Dementia and COVID-19: complications of managing a pandemic during another pandemic.

Saeed Sadigh-Eteghad,Sepideh Seyedi Sahebari,Amirreza Naseri

doi:10.1590/1980-57642020dn14-040017

Saeed Sadigh-Eteghad, Sepideh Seyedi Sahebari + Show 1 more

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Managing COVID-19 pandemic during the pandemic of dementia, seems to be challenging. Demented people may not be capable of following the health recommendations, which makes them more susceptible to getting infected. Differences in the clinical manifestation of COVID-19 in demented patients can lead to lack of diagnosis and more spreading of the virus. Also, taking care of dementia patients is more probable to get a poor outcome. The neuropsychiatric symptoms of Alzheimer’s disease seem to get deteriorate in COVID-19 confinement. The direct neuroinvasive capacity of coronavirus to infect the central nervous system is not well known, but there as multiple possible mechanisms suggested for indirectly mediated inflammation. Also, stress due to such a pandemic can accelerate cognitive decline. COVID-19 should not overshadow dementia care and demented patients’ mental and physical health should not be neglected during this pandemic.

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Taking care of dementia patients is more probable to get a poor outcome.6 Recent studies found that individuals with dementia are more likely to have other COVID-19 risk factors such as diabetes and cardiovascular disease.7 Besides, a systematic review of literature found a twice as high pneumonia mortality rate in patients with dementia.8 During this pandemic, individuals with dementia showed higher mortality rate compared to patients without dementia which makes severe dementia independent risk factors for death due to COVID-19.4,9
The cytokines produced in COVID-19 infection such as interleukin-1 (IL-1) and interleukin-6 (IL-6) may synergize with amyloid-stimulated type I interferon (IFN) in Alzheimer disease (AD) patients and play a role in the presentation of symptoms. This may be a silent impact of SARS-CoV2 on the deterioration of AD
It may be a reason for facing severe COVID-19 symptoms earlier, after the onset of the infection in AD patients

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Introduction

Taking care of dementia patients is more probable to get a poor outcome.6 Recent studies found that individuals with dementia are more likely to have other COVID-19 risk factors such as diabetes and cardiovascular disease.7 Besides, a systematic review of literature found a twice as high pneumonia mortality rate in patients with dementia.8 During this pandemic, individuals with dementia showed higher mortality rate compared to patients without dementia which makes severe dementia independent risk factors for death due to COVID-19.4,9.

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