COVID-19 and Dementia

–Annals of Neurosciences

The world is reeling with coronavirus disease-2019 (COVID-19). The causative agent for this disease is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It started with an outbreak of pneumonia of unknown etiology in Wuhan, Hubei Province of China, in December 2019. The coronavirus outbreak has turned into a pandemic. So far, this virus has infected more than 161 million individuals and caused more than 3.3 million deaths across different countries (see https://coronavirus.jhu.edu/map.html). The COVID-19 pandemic has burdened the healthcare system. It has negatively affected the world economy also.

COVID-19 and Dementia

Dementia is a progressive decline in cognitive abilities which interferes with daily activities. Dementia is devastating with respect to not only the affected person but also the caregivers. The prevalence of dementia cases is projected to increase in the coming years, which is likely to put tremendous burden on the healthcare system and society. Alzheimer’s disease (AD) accounts for majority of the cases. Other dementia conditions include vascular dementia, frontotemporal dementia (FTD), and Lewy body dementia.

Pulmonary complications are well recognized in COVID-19 patients. In addition, impairment of the sense of smell and taste has also been widely reported in these patients. It has been reported that about 30% of COVID-19 patients requiring hospitalization develop neurological manifestations including dizziness, impairment in consciousness, seizure, stroke, olfactory and gustatory dysfunctions, encephalitis, and headache. In addition to the acute effects, it is important to understand the potential long-term consequences of COVID-19 on neurological functions.

Several studies have examined the effects of COVID-19 on dementia patients. A study by Cagnin and colleagues evaluated the effects of quarantine on behavioral and other parameters in dementia patients in Italy. It was found that one month from the declaration of quarantine, AD patients showed more anxiety and depression.

Worsening of hallucination and sleep disorder were associated with dementia with Lewy body, and wondering and change in appetite were associated with FTD. In addition, during the lockdown period in Spain, the neuropsychiatric symptoms such as apathy and anxiety worsened in AD patients and in individuals with mild cognitive impairment.

Another study found that about 26% of AD patients who were confined to their homes for about two months demonstrated neuropsychiatric changes. These patients also showed a worse performance on mini-mental state examination in comparison to the patients who did not show neuropsychiatric changes.

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