplacing things.
- Having difficulty carrying out a familiar task.
- Easily overwhelmed.
- Disorientation to time or place.
- Language difficulties.
- Repeating conversations.
- Having difficulty problem-solving or planning.
- Impaired judgment.
- Changes in mood or personality.
Suppose you notice one or more of these signs consistently with your loved one. In that case, you should contact your medical practitioner or Alzheimer’s Association for direction. A comprehensive medical assessment will aid in the diagnosis, including cognitive screening, functional assessments, blood work, CT scan, or MRI. This can provide early identification, treatment, and ongoing monitoring.
Avoiding the disease is the best prevention of lasting cognitive decline associated with COVID-19. Vaccination with the most recent booster continues to be the best defense against severe illness or death.
According to the CDC, the most recent bivalent booster was available as of September 2, 2022. Continue to wash your hands regularly, use alcohol-based hand sanitizer, and wear a mask indoors when unable to distance yourself at least six feet from others. Always remember to stay home if you are feeling unwell.
Having COVID-19 does not mean you or your loved one will develop dementia. Be alert for signs of cognitive decline, and contact your medical practitioner if you have concerns. You can reduce the risks by being physically and mentally active, having regular social connections, eating a balanced diet, and sleeping seven to eight hours a night. Early recognition and treatment of any cognitive decline can slow disease progression and promote well-being.
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