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1.
Alzheimers Dement (Amst) ; 13(1): e12144, 2021.
Article in English | MEDLINE | ID: covidwho-1680306

ABSTRACT

INTRODUCTION: There is an urgent need to validate telephone versions of widely used general cognitive measures, such as the Montreal Cognitive Assessment (T-MoCA), for remote assessments. METHODS: In the Einstein Aging Study, a diverse community cohort (n = 428; mean age = 78.1; 66% female; 54% non-White), equivalence testing was used to examine concordance between the T-MoCA and the corresponding in-person MoCA assessment. Receiver operating characteristic analyses examined the diagnostic ability to discriminate between mild cognitive impairment and normal cognition. Conversion methods from T-MoCA to the MoCA are presented. RESULTS: Education, race/ethnicity, gender, age, self-reported cognitive concerns, and telephone administration difficulties were associated with both modes of administration; however, when examining the difference between modalities, these factors were not significant. Sensitivity and specificity for the T-MoCA (using Youden's index optimal cut) were 72% and 59%, respectively. DISCUSSION: The T-MoCA demonstrated sufficient psychometric properties to be useful for screening of MCI, especially when clinic visits are not feasible.

2.
J Int Neuropsychol Soc ; 28(2): 188-202, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1671443

ABSTRACT

OBJECTIVE: Cognitive impairment is a key element in most mental disorders. Its objective assessment at initial patient contact in primary care can lead to better adjusted and timely care with personalised treatment and recovery. To enable this, we designed the Mindmore self-administrative cognitive screening battery. What is presented here is normative data for the Mindmore battery for the Swedish population. METHOD: A total of 720 healthy adults (17 to 93 years) completed the Mindmore screening battery, which consists of 14 individual tests across five cognitive domains: attention and processing speed, memory, language, visuospatial functions and executive functions. Regression-based normative data were established for 42 test result measures, investigating linear, non-linear and interaction effects between age, education and sex. RESULTS: The test results were most affected by age and to a lesser extent by education and sex. All but one test displayed either linear or accelerated age-related decline, or a U-shaped association with age. All but two tests showed beneficial effects of education, either linear or subsiding after 12 years of educational attainment. Sex affected tests in the memory and executive domains. In three tests, an interaction between age and education revealed an increased benefit of education later in life. CONCLUSION: This study provides normative models for 14 traditional cognitive tests adapted for self-administration through a digital platform. The models will enable more accurate interpretation of test results, hopefully leading to improved clinical decision making and better care for patients with cognitive impairment.

3.
Geriatr Nurs ; 42(5): 1230-1239, 2021.
Article in English | MEDLINE | ID: covidwho-1575510

ABSTRACT

The purpose of this study was to systematically examine the association between dementia and mortality among older adults with COVID-19. To do so, we conducted a search of 7 databases for relevant full-text articles. A cohort study and case-control study were included. A meta-analysis was performed to synthesize the pooled odds ratio with a random-effects model. We identified studies that reported mortality among older adults with dementia and non-dementia who have COVID-19. The pooled mortality rates of dementia and non-dementia older adults infected with COVID-19 were 39% (95% CI: 0.23-0.54%, I2 = 83.48%) and 20% (95% CI: 0.16-0.25%, I2 = 83.48%), respectively. Overall, dementia was the main factor influencing poor health outcomes and high rates of mortality in older adults with COVID-19 infection (odds ratio 2.96; 95% CI 2.00-4.38, I2 = 29.7%), respectively. Our results show that older adults with dementia with COVID-19 infection have a higher risk of mortality compared with older adults without dementia. This current study further highlights the need to provide focused care to the older adults with dementia or cognitive impairment who have COVID-19.


Subject(s)
COVID-19 , Dementia , Aged , Case-Control Studies , Cohort Studies , Humans , Observational Studies as Topic , SARS-CoV-2
4.
Disabil Rehabil ; 43(10): 1342-1358, 2021 05.
Article in English | MEDLINE | ID: covidwho-1455011

ABSTRACT

PURPOSE: Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS: An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS: After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS: In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.


Subject(s)
Activities of Daily Living , Cognitive Dysfunction , Adult , Cognition , Cognitive Dysfunction/diagnosis , Executive Function , Humans , Neuropsychological Tests
5.
Front Psychol ; 11: 570160, 2020.
Article in English | MEDLINE | ID: covidwho-1389238

ABSTRACT

Reduced self-awareness is a well-known phenomenon investigated in patients with vascular disease; however, its impact on neuropsychological functions remains to be clarified. Importantly, selective vascular lesions provide an opportunity to investigate the key neuropsychological features of reduced self-awareness in neurocognitive disorders. Because of its rarity, we present an unusual case of a woman affected by a combined polar and paramedian bilateral thalamic infarction. The patient underwent an extensive neuropsychological evaluation to assess cognitive, behavioral, and functional domains, with a focus on executive functions. She was assessed clinically in the acute phase and after 6 months from the stroke, both clinically and by magnetic resonance imaging. The patient developed a cognitive impairment, characterised by prevalent executive dysfunction associated with reduced self-awareness and mood changes, in terms of apathy and depression. Such condition persisted after 6 months. In May 2020, the patient underwent the serology test in chemiluminescence to detect IgG antibodies against SARS-CoV-2. The result of the quantitative test highlighted a high probability of previous contact with the virus. We suggest that reduced self-awareness related to executive dysfunction and behavioral changes may be due to combined polar and paramedian bilateral thalamic lesion. Metacognitive-executive dysfunction affecting the instrumental abilities of everyday life might make people less able to take appropriate precautions, facilitating the risk of SARS-CoV-2 contagion.

6.
Hemodial Int ; 25(4): E44-E47, 2021 10.
Article in English | MEDLINE | ID: covidwho-1270838

ABSTRACT

Neurological manifestations of coronavirus disease 2019 (COVID-19) often have tragic repercussions. Although many reports of neurological complications of severe acute respiratory syndrome coronavirus 2 infection exist, none of them are of patients on hemodialysis, who have a fivefold greater risk of stroke than the general population. In this report, we emphasize the importance of being vigilant for mild stroke in high risk populations-such as patients on hemodialysis-with COVID-19, since these conditions have overlapping symptoms.


Subject(s)
COVID-19 , Cognitive Dysfunction , Nervous System Diseases , Cognitive Dysfunction/etiology , Humans , Renal Dialysis/adverse effects , SARS-CoV-2
7.
Exp Gerontol ; 152: 111434, 2021 09.
Article in English | MEDLINE | ID: covidwho-1258367

ABSTRACT

BACKGROUND: Evidence-based interventions to improve mobility in older people include balance, strength and cognitive training. Digital technologies provide the opportunity to deliver tailored and progressive programs at home. However, it is unknown if they are effective in older people, especially in those with cognitive impairment. OBJECTIVE: The aim of this study was to examine the efficacy of a novel tablet-delivered cognitive-motor program on mobility in older people with cognitive impairment. METHODS: This was a 6-month single-blind randomised controlled trial of older people living in the community with subjective and/or objective cognitive impairment. Participants randomised to the intervention were asked to follow a 120 min per week balance, strength and cognitive training program delivered via an app on an iPad. Both the intervention and control group received monthly phone calls and health fact sheets. The primary outcome measure was gait speed. Secondary measures included dual-task gait speed, balance (step test, FISCIT-4), 5 sit to stand test, cognition (executive function, memory, attention), mood and balance confidence. Adherence, safety, usability and feedback were also measured. RESULTS: The planned sample size of 110 was not reached due to COVID-19 restrictions. A total of 93 (mean age 72.8 SD 7.0 years) participants were randomised to the two groups. Of these 77 participants returned to the follow-up clinic. In intention-to-treat analysis for gait speed, there was a non-significant improvement favouring the intervention group (ß 0.04 m/s 95% CI -0.01, 0.08). There were no significant findings for secondary outcomes. Adherence was excellent (84.5%), usability of the app high (76.7% SD 15.3) and no serious adverse events were reported. Feedback on the app was positive and included suggestions for future updates. CONCLUSION: Due to COVID-19 the trial was under powered to detect significant results. Despite this, there was a trend towards improvement in the primary outcome measure. The excellent adherence and positive feedback about the app suggest a fully powered trial is warranted.


Subject(s)
COVID-19 , Cognitive Dysfunction , Accidental Falls , Aged , Cognition , Cognitive Dysfunction/therapy , Exercise , Exercise Therapy , Humans , Postural Balance , SARS-CoV-2 , Single-Blind Method , Tablets
8.
Healthcare (Basel) ; 9(4)2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1241262

ABSTRACT

Olfactory function is an emerging topic of research in the fields of cognitive impairment and neurodegenerative diseases. We aimed to confirm the association between olfactory function and cognitive impairment by assessing the olfactory function of older persons with cognitive impairment and identify whether olfactory function is associated with cognitive impairment. For this study, we recruited 117 older people aged ≥65 years with cognitive impairments from a public hospital in Korea. We used the Korean version of the expanded clinical dementia rating scale to evaluate participants' cognitive impairments, and the University of Pennsylvania's smell identification test to assess their olfactory function. Our results indicate a significant negative correlation between olfactory function and all domains of cognitive impairment (memory, orientation, judgement and problem-solving, community affairs, home and hobbies, and personal care). In addition, olfactory function was a factor associated with cognitive impairment in older persons. Therefore, we expect that our results to provide useful data for the development of interventions using olfactory stimulation to improve cognitive function in older persons with cognitive impairment.

9.
J Am Med Dir Assoc ; 22(7): 1352-1356.e2, 2021 07.
Article in English | MEDLINE | ID: covidwho-1240413

ABSTRACT

OBJECTIVES: We aimed to examine the association between the transition to social isolation and cognitive decline in older adults during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Longitudinal study. SETTING AND PARTICIPANTS: The study included participants from a community in a semiurban area of Japan. We conducted a mailed questionnaire survey of 2000 noninstitutionalized older adults who were randomly sampled. Of those who completed both the baseline and follow-up surveys in March and October 2020, respectively, participants aged ≥70 years without cognitive impairment at baseline were included in the analysis. METHODS: Participants were classified into 4 groups based on their baseline and follow-up social isolation status, which were as follows: "remained nonisolated," "isolated from nonisolation," "nonisolated from isolation," and "consistent isolation." Self-reported cognitive function was assessed using the Cognitive Performance Scale, and level 2 (mild impairment) or higher (moderate to severe impairment) was defined as cognitive impairment. RESULTS: Ultimately, 955 older adults were analyzed. The mean age of the participants was 79.6 years (standard deviation = 4.7) and 54.7% were women. During the follow-up period, 54 (5.7%) participants developed cognitive impairment. Multivariable logistic regression analysis revealed that compared with the group that remained nonisolated, the isolated from nonisolation and consistent isolation groups were significantly associated with the onset of cognitive impairment [isolated from nonisolation: odds ratio (OR) = 2.74, 95% confidence interval (CI) = 1.13-6.61, P = .026; consistent isolation: OR = 2.33, 95% CI = 1.07-5.05, P = .033]. CONCLUSIONS AND IMPLICATIONS: Social isolation during the COVID-19 pandemic was associated with a decline in cognitive function among older adults. Attention to the social isolation process during the pandemic may be necessary to protect older adults' cognitive health.


Subject(s)
COVID-19 , Cognitive Dysfunction , Aged , Cognitive Dysfunction/epidemiology , Female , Humans , Japan/epidemiology , Longitudinal Studies , Pandemics , SARS-CoV-2 , Self Report , Social Isolation
10.
Transl Neurodegener ; 10(1): 15, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1215126

ABSTRACT

Alzheimer's disease (AD) has emerged as a key comorbidity of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The morbidity and mortality of COVID-19 are elevated in AD due to multiple pathological changes in AD patients such as the excessive expression of viral receptor angiotensin converting enzyme 2 and pro-inflammatory molecules, various AD complications including diabetes, lifestyle alterations in AD, and drug-drug interactions. Meanwhile, COVID-19 has also been reported to cause various neurologic symptoms including cognitive impairment that may ultimately result in AD, probably through the invasion of SARS-CoV-2 into the central nervous system, COVID-19-induced inflammation, long-term hospitalization and delirium, and post-COVID-19 syndrome. In addition, the COVID-19 crisis also worsens behavioral symptoms in uninfected AD patients and poses new challenges for AD prevention. In this review, we first introduce the symptoms and pathogenesis of COVID-19 and AD. Next, we provide a comprehensive discussion on the aggravating effects of AD on COVID-19 and the underlying mechanisms from molecular to social levels. We also highlight the influence of COVID-19 on cognitive function, and propose possible routes of viral invasion into the brain and potential mechanisms underlying the COVID-19-induced cognitive impairment. Last, we summarize the negative impacts of COVID-19 pandemic on uninfected AD patients and dementia prevention.


Subject(s)
Alzheimer Disease/complications , COVID-19/complications , Pandemics , Aged , Aged, 80 and over , Alzheimer Disease/epidemiology , COVID-19/epidemiology , Comorbidity , Humans
11.
Int J Biol Sci ; 17(6): 1443-1445, 2021.
Article in English | MEDLINE | ID: covidwho-1206423

ABSTRACT

The coronavirus disease-19 (COVID-19) has spread throughout the world, affecting many vulnerable populations including patients with severe mental illness (SMI). Recent studies have found that patients with SMI compared to the general population could have a greater risk of morbidity and mortality from COVID-19 due to cognitive impairment, poor awareness of risk, and difficulties in complying with infection control measures. Although some researchers have suggested that patients with SMI should be prioritized for COVID-19 vaccination to reduce the risk of infection, this issue remains controversial.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Priorities , Mental Disorders , COVID-19/complications , COVID-19/virology , Humans , Mental Disorders/complications , Mental Disorders/psychology , SARS-CoV-2/isolation & purification , Severity of Illness Index
12.
JMIR Res Protoc ; 10(4): e22670, 2021 Apr 26.
Article in English | MEDLINE | ID: covidwho-1202410

ABSTRACT

BACKGROUND: A high percentage of patients with cancer experience cognitive impairment after cancer treatment, resulting in a decreased health-related quality of life and difficulty returning to work. Consequently, there is a need for effective treatment options to improve cognitive functioning in these patients. In a healthy aging population, multidomain web-based lifestyle interventions have been found to be effective in preventing cognitive decline and improving cognitive functioning. OBJECTIVE: This study aims to investigate the feasibility and effectiveness of the web-based lifestyle intervention Mijn Fitte Brein (My Fit Brain [MFB]) on cognitive functioning in patients with cancer returning to work. METHODS: The study consists of a feasibility study (N=10), followed by a randomized controlled trial (RCT; N=220). Patients will be recruited by their occupational physicians after their return to work following cancer treatment. Mijn Fitte Brein is organized into 4-week cycles in which patients set a lifestyle goal using the Goal Attainment Scale, receive weekly tips and support, and finally evaluate whether they succeeded in achieving this goal. Lifestyle goals are based on 6 domains: physical exercise, diet, sleep, stress, alcohol use, and smoking. In the feasibility study, data on user experience (structured interview) and usability, assessed with the Post-Study System Usability Scale, will be collected and used to optimize Mijn Fitte Brein. In the RCT, patients will be randomized 1:1 between an intervention group and a control group. Patients will be assessed at baseline, 3 months, and 6 months. The primary outcome measure is subjective cognitive functioning, assessed with the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). Secondary outcome measures are lifestyle, objective cognitive functioning, and work and psychosocial factors. RESULTS: Recruitment for the feasibility study has started in February 2020. As of July 2020, however, no patients have been enrolled (due to COVID-19 restrictions). The findings of the feasibility study will be used to optimize the Mijn Fitte Brein intervention. Enrollment for the RCT will continue when possible. The feasibility study will take 6 months (including making adjustments to the intervention), and the RCT will take 2 years. The final results are expected in 2024. The results of the feasibility study and the RCT will be published in peer-reviewed journals. CONCLUSIONS: This is the first time the feasibility and efficacy of a multidomain web-based lifestyle intervention will be studied in patients with cancer. If Mijn Fitte Brein is found to be effective in decreasing cognitive complaints in these patients returning to work, it will be a promising treatment option because of being both affordable and accessible. TRIAL REGISTRATION: Netherlands Trial Register NL8407; https://www.trialregister.nl/trial/8407. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/22670.

13.
Am J Emerg Med ; 46: 146-149, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1198572

ABSTRACT

INTRODUCTION: Little is known on prevalence of early return hospital admission of subjects with COVID-19 previously evaluated and discharged from emergency departments (EDs). This study aims to describe readmission rate within 14 days of patients with COVID-19 discharged from ED and to identify predictors of return hospital admission. METHODS: We performed a retrospective cohort study of adult patients with COVID-19 discharged from two EDs. Return hospital admission was defined as an unscheduled return ED visit within 14 days after initial ED evaluation and discharge. We compared the group of patients who had a return hospital admission to those who did not. We also evaluated selected clinical characteristics (age, neutrophilia, SOFA, lactate dehydrogenase, C-reactive protein and D-dimer) associated with return hospital admission. RESULTS: Of 283 patients included in the study, 65 (22.9%) had a return ED visit within 14 days. 32 of those patients (11%) were then hospitalized, while the remaining 33 were again discharged. Patients requiring a return hospital admission was significantly older, had higher pro-calcitonin and D-dimer levels. Major predictors of return hospital admission were cognitive impairment (OR 17.3 [CI 4.7-63.2]), P/F < 300 mmHg (OR 8.6 [CI 1.6-44.3]), being resident in geriatric care facility (OR 7.6 [CI 2.1-26.4]) and neutrophilia (OR 5.8 [CI 1.6-22.0]). CONCLUSION: Several factors are associated with 14-day return hospital admission in COVID-19 subjects. These should be considered when assessing discharge risk in ED clinical practice.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Patient Discharge/statistics & numerical data , Patient Readmission/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/therapy , Female , Follow-Up Studies , Hospitalization/statistics & numerical data , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Young Adult
14.
BMC Neurol ; 21(1): 157, 2021 Apr 12.
Article in English | MEDLINE | ID: covidwho-1194442

ABSTRACT

BACKGROUND: ALS patients have changed peripheral immunity. It is unknown whether peripheral immunity is related to cognitive dysfunction in ALS patients. OBJECTIVE: To explore the relationship between the peripheral blood lymphocyte subsets and the cognitive status in ALS patients. METHODS: Among 81 ALS patients, we compared the demographic, clinical, and peripheral levels of total T lymphocyte, CD4+ T lymphocyte, CD8+ T lymphocyte, B lymphocyte, and NK cell between those with cognitive impairment (ALS-ci) and those without (ALS-nci). The cognitive status was evaluated via the Chinese version of the Edinburgh cognitive and behavioral screen (ECAS). Significant predictors of cognitive impairment in univariate logistic regression analysis were further examined using multivariate logistic regression analysis. RESULTS: 39.5% of all ALS patients had cognitive impairment. The ALS-ci group had shorter education time, older age at both symptom onset and testing, longer disease duration, and lower levels of peripheral total, CD4+, and CD8+ T lymphocyte and B lymphocyte than the ALS-nci group. Frequency of behavioral impairment did not differ between the two groups. While parameters with significant differences identified by group comparison were also significant predictors of cognitive impairment in univariate logistic regression analysis except the level of B lymphocyte, only older age at testing, education time less than 9 years, and lower level of CD4+ T lymphocyte remained significant in multivariate logistic regression analysis. The predictive model combining these three parameters had an area under the receiver operating characteristic curve value of 0.842 with a sensitivity of 90.6% and a specificity of 67.3%. CONCLUSION: In Chinese ALS patients, blood CD4+ T lymphocyte might help evaluate cognitive impairment along with age and education level.


Subject(s)
Amyotrophic Lateral Sclerosis/immunology , CD4-Positive T-Lymphocytes , Cognitive Dysfunction/immunology , Lymphocyte Subsets , Adult , Aged , Amyotrophic Lateral Sclerosis/complications , CD4 Lymphocyte Count , Cognitive Dysfunction/diagnosis , Educational Status , Female , Humans , Male , Middle Aged , Neuropsychological Tests , ROC Curve
15.
Sci Bull (Beijing) ; 66(21): 2153-2156, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1192980
16.
Acta Clin Belg ; : 1-8, 2021 Apr 17.
Article in English | MEDLINE | ID: covidwho-1191081

ABSTRACT

AIM: Associations of depression, dementia, and poor life quality with mortality of COVID-19have not been studied yet. We aimed to identify the risk factors for mortality and analyze the associations with patients' physiological and mental well-being, as reflected by comorbidities, life quality, depression, and cognitive impairment. METHODS: : Older patients receiving inpatient hospital care for COVID-19 were included.Demographic data, medical history, symptoms at admission, laboratory findings, and treatment outcomes were recorded. RESULTS: : There were 122 patients with a median age of 73.0 years. The mortality rate was 9.0% (n = 11 patients). Patients with mortality were significantly active smokers, obese, and having comorbidities using polypharmacy. Weight loss ≥of 10% during hospitalization was significantly associated with mortality.Poor life quality and a higher risk of depression, cognitive impairment, and falling were more frequently seen in non-survived patients. (p < 0.05). High ferritin was the only independent risk factor for mortality (OR = 15.61, 95% CI:1.08-226.09, p = 0.044). CONCLUSION: : The presence of comorbidities, depression, cognitive impairment, higher falling risk, and poor life quality were significantly associated with higher mortality rates in older adults with COVID-19. High ferritin level was an independent risk factor for mortality.

17.
Dement Geriatr Cogn Disord ; 50(1): 68-73, 2021.
Article in English | MEDLINE | ID: covidwho-1183423

ABSTRACT

BACKGROUND: Hyposmia is frequently reported as an initial symptom in coronavirus disease 2019 (COVID-19). OBJECTIVE: As hyposmia accompanies cognitive impairment in several neurological disorders, we aimed to study whether hyposmia represents a clinical biomarker for both neurological involvement and cognitive impairment in mild CO-VID-19. We aimed to study whether olfactory dysfunction (OD) represents a clinical biomarker for both neurological involvement and cognitive impairment in mild COVID-19. METHODS: Formal olfactory testing using the Sniffin'Sticks® Screening test, neuropsychological assessment using the Montreal Cognitive Assessment (MoCA), and detailed neurological examination were performed in 7 COVID-19 patients with mild disease course and no history of olfactory or cognitive impairment, and 7 controls matched for age, sex, and education. Controls were initially admitted to a dedicated COVID-19 screening ward but tested negative by real-time PCR. RESULTS: The number of correctly identified odors was significantly lower in COVID-19 than in controls (6 ± 3, vs. 10 ± 1 p = 0.028, r = 0.58). Total MoCA score was significantly lower in COVID-19 patients than in controls (20 ± 5 vs. 26 ± 3, p = 0.042, r = 0.54). Cognitive performance indicated by MoCA was associated with number of correctly identified odors in COVID-19 patients and controls (COVID-19: p = 0.018, 95% CI = 9-19; controls: p = 0.18, r = 0.63, 95% CI = 13-18.5 r = 0.64). DISCUSSION/CONCLUSION: OD is associated with cognitive impairment in controls and mild COVID-19. OD may represent a potentially useful clinical biomarker for subtle and even subclinical neurological involvement in severe acute respiratory distress syndrome coronavirus-2 infection.


Subject(s)
Anosmia/etiology , COVID-19/complications , Cognition , Cognitive Dysfunction , Aged , Aged, 80 and over , Anosmia/pathology , Biomarkers , COVID-19/pathology , Female , Humans , Male , Mental Status and Dementia Tests , SARS-CoV-2
18.
Biofactors ; 47(2): 232-241, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1178977

ABSTRACT

COVID-19 leads to severe respiratory problems, but also to long-COVID syndrome associated primarily with cognitive dysfunction and fatigue. Long-COVID syndrome symptoms, especially brain fog, are similar to those experienced by patients undertaking or following chemotherapy for cancer (chemofog or chemobrain), as well in patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or mast cell activation syndrome (MCAS). The pathogenesis of brain fog in these illnesses is presently unknown but may involve neuroinflammation via mast cells stimulated by pathogenic and stress stimuli to release mediators that activate microglia and lead to inflammation in the hypothalamus. These processes could be mitigated by phytosomal formulation (in olive pomace oil) of the natural flavonoid luteolin.


Subject(s)
COVID-19/drug therapy , Cognitive Dysfunction/drug therapy , Fatigue/drug therapy , Luteolin/therapeutic use , Brain/drug effects , Brain/physiopathology , Brain/virology , COVID-19/complications , COVID-19/physiopathology , COVID-19/virology , Cognitive Dysfunction/complications , Cognitive Dysfunction/physiopathology , Cognitive Dysfunction/virology , Cytokines/genetics , Fatigue/complications , Fatigue/physiopathology , Fatigue/virology , Humans , Mast Cells/drug effects , Mast Cells/virology , SARS-CoV-2/pathogenicity
19.
Aging Dis ; 12(2): 345-352, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1168240

ABSTRACT

The SARS-CoV-2 infection has spread to all continents, affecting particularly older people. The complexity of SARS-CoV2 infection is still under study. Despite respiratory involvement is the main clinical manifestation of COVID-19, neurological manifestations are common. Although it is obvious to give priority to infectious emergency and the infectious disease itself, at present, however, data on potential long-term damages generally and on long-term cognitive functions impairment of older COVID-19 survivors have yet to be investigated. Because the hypothesis on the involvement of SARS-CoV-2 on the long-term cognitive decline pathogenesis would seem difficult to prove, we wanted to explore the brain mechanisms of SARS-CoV-2, in order to provide more in-depth analysis and to draw attention to a topic relevant to basic scientific research and, more generally, to the elderly population.Looking forward, we argue that an early clinical and instrumental cognitive assessment can help prevent and slow down this possible complication or at least improve the quality of life for older people Covid-19 survivor.

20.
Gerontol Geriatr Med ; 7: 23337214211005223, 2021.
Article in English | MEDLINE | ID: covidwho-1166874

ABSTRACT

Introduction: Since the declaration of coronavirus disease 2019 (COVID-19) as a pandemic, patients with dementia, were specifically vulnerable to the negative impact of the outbreak. Objective: To examine the association between lockdown amid COVID-19 pandemic and the rate of cognitive decline among patients with dementia and mild cognitive impairment (MCI). Methods: We conducted a cross-sectional observational study on patients with dementia and MCI who attended the outpatient clinic at Ibn Sina Hospital, the main tertiary neurology center in Kuwait, during the month of September 2020. The rate of cognitive decline, estimated by MMSE scores, was compared between the period prior to, and during lockdown. Results: We evaluated 36 consecutive patients with cognitive impairment (23 females [63.9%], mean age 71 ± 10.8 years, mean disease duration 34.6 ± 29 months). Eleven patients (30.6%) progressed to a more severe stage during the study period; 1 MCI (2.8%) converted to mild dementia, 6 (16.6%) mild to moderate, and 4 (11.1%) moderate to severe dementia. Monthly decline of MMSE scores before lockdown was 0.2 ± 0.1 points, while it was 0.53 ± 0.3 points during lockdown, which was statistically significant (p = .001). The most affected cognitive domain was the memory with a mean decline of 1.5 ± 0.8 points. Conclusions: This study provides "real-world" data suggesting rapid cognitive decline in patients with dementia during the lockdown period. Healthcare systems should pay more attention to this vulnerable group, to help them maintain their mental, physical and social well-being during this crisis.

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