Impact of Covid-19 on dementia patients

Ever thought how Covid 19 could have an impact on the lives of Dementia patients? Today’s Health Capsule is dedicated to the topic on Dementia and how Covid 19 could have an impact on Dementia patients. Addressing the topic, Consultant Neurologist Dr. Padma S. Gunaratne said, “Dementia is a failure in cognitive function particularly of the memory in an individual, to an extent that it impedes their day to day work”. 

Briefing on the symptoms of dementia, Dr. Gunaratne stated that memory impairment is the commonest feature. Patients start showing symptoms when they lose their recent memory. For an example they may forget where they left their money and might blame others for stealing the money when in reality, they have stored it securely in a place only known to them. Hence, the dominant feature is memory impairment, which will affect the patient in a manner where he can no longer continue his activities the way he used to do. “Repetitive behaviour is another symptom that may create a conflict between the carer and the patient. Communication will also get affected as a result of language difficulties. The patient will not be able to express himself properly to the same extent that they were able to do previously. 

They may also lose familiarity with their usual surroundings; hence spatial orientation will also get affected. Such patients unlike in their past- where they may have led a decent life- may have the tendency to lose all inhibitions and may engage in activities that are not much socially acceptable,” explained Dr. Gunaratne. The patient’s personality may change and he or she may have a confused state of mind and will not be able to make proper judgement. These symptoms continue to progress overtime. 

Causes 
There are many reasons leading towards the development of dementia and among them the commonest is neuro degenerative diseases. Out of them the most common is Alzheimer’s dementia. The role played by genetics including other environmental factors that have not been clearly identified yet could be among other reasons. In the case of Alzheimer’s, any tumor or any other entity is not usually seen other than how the brain volume gradually diminishes. 

Convincing evidence
“In the case of Covid, some patients are diagnosed with either mild or moderate. However, in the case of the elderly, some develop the long Covid where the patient would experience continuous symptoms for weeks or months such as fatigue, cough, shortness of breath or joint pain. While patients would continue to have these symptoms, such patients generally do not return to their usual state for a longer period; particularly in patients with systemic diseases such as high blood pressure, diabetes and cholesterol- which are all contributory factors to the narrowing of blood vessels, leading to cerebrovascular disease,” Dr. Gunaratne said. 

Patients with cerebrovascular disease, Parkinson’s disease, milder forms of Alzheimer’s are more vulnerable to develop neurological manifestations. Scientists have shown significant and convincing evidence to indicate that Covid can affect the brain. According to the doctor, one is by the invasion of the virus itself and the other is by the initiation of an inflammation cascade when the infection enters the body. Elderly people with other systemic illnesses develop this cognitive impairment in comparison to others. Hence, people who contracted Covid, particularly the elderly, will be more vulnerable to develop the recent cognitive impairment as well as the long term dementia. 

Take home message
“The take home message is that when the illness reaches the dementia stage, it is very much irreversible. Dementia is an interrelated and common disease. It is more common in patients with Covid and pre- existing neurological diseases. The important message for all is to adhere to a healthy life style. This is because if you were healthy at the the initial stage prior to contracting Covid, following the recovery process, the outcome will also be better. Stick to a healthy diet, regular exercise, avoid alcohol consumption and smoking and control the high blood pressure, diabetes, cholesterol and the risks for other heart ailments. Then there is hope for a better outcome with any respiratory viruses including Covid 19, because even other respiratory viruses are known to affect the brain,” Dr. Gunaratne concluded.