COVID-19 infection ‘increases dementia progression’

Individuals with dementia experience rapidly progressive symptoms after they have had COVID-19, according to a new study.

Researchers from Bangur Institute of Neurosciences (BIN), Kolkata, India, and University Hospital 12 de Octubre Madrid, Spain, also found the line of demarcation between different types of dementia blurred significantly after COVID-19.

Since the first wave, neurologists have noticed both acute and long-term neurological syndromes and neuropsychiatric sequelae of COVID-19, but the impact on human cognition has so far remained unclear.

In this study, published in the * Journal of Alzheimer’s Disease Reports*, lead investigators Dr Souvik Dubey, from India, and Dr Julián Benito-León, in Spain, examined the effects of COVID-19 on cognitive impairment in 14 patients, four of whom had Alzheimer’s disease (AD), five had vascular dementia, three had Parkinson’s disease dementia, and two with the behavioural variant of frontotemporal dementia. All had suffered further cognitive deterioration following COVID-19.

They found the characteristics of a particular type of dementia changed following COVID-19, and both degenerative and vascular dementias started behaving like mixed dementia clinically and radiologically.

The study also observed a rapidly and aggressively deteriorating course in patients having insidious onset, slowly progressive dementia, and who were previously cognitively stable.

Subsequent follow ups found cortical atrophy and investigators concluded that coagulopathy involving small vessels and inflammation was the most important pathogenetic indicator.

They believe the rapid progression of dementia, plus further deterioration of cognitive abilities and the increase or new appearance of white matter lesions, means previously compromised brains are unable to withstand the new impact.

They suggest that the term ‘brain fog’ should be replaced with ‘FADE-IN MEMORY’ (Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).

Co-investigator Dr Mahua Jana Dubey, from Berhampur Mental Hospital, West Bengal, India, said: “Amidst various psychosocial impacts of COVID-19, cognitive deficits, when accompanied by depression and/or apathy and fatigue in patients with or without pre-existing dementia, require meticulous evaluation because it imposes added stress and burden on caregivers, one of the most important but often forgotten issues that may have the potential to hamper treatment.

“As the ageing population and dementia are increasing globally, we believe pattern recognition of COVID-19-associated cognitive deficits is urgently needed to distinguish between COVID-19-associated cognitive impairments per se and other types of dementia. This understanding will have a definitive impact on future dementia research.”

Dubey S, Das S, Ghosh R et al. The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia. Journal of Alzheimer’s Disease Reports February 2023


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