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Will COVID-19 Increase the Risk for Later Dementia?

Neurologists worry that SARS-CoV-2 infection may affect the brain and raise the possibility of later dementia as a consequence.
Will COVID-19 Increase the Risk for Later Dementia?
Dementia and Alzheimer’s disease medical concept, 3D illustration. Memory loss, brain aging. Conceptual image showing blurred brain with loss of neuronal networks

Could recovering from a COVID-19 infection leave a person more vulnerable to later dementia? Brain researchers are worried that COVID-19 infections could put survivors at higher risk for Parkinson disease, Alzheimer disease or other neurological complications.

On the Alert for Later Dementia After Recovery:

Previous research has shown that respiratory infections can have unexpected consequences for the nervous system. In certain vulnerable individuals, they can invade the brain, causing encephalopathy or, much later, dementia (Viruses, Dec. 20, 2019). Coronaviruses appear especially adept at this. They may damage nervous tissue directly or trigger harmful immune responses. 

Although we may think of COVID-19 as a respiratory disease, up to two-thirds of patients show signs of injury in the central nervous system (Alzheimer’s Research & Therapy, Dec. 30, 2020). Some survivors have reported Bell’s palsy, confusion, forgetfulness, anxiety, sleep difficulties, depression and, in rare cases, psychosis. When people lose their sense of smell as an early symptom of COVID-19, the virus may be invading the brain from the nose. Neurologists worry that the infection may speed beta-amyloid accumulation, encouraging the development of plaques typical of Alzheimer disease.

A New Study Will Look for Cognitive Effects:

Some people have reported significant problems with forgetfulness or confusion after hospitalization with COVID-19. As a result of these concerns, scientists plan to study older individuals who have recovered (https://www.alz.org/research/for_researchers/partnerships/sars-cov2-global-brain-study). The goal is to see whether they are at higher risk for cognitive impairment. This international protocol aims to enroll 40,000 volunteers for long-term follow-up.

Inflammation in Response to SARS-CoV-2:

Autopsies of people who died from COVID-19 offer additional evidence of complications. Scientists who examined 13 brains found widespread vascular abnormalities in 10 of them (New England Journal of Medicine, Dec. 30, 2020). Although they did not detect SARS-CoV-2 in the brain tissue, they did see inflammation. Moreover, a study in mice indicates that a spike protein from the coronavirus is able to cross the blood-brain barrier and cause damage (Nature Neuroscience, Dec. 16, 2020). This might well hint at its potential to trigger later dementia.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
Citations
  • Desforges M et al, "Human coronaviruses and other respiratory viruses: Underestimated opportunistic pathogens of the central nervous system?" Viruses, Dec. 20, 2019. DOI: 10.3390/v12010014
  • Miners S et al, "Cognitive impact of COVID-19: Looking beyond the short term." Alzheimer's Research & Therapy, Dec. 30, 2020. DOI: 10.1186/s13195-020-00744-w
  • Lee M-H et al, "Microvascular injury in the brains of patients with Covid-19." New England Journal of Medicine, Dec. 30, 2020. DOI: 10.1056/NEJMc2033369
  • Rhea EM et al, "The S1 protein of SARS-CoV-2 crosses the blood–brain barrier in mice." Nature Neuroscience, Dec. 16, 2020. https://doi.org/10.1038/s41593-020-00771-8
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