PERSISTENT LOSS OF SMELL DUE TO COVID-19 CLOSELY CONNECTED TO LONG-LASTING COGNITIVE PROBLEMS
PR97277
SAN DIEGO, Aug. 1, 2022 /PRNewswire=KYODO JBN/ --
FROM THE ALZHEIMER'S ASSOCIATION INTERNATIONAL CONFERENCE 2022
Also, ICU Stay May Double Risk of Dementia in Older Adults
New insights into factors that may predict, increase or protect against the
impact of COVID-19 and the pandemic on memory and thinking skills were revealed
by multiple studies reported today at the Alzheimer's Association International
Conference (R) (AAIC(R)) 2022 (
) in San Diego and virtually.
Logo - https://mma.prnewswire.com/media/1869584/AAIC22_purple_font_rgb_Logo.jpg
Among the key findings reported at AAIC 2022:
-- A group from Argentina found that persistent loss of the sense of smell
may be a better predictor of long-term cognitive and functional
impairment than severity of the initial COVID-19 disease.
-- Hospitalization in the intensive care unit was associated with double
the risk of dementia in older adults, according to a study by Rush
Alzheimer's Disease Center in Chicago.
-- During the pandemic, female gender, not working and lower socioeconomic
status were associated with more cognitive symptoms in a large study
population drawn from nine Latin American countries.
-- In that same Latin American population, experiencing a positive life
change during the pandemic (such as more quality time with friends and
family or spending more time in nature) reduced the negative impact of
the pandemic on memory and thinking skills.
"COVID-19 has sickened and killed millions of people around the world, and for
some, the emerging research suggests there are long-term impacts on memory and
thinking as well," said Heather M. Snyder, Ph.D., vice president of medical and
scientific relations at the Alzheimer's Association. "As this virus will likely
be with us for a long time, identifying the risk and protective factors for
cognitive symptoms can assist with the treatment and prevention of 'long COVID'
moving forward."
Persistent loss of smell better predicts cognitive impairment than severity of
COVID-19
Researchers in Argentina working with the Alzheimer's Association Consortium on
Chronic Neuropsychiatric Sequelae of SARS-CoV-2 Infection (
) followed 766 adults age 55-95 exposed to COVID-19 for one year, and conducted
a series of regular physical, cognitive and neuropsychiatric tests. Of the
study group, 88.4% were infected and 11.6% were controls.
Clinical assessment showed functional memory impairment in two-thirds of the
infected participants, which was severe in half of them. Another group of
cognitive tests identified three groups with decreased performance:
-- 11.7% showed memory-only impairment.
-- 8.3% had impairment in attention and executive function.
-- 11.6% displayed multidomain (including memory, learning, attention and
executive function) impairment.
Statistical analysis revealed that persistent loss of smell was a significant
predictor of cognitive impairment, but severity of the initial COVID-19 disease
was not.
"The more insight we have into what causes or at least predicts who will
experience the significant long-term cognitive impact of COVID-19 infection,
the better we can track it and begin to develop methods to prevent it," said
Gabriela Gonzalez-Aleman, LCP, Ph.D., professor at Pontificia Universidad
Catolica Argentina, Buenos Aires.
A stay in the intensive care unit may signal higher dementia risk
Researchers from the Rush Alzheimer's Disease Center (RADC), part of Chicago's
Rush University System for Health, used data from five diverse studies of older
adults without known dementia (n=3,822) to observe intensive care unit (ICU)
hospitalizations. ICU hospitalizations were previously linked to cognitive
impairment in older patients, but few studies have examined whether they
increase risk for dementia.
They reviewed Medicare claims records from 1991 to 2018 (pre-pandemic), and
checked annually for development of Alzheimer's and all type dementia using a
standardized cognitive assessment. During an average 7.8 years follow up, 1,991
(52%) participants experienced at least one ICU hospitalization; 1,031 (27%)
had an ICU stay before study enrollment; and 961 (25%) had an ICU stay during
the study period.
The researchers found that, in analyses adjusted for age, sex, education and
race, experiencing ICU hospitalization was associated with 63% higher risk of
Alzheimer's dementia and 71% higher risk of all type dementia. In models
further adjusted for other health factors such as vascular risk factors and
disease, other chronic medical conditions, and functional disabilities, the
association was even stronger: ICU hospitalization was associated with 110%
greater risk of Alzheimer's and 120% greater risk of all type dementia.
"We found that ICU hospitalization was associated with double the risk of
dementia in community-based older adults," said Bryan D. James, Ph.D.,
epidemiologist at RADC. "These findings could be significant given the high
rate of ICU hospitalization in older persons, and especially due to the
tremendous upsurge in ICU hospitalizations during the COVID-19 pandemic.
Understanding the link between ICU hospitalization and the development of
dementia is of utmost importance now more than ever."
"More research is necessary to replicate these findings and elucidate the
factors that may increase dementia risk. For example, is it the critical
illness that sends someone to the hospital or potentially modifiable procedures
during the hospitalization that drives dementia risk?" James added.
One positive life change during the pandemic may buffer against cognitive
symptoms
Investigators from countries across Central and South America and the United
States examined whether sociodemographic factors and changes in life associated
with the pandemic were related to experiencing cognitive symptoms, including
problems with memory, attention and other thinking skills, during the early
phases of the pandemic.
In the study reported at AAIC, 2,382 Spanish-speaking adults age 55-95 (average
65.3 years, 62.3% female) from nine countries in Latin America completed an
online or telephone survey, had electronic cognitive testing, and filled out an
inventory assessing the positive and negative impacts of the pandemic between
May and December 2020. Of the total study population, 145 (6.09%) experienced
COVID-19 symptoms.
Participants were from: Uruguay (1,423, 59.7%), Mexico (311, 13.1%), Peru (153,
6.4%), Chile (152, 6.4%), Dominican Republic (117, 4.9%), Argentina (106,
4.5%), Colombia (50, 2.1%), Ecuador (39, 1.6%), Puerto Rico (19, 0.8%) and
Other (12, 0.5%)
Key findings:
-- Female gender, not currently working and lower socioeconomic status were
all independently associated with more cognitive symptoms during the
early part of the pandemic.
-- Negative life changes during the pandemic, such as economic difficulties
and limited social activities, were significantly associated with more
cognitive symptoms. However, this association was weaker among study
participants who reported at least one positive life change during the
pandemic, including spending more time with friends and family or more
time outside in nature.
"Identifying risk and protective factors for cognitive symptoms during the
pandemic is an important step towards the development of prevention efforts,"
said Maria Marquine, Ph.D., associate professor in the Departments of Medicine
and Psychiatry, and director of disparities research in the Division of
Geriatrics, Gerontology and Palliative Care at the University of California,
San Diego. "The experience of positive life changes during the pandemic might
buffer the detrimental impact of negative life changes on cognitive symptoms."
"This study is an example of how investigators from diverse countries in Latin
America and the United States, many of whom had never worked together before
and had limited resources, came together under difficult circumstances but with
a shared goal to advance scientific understanding about Alzheimer's, and the
important contributions that such multicultural partnerships can yield,"
Marquine added.
About the Alzheimer's Association International Conference(R) (AAIC(R))
The Alzheimer's Association International Conference (AAIC) is the world's
largest gathering of researchers from around the world focused on Alzheimer's
and other dementias. As a part of the Alzheimer's Association's research
program, AAIC serves as a catalyst for generating new knowledge about dementia
and fostering a vital, collegial research community.
AAIC 2022 home page: www.alz.org/aaic/
AAIC 2022 newsroom: www.alz.org/aaic/pressroom.asp
AAIC 2022 hashtag: #AAIC22
About the Alzheimer's Association(R)
The Alzheimer's Association is a worldwide voluntary health organization
dedicated to Alzheimer's care, support and research. Our mission is to lead the
way to end Alzheimer's and all other dementia — by accelerating global
research, driving risk reduction and early detection, and maximizing quality
care and support. Our vision is a world without Alzheimer's and all other
dementia(R). Visit alz.org (
https://c212.net/c/link/?t=0&l=en&o=3608523-1&h=2360337763&u=https%3A%2F%2Fwww.alz.org%2F&a=alz.org)
or call 800.272.3900.
-- Gabriela Gonzalez-Aleman, LCP, Ph.D., et al.Olfactory dysfunction but
not COVID-19 severity predicts severity of cognitive sequelae following
SARS-CoV-2 infection in Amerindian older adults. (Funders: Fundación de
Lucha contra los Trastornos Neurológicos y Psiquiátricos en Minorías
(FULTRA); Alzheimer's Association)
-- Bryan James, Ph.D., et al. ICU hospitalization and incident dementia in
community-based cohorts of older adults. (Funder: National Institute on
Aging)
-- Maria Marquine, Ph.D., et al. Cognitive symptoms among middle- and
older-age adults in Latin America during the coronavirus disease 2019
(COVID-19) pandemic: Risk and protective factors. (Funders:
Massachusetts General Hospital Executive Committee on Research,
Philanthropic Gift to the University of California, San Diego Division
of Geriatrics, Plan Ibirapita Uruguay (Inclusion Digital de Personas
Mayores)).
*** AAIC 2022 news releases may contain updated data that does not match what
is reported in the following abstracts.
Proposal ID: 66868
Title: Olfactory dysfunction but not COVID-19 severity predicts severity of
cognitive sequelae following SARS-CoV-2 infection in Amerindian older adults
Background: COVID-19 has affected more than 380 million people. Infections may
result in long term sequelae, including neuropsychiatric symptoms. In older
adults COVID-19 sequelae resemble early Alzheimer's disease, and may share risk
factors and blood biomarkers with it. The Alzheimer's Association Consortium on
Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) established
harmonized definitions, ascertainment and assessment methodologies to evaluate
and longitudinally follow up cohorts of older adults with exposure to COVID-19.
We present one year data in a prospective cohort from Argentina.
Method: Participants (n=766) are older adults (> or = 60 years) recruited from
the provincial health registry containing all SARS-CoV-2 testing data. We
randomly invite older adults stratified by PCR COVID-19 testing status
regardless of symptom severity, between 3 and 6 months after recovery.
Assessment includes interview with the Schedules for Clinical Assessment in
Neuropsychiatry (SCAN) and Clinical Dementia Rating scale (CDR); neurocognitive
assessment; emotional reactivity scale; and neurological assessment including
semiquantitative olfactory function test, motor function, coordination and gait.
Result: We assessed 88.4% infected participants and 11.6 % controls. Education
is 10.36 +/- 5.6 years and age is 66.9 +/- 6.14 years. Level of care during
COVID-19 is described in Figure 1. Normalized cognitive Z-scores categorize the
cohort in 3 groups with decreased performance compared to normal cognition:
memory only impairment (Single-domain,11.7%); impairment in attention+executive
function without memory impairment (Two-domain, 8.3%); and multiple domain
impairment (Multiple domain,11.6%). Logistic regression showed that severity of
anosmia, but not clinical status, significantly predicts cognitive impairment.
No controls had olfactory dysfunction. Cognitive impairment is defined as
Z-scores below (- 2) (Table 1). Clinical assessment with SCAN revealed
functional memory impairment in two thirds of infected patients (CDR > or = 1),
which was severe in half of them. Phone-based follow up at 1 year revealed high
adherence (4 participants declined). Five were deceased at follow up. Rates of
re-infection (between 10 and 23%) were not affected by the vaccination schedule
(Table 2).
Conclusion: The longitudinal cohort had very high adherence. Persistent
cognitive and functional impairment after SARS-CoV-2 infection is predicted by
persistent anosmia but not by the severity of the initial COVID-19 disease.
Presenting Author
Gabriela Gonzalez-Aleman, LCP, Ph.D. (gabigoa@gmail.com)
Pontificia Universidad Catolica Argentina, Buenos Aires
Proposal ID: 61678
Title: Cognitive symptoms among middle- and older-age adults in Latin America
during the coronavirus disease 2019 (COVID-19) pandemic: Risk and protective
factors
Background: The COVID-19 pandemic has impacted daily life worldwide, with
possible negative consequences for cognitive health. Self-reported cognitive
symptoms are linked to the development of Alzheimer's disease and related
dementias (ADRDs). Identifying risk and protective factors for cognitive
symptoms during the pandemic is an important step towards the development of
ADRD prevention efforts. We aimed to examine correlates of cognitive symptoms
among middle- and older-age adults in Latin America before the availability of
vaccines to prevent COVID-19, including sociodemographic factors and changes in
life.
Method: Spanish-speaking adults ages 55-95 (N=2,382, Table 1) living in Latin
America completed an online survey between May and December 2020. Cognitive
symptoms were assessed via the 12-item Everyday Cognition (ECog) questionnaire.
Negative (e.g., economic difficulties, limited social activities) and positive
(e.g., more quality time with close others, increased time in nature/outside)
life changes associated with the pandemic were measured via a subset of items
from the Epidemic-Pandemic Impacts Inventory. Sociodemographic factors included
age, years of education, gender, occupation and socioeconomic status (SES).
Covariates included time since March 2020 (estimated onset of the pandemic in
Latin America), country of survey completion, and having experienced COVID-19
symptoms. Multivariable linear regression models were ran on ECog total scores
including covariates and sociodemographic factors (Model 1), and then adding
terms for negative and positive life changes and their interaction (Model 2).
Results: Model 1 showed female gender (p=.04), not currently working (p=.02)
and lower SES (p<.001) were independently associated with more cognitive
symptoms. Model 2 showed a significant interaction between negative and
positive life changes (p<.001), indicating that negative life changes were
significantly associated with more cognitive symptoms, but this association was
weaker among participants who reported at least one positive life change during
the pandemic (Figure 1).
Conclusion: Cognitive symptoms might be more common among certain segments of
the Latin American population, including women, and those who are not working
and have low SES. The experience of positive life changes during the pandemic
might buffer the detrimental impact of negative life changes on cognitive
symptoms. These risk and protective factors might be considered in ADRD
prevention efforts.
Presenting Author
Maria Marquine, PhD mmarquine@health.ucsd.edu
University of California San Diego, La Jolla, California
Proposal ID: 67719
Title: ICU hospitalization and incident dementia in community-based cohorts of
older adults
Background: Critical illness and intensive care unit (ICU) hospitalization in
older patients have been shown to increase risk of long-term cognitive
impairment. However, most data come from patients recruited from the ICU
without controls or information on pre-ICU cognition. We are not aware of a
community-based sample that allows examination of how ICU hospitalization
changes risk for dementia.
Method: We used data from 5 diverse epidemiologic cohorts at the Rush
Alzheimer's Disease Center (RADC) linked to Medicare claims data from 1991 to
2018 to observe ICU hospitalizations (both prior to RADC enrollment and during
RADC follow-up) in older adults enrolled without known dementia. Incident
Alzheimer's and all type dementia was assessed using standardized annual
cognitive assessment. The association of ICU hospitalization with incident
dementia was tested in a time-varying Cox model allowing hazard rate to change
at time of ICU hospitalization during follow-up. All models were adjusted for
age, sex, education, and race. Fully adjusted models also included terms for
baseline measures of hypertension, diabetes, BMI, vascular risk factors,
vascular disease burden, other chronic medical conditions, functional
disabilities, depression, and physical activity.
Result: Participants (n=3,822; mean age=77.3, SD=7.5) were followed for an
average of 7.8 years (SD=5.5) from study enrollment. ICU hospitalization was
experienced by 1,992 (52.1%) of participants; 1031 (27.0%) before RADC
enrollment, and 961 (25.1%) during follow-up. In models adjusted for
demographics, ICU hospitalization was associated with an increased risk of
Alzheimer's (HR=1.63, 95% CI = 1.41, 1.88) and all type dementia (HR=1.71, 95%
CI = 1.48, 1.97). In fully adjusted models, the association was stronger with
ICU associated with double the risk of Alzheimer's (HR=2.10, 95% CI = 1.66,
2.65) and all type dementia (HR=2.20, 95% CI = 1.75, 2.77).
Conclusion: We found that ICU hospitalization was associated with double the
risk of dementia in community-based older adults compared to those who did not
experience ICU hospitalization using standardized annual cognitive assessment.
These findings could be significant given the high rate of ICU hospitalization
in older persons, and rising ICU hospitalizations more recently during the
COVID-19 pandemic.
Presenting Author
Bryan James, PhD Bryan_James@rush.edu
Rush Alzheimer's Disease Center, Chicago, Illinois
SOURCE Alzheimer’s Association
CONTACT: Alzheimer's Association Media Line, 312.335.4078, media@alz.org; AAIC
2022 Press Office, aaicmedia@alz.org
本プレスリリースは発表元が入力した原稿をそのまま掲載しております。また、プレスリリースへのお問い合わせは発表元に直接お願いいたします。
このプレスリリースには、報道機関向けの情報があります。
プレス会員登録を行うと、広報担当者の連絡先や、イベント・記者会見の情報など、報道機関だけに公開する情報が閲覧できるようになります。
