Journal of Alzheimer's disease : JAD
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Meta Analysis
The Impact of Dementia on the Clinical Outcome of COVID-19: A Systematic Review and Meta-Analysis.
The emergence of the coronavirus disease 2019 (COVID-19) has brought large challenges to dementia patients. We reviewed the existing literature on COVID-19 to assess the incidence and mortality of dementia comorbidities in COVID-19 patients. ⋯ Emerging literature shows that dementia comorbidities are a high risk factor for the prevalence and mortality of COVID-19. Our results should have an impact on preventive interventions and encourage more targeted approaches to prioritize older people with specific risk factors, such as dementia.
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Comment
Potential Novel Role of COVID-19 in Alzheimer's Disease and Preventative Mitigation Strategies.
There are a number of potential implications for the field of Alzheimer's disease (AD) stemming from the global spread of SARS-CoV-2. Neuroinflammation is known to be a prominent feature of neurodegeneration and plays a major role in AD pathology. ⋯ Genetic and socioeconomic factors influencing the rates of T2D, AD, and COVID-19 severity may create an exceptionally high-risk profile for certain demographics such as African Americans and Hispanic Americans. Type I interferon response plays an important role in both host response to viral infection, as well as AD pathology and may be a sensible therapeutic target in both AD and COVID-19.
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Significant variability exists in the trajectories of late-life cognitive decline; however, their associated lifestyle factors remain less studied. We examined these trajectories among elderly participants from the recent five waves (at three-year intervals) of the Chinese Longitudinal Healthy Longevity Study (CLHLS) from 2002 to 2014. Participants from this cohort were included if they completed at least four waves of measurements. ⋯ The inclusion of lifestyle factors significantly improved the prediction of the different trajectories, above and beyond demographics and medical variables; the 'no decline' class was significantly more likely to report exercising regularly. Changes in cognitive functioning across the late-life period are characterized by multiple trajectories. Cognitive decline is not inevitable across the late-life period; the absence of such cognitive decline is partly explained by certain lifestyle factors.
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The COVID-19 pandemic is changing clinical practice in neurology, after the governments decided the introduction of social distancing and interruption of medical non-emergency services in many countries. Teleneurology is an effective tool for the remote evaluation of patients but its adoption for frontotemporal lobar dementia (FTD) is in a preliminary stage. ⋯ The study was conducted in Italy, one of the countries hit particularly hard by the COVID-19 pandemic, with interruption of all non-emergency medical services. Our study indicates that telemedicine is a valid tool to triage patients with FTD to increase practice outreach and efficiency.
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Frontotemporal dementia (FTD) is the second most common cause of early-onset neurodegenerative dementia. Several studies have focused on early imaging changes in FTD patients, but once subjects meet full criteria for FTD diagnosis, structural changes are generally widespread. ⋯ Temporal lobe, cingulate cortex and the lingual gyrus seem to be early targets of the disease and may serve as biomarkers for FTD prior to overt symptom onset.