There is concern in the scientific community that COVID infection may accelerate cognitive decline in older adults, resulting in a wave of dementia cases in the coming years as the population ages. A new $3.7 million grant from the National Institutes of Aging will allow researchers to more precisely understand how the virus triggers damage in the brain and the long-term impact on cognitive performance.
“Given the high rate of COVID world-wide and aging, the possible added toll to the existing burden of dementia could increase exponentially in the near future,” said University of Rochester Medical Center (URMC) neurologist Giovanni Schifitto M.D., the principal investigator of the new study. “We need to better understand the burden and progression of cognitive decline and the mechanisms by which this occurs. This will help point the way to new interventions designed to forestall the onset of dementia in these individuals.”
The new study will involve a multidisciplinary team of URMC neurologists, infectious disease experts, radiologists, and computer scientists, including Nasir Uddin, Ph.D., Meera Singh, Ph.D., Miriam Weber, Ph.D., Henry Wang, M.D., Ph.D., Hongmei Yang, Ph.D., and Angela Branche, M.D.
Several reports have highlighted the presence of cognitive and psychiatric symptoms associated with COVID infection, particularly in older adults who experienced moderate to severe infection. Other studies suggest that the COVID virus can damage the endothelial cells that line blood vessels through both direct infection and the resulting immune response.
The brain is supplied with blood by a vast network of microscopic vessels. The integrity of this microvasculature declines as we age, compromising the integrity of the blood brain barrier and leaving the brain vulnerable to infection, inflammation, and damage from the immune system. The fear is that the damage caused to blood vessels by COVID infection could speed this process up, increasing risk for cerebral small vessel disease (CSVD), which is associated with cognitive decline and ultimately dementia.
The new study will recruit 300 volunteers 65 and older who had a severe enough COVID infection that it required hospitalization, excluding individuals who required intensive care and had to be placed on a ventilator. Participants will be followed for two years with neurocognitive evaluations, advanced quantitative neuroimaging that will search for changes in white matter, blood flow, and the integrity of blood vessel, and blood biomarkers of inflammation and brain injury.