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Experts discuss Alzheimer’s and COVID — and the need to know more through research and study


By Maridith Yahl
NKyTribune health reporter

The 2020 Alzheimer’s Association International Conference (AAIC) held a panel discussion that provided different perspectives on potential long-term effects of COVID-19. Issues included its impact on Alzheimer’s research studies, health disparities and gender differences, on long-term care facilities, and long-term effects on the brain. A new global research collaboration on linking COVID and Alzheimer’s risk was explained.

Dr. Gregory Jicha (Photos provided, Alzheimer’s Association

When the pandemic shut everything down, Alzheimer’s research studies could not shut down. Dr. Gregory A. Jicha, University of Kentucky College of Medicine, Alzheimer’s Disease Center, made necessary safety changes to be able to continue clinical trials.

A current study is one of the largest secondary prevention trials, using a drug to reduce the likelihood of Alzheimer’s disease. This trial is making progress. However, 80% of those participating must complete the study for it to be viable. So, continuing was crucial.

“We know we can screen for symptoms, we can socially distance, we can minimize exposure, we can limit time in the clinic, we can use masks, and we can test,” he says.

Taking all safety precautions has been the key to keeping the study going and reduces the risk of contracting COVID. At the center, everyone is tested for COVID before entering.

“I think we need to focus on safety, so far so good across the globe. It is my understanding in facing this challenge we need to do this, we need to not throw away our next best treatment for this disease,” Dr. Jicha says.

Dr. Neelum Aggarwal

Dr. Neelum T. Aggarwal, Rush Alzheimer’s Disease Center, says the main concern when the pandemic began was for older adults with heart and respiratory conditions and those whose immune systems were compromised. As the pandemic continued, Dr. Aggarwal said it was noticed that COVID also moved toward the nervous system.

Since cardio and cerebral risk factors play a significant part in the development of Alzheimer’s Disease, studying to see if COVIDs effect on the brain and if that will be an increased risk for Alzheimer’s has become a concern.

Researching risk factors of health disparities, making connections to the development of Alzheimer’s impact from COVID on cognitive function has begun.

Gender differences are seen among Alzheimer’s patients, including the varying differences in intensity of risk factors. Likewise, there is a need to understand how COVID might impact men and women differently. Aggarwal suggests beginning Alzheimer’s research on differences by gender. Looking at gender differences can only strengthen the understanding of how COVID has and will have an impact on the older population, those who may now have an increased risk for developing dementia or Alzheimer’s, she says.

Beth Kallmyer

Five months into the pandemic and there is still no framework to suitably manage long term care facilities, which have been hit extremely hard, says Beth Kallmyer, Alzheimer’s Association. These facilities are group living settings in which residents gather to eat, participate in activities, and socialize. This type of setting does not allow for social distancing.

“There have been 59,000 residents and employees of long-term care facilities who have died as a result of COVID-19, that is 42% of all US deaths,” Kallmyer says. She says dementia patients make up a large percentage of those deaths.

Residents are quarantined to their room, only interacting with staff. This affects mood and cognition. Those with dementia might not be able to express their needs clearly, creating more challenges.

“We might be saving them from COVID but we’re losing them to the social isolation and cognitive decline,” one long term care provider said to Kallmyer. To remedy this, the Alzheimer’s Association came up with policy recommendations for federal and state governments. The policies would allow residents to live in long-term facilities to safely receive care and see their families.

The first recommendation is to increase testing. Testing every resident and employee entering the facility would end the need for residents to be quarantined to their rooms.

Secondly, reporting varies by state, making requirements overwhelming and confusing. Having a single portal would make reporting easy and efficient.

Third, having such a reporting system to locate outbreaks would allow Strike Force Teams to be sent in for support; support for resident care or to fill staffing shortages.

Lastly, long-term care providers still do not have adequate PPE. This, she says, is unacceptable, putting caregivers and residents at risk.

Dr. Maria Carillo

Dr. Maria C. Carrillo, Alzheimer’s Association spoke to the significant health disparities COVID has exposed.

“The Alzheimer’s Association is committed to the inclusion of all communities in the advancement of health equity through our research, advocacy, support, and partnerships,” Carrillo says.

The pandemic has exposed the health differences between racial and ethnic groups and unequal health access due to economic and social conditions. African Americans are twice as likely, and Hispanics are about one and half times more likely, to develop Alzheimer’s disease than whites. Those with Alzheimer’s and dementia are more likely to live in long-term care facilities, resulting in greater exposure to COVID-19.

There is a wide range of personal, social, economic, and environmental factors that influence health, such as lack of stable housing and transportation. The type of work and work-place policies affect. Policies of no paid leave force individuals to continue to work when sick.

Hispanics and African Americans are uninsured at a higher rate than whites. These ethnicities also have higher rates of chronic conditions which increase the risk for COVID and Alzheimer’s, according to Carrillo.

Taking into consideration genetics, not just those of whites, but all races, can lead to a better understanding of the impact of Alzheimer’s, dementia, and COVID-19, says Carrillo.

Dr. Gabriel Erausquin

Dr. Gabriel A. de Erausquin, University of Texas Health San Antonio, elaborated on the new international research study by the Alzheimer’s Association. He says it is a global collaboration to learn the long-term impact the coronavirus has on the brain. Scientists from over 30 countries will participate, including multiple countries in Africa, Latin America, and Europe, as well as China and the US. The study will establish partner groups around the world.

One will focus on the Scandinavian countries, specifically Sweden and Denmark, that have national health registries. Registries will be used to randomly select individuals that were exposed to the virus or developed symptoms, to study the effects.

A second focus will be following up on those who had been hospitalized and investigate their complications and long-term outcomes.

Last, Dr. Erausquin says perhaps the most promising perspective in understanding the biology of the virus, is to study brain biological markers and compare those who were infected versus those who were immune or showed no symptoms.

Dr. Erausquin says the goal is to have 1,000 participants per group, totaling at least 20,000 to as many as 40,000 participants overall.

What researches and scientists know about coronavirus and its long-term effects on the brain is enough to know that in the future there may be a link between Alzheimer’s and having had the virus. The panel was diverse in discussing a wide range of issues that need to be addressed and continued to be studied to learn more about both.

See the Alzheimer’s Association webpage for resources and help.

Maridith Yahl is the NKyTribune’s health reporter

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