Covid infection could speed up progression of dementia
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In the early days of the pandemic not a huge amount was understood about the Covid virus. Most people were aware of the common symptoms experienced when infected but that was about it. Since then scientists are continuing to uncover more about what some of the long-term effects of the virus could be.
A new study, published in the Journal of Alzheimer’s Disease Reports, has discovered that infection with SARS-CoV-2 (the virus that causes Covid) has a significant impact on cognitive function in patients with pre-existing dementia.
As part of this, patients with all subtypes of dementia were included, with each of them experiencing a rapid decline.
Since the first wave of COVID-19, neurologists have noticed both acute and long-term neurological syndromes and complications of the disease.
However, the impact of Covid on cognition has so far remained unclear, with neurologists simply referring to “brain fog” as a symptom of infection.
Therefore, a group of researchers from universities in India and Spain were driven to gain a better understanding of the effects of COVID-19 on the brain.
They studied 14 patients with pre-existing dementia (four with Alzheimer’s disease, five with vascular dementia, three with Parkinson’s disease dementia, and two with frontotemporal dementia), who had suffered further cognitive deterioration following Covid infection.
Lead investigator Souvik Dubey explained: “We speculated there must have been some deleterious effect of COVID-19 in patients with pre-existing dementia extrapolating our understanding from the cognitive impact of this viral infection in patients without dementia.
“However, post-COVID-19 evaluation of cognitive impairments in patients with pre-existing dementia is difficult due to multiple confounders and biases.”
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In addition to finding that all subtypes of dementia behaved like rapidly progressive dementia following Covid, investigators found that the boundaries between different types of dementia became remarkably blurry post-infection.
Co-investigator Ritwik Ghosh, expressed his concern about dementia subtyping.
He said: “It is more difficult in the post-COVID-19 era, where the history of this viral infection plays the most important role.
“Few patients with a history of COVID-19 without pre-existing dementia have phenotypically and imaging-wise similar brain changes mimicking other degenerative and vascular dementias.”
Researchers also found that the characteristics of a particular type of dementia changed following Covid.
Both degenerative and vascular dementias started behaving like mixed dementia both clinically and radiologically.
A rapidly and aggressively deteriorating course was observed in patients with slowly progressive dementia, who were previously cognitively stable.
Cortical atrophy (a loss of brain cells) was also evident in the study’s subsequent follow-ups.
These findings suggest that dementia patients would have little defence to withstand a second infection or immune response and inflammation caused by Covid.
Dr Dubey, expressed the importance of the findings.
“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,” he said.
“This understanding will have a definitive impact on future dementia research.”
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