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Covid and Dementia

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Sep 2021 21

Covid and Dementia

By Dr. Asae Tanaka BSc, MD, CCFP

It is well known that COVID-19, the disease caused by the SARS-COV-2 virus, has caused many devastating effects in people with chronic illness and seniors.  However, there has been little publicity on the effects it has on people with dementia. More and more evidence is coming out that people living with dementia are disproportionally impacted by the current COVID-19 pandemic.

  1. Persons living with dementia are particularly vulnerable to the consequences of the pandemic.  Measures such as physical distancing and prevention of travel outside of the community leads to social isolation where they are no longer able to meet face to face with family and friends. Disruptions in the healthcare system with cancellation of day programs and virtual visits with physicians mean that their dementia care is interrupted.  All this leads often leads to progression of dementia.
  1. It is now becoming evident that underlying dementia, compared to other medical co-morbidities, confers the greatest risk for contracting COVID‐19 in adults over 65 years.  As dementia prevents one from forming new memory, it is difficult for a person with dementia to understand the “new normal” life. Forming new routines is very difficult and many people with dementia are unable to remember to wear a mask, to wash their hands, or to take other recommended precautions to prevent infection.
  1. Statistics Canada recently reported that 90% of people who died of COVID-19 in 2020 had at least one co-morbidity and dementia; and Alzheimer’s was the most commonly mentioned diagnosis on the COVID-19 death certificates.    
     
  2. Even if a person does not have dementia, early observations have shown that infection with COVID-19 has led to new onset of dementia especially when a person presents to the emergency with symptoms of delirium or confusion. Around 70% of those with symptoms eventually recover completely. However, in the 30% who do not, an episode of delirium predicts a slow decline over a period of months that leads to profound cognitive impairment and even dementia. The loss of smell and taste in COVID-19 patients emerged as one of the first signs that SARS-CoV-2, the virus that causes COVID-19, is affecting the brain. A team of researchers looking at the brains of deceased COVID-19 patients found that small blood vessels in different areas of the brain were leaking as if patients had suffered mini-strokes. A team of researchers reported in the January issue of Alzheimer’s & Dementia that the brain inflammation and mini-strokes observed in COVID-19 patients may place them at increased risk of developing Alzheimer’s disease and other dementias.

COVID-19 has left many Canadians living with dementia, caregivers, and families facing challenges they’ve never experienced, as the pandemic has exposed the gaps in dementia care across Canada’s health and long-term care systems.

In response, the Alzheimer Society has convened the COVID-19 and Dementia Task Force compiled of leading researchers, clinicians, and dementia specialists across the country, as well people with experience, and are working to find solutions to this problem. 

On an individual basis, there are things one can do such as:

  1. Protect people with dementia from Covid-19.
  2. Minimize the disruption for dementia care such as access to primary care and support networks and programs.
  3. Decrease the risk of dementia by decreasing risk factors for vascular dementia such as hypertension, diabetes high cholesterol, and obesity through better diet and regular exercise.
  4. Exercise the short-term memory by continuing to challenge the brain to learn new things.

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