COVID Dementia: Can COVID Cause Cognitive Impairment?

A few years out from the worst of the COVID pandemic, researchers are seeking to more fully understand the impact of the coronavirus on a variety of health conditions, including dementia. Dementia generally refers to a set of neurodegenerative disorders that typically affect people over age 65 and can result in difficulties with memory and day-to-day functioning. Some of the long-term symptoms of COVID can also lead to cognitive concerns. Understanding the similarities and differences between COVID and dementia, as well as the ways the two conditions can interact, can help both dementia patients and caregivers effectively address these conditions. Therapy may be a helpful part of treatment, whether you’re living with COVID brain fog or dementia.

Is it the beginning of dementia, or just COVID brain fog?

An online therapist may offer insight

What is COVID-19 infection?

COVID, also referred to as COVID-19, coronavirus, or its full scientific name, severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), is a virus that can cause a range of problematic symptoms, typically respiratory issues similar to those associated with an influenza infection. COVID emerged as a novel virus in late 2019 and quickly spread around the world, leading to the declaration of the COVID pandemic. 

Severity of COVID-19 infection

For many people, a COVID infection causes symptoms no worse than those of a bad cold. However, older adults and immunocompromised people tend to have a higher risk of developing severe illness that could require hospitalization and may be fatal.

Long coronavirus COVID symptoms

In the months and years following the initial COVID outbreak, it seems that some individuals, even those who only encountered mild initial infections, experience symptoms that persist long after their immune systems have cleared the virus. This condition, frequently known as “long COVID,” can involve symptoms that are notably different from the typical respiratory issues associated with active infection. These may include chest pain, menstrual cycle disruptions, and changes in smell or taste. 

Cognitive impairment and long COVID’s impact on the brain

Long COVID can also involve cognitive impairment, which patients often refer to using the umbrella term “brain fog.” Some of these negative impacts on cognitive function can include problems with the following:

• Attention
• Executive function
• Memory
• Learning
• Language
• Switching between tasks
• Spatial orientation
• Visual, auditory, or sensory perception
• Fatigue
• Lack of motivation
• Sleep disruption
• Processing speed

Many of these problems can mimic some of the more minor impacts on cognitive function caused by neurodegenerative disorders like dementia. 

COVID’s impact on the brain: Brain fog and more

COVID belongs to a class of respiratory disorders, not neurological disorders, but contracting COVID can result in damage to the central nervous system. There are several theories as to why some instances of COVID can lead to neurological impacts and the brain fog associated with long COVID.

Possible causes of neurological impacts

There are several theories as to why some instances of COVID can lead to neurological impacts and the brain fog associated with long COVID.

Impact of oxygen deprivation on COVID dementia

First, one of the most common symptoms of COVID is difficulty breathing. These respiratory issues can lead to lower levels of oxygen in the blood, which can have negative impacts on various organs, including the brain. The neurological damage caused by decreased oxygen flow to the brain can be similar to what occurs in vascular dementia, in which dementia symptoms are typically caused by a cardiovascular event like a stroke or brain hemorrhage that prevents blood (and the oxygen it carries) from reaching the brain.

Immune response and inflammation

Another explanation could involve the whole body’s immune response to COVID. Some children who contracted COVID-19 experienced an overly active immune response, resulting in a condition known as multisystem inflammatory syndrome in children (MIS-C), in which the body essentially attacks itself. Something similar could occur with the cognitive impacts of long COVID, in which the body’s immune response could have caused inflammation in nerve and brain cells that led to lasting damage.  

It is thought that the risk of both oxygen-related and immune response-related brain cell damage increases with cases involving more severe COVID infections.

Can coronavirus directly cause dementia?

As closely as some “brain fog” symptoms of long COVID can mimic dementia symptoms, there tend to be distinct differences between the two. Dementia is usually associated with cognitive decline, in which symptoms become worse over time. With long COVID, neurological symptoms can wax and wane, but generally improve as time goes on.

Differences between long COVID brain fog and dementia 

As dementia progresses to its final stages, patients may entirely lose their sense of self and develop what is known as a “lack of insight,” meaning they are unaware that they have any sort of neurological condition. 

While long COVID patients may have some difficulty remembering details, they are unlikely to forget core memories that comprise their sense of self, and they usually recognize their cognitive impairment. Rather than experiencing a lack of insight, the difference between their cognitive function pre- and post-COVID infection can be a source of frustration and mental health challenges for individuals with long COVID. 

Potential increased dementia risk after COVID

Research findings on COVID and dementia progression

Current research has found that for people who were already undergoing the brain changes associated with dementia, contracting COVID may have worsened or sped up their symptom development, according to the National Institute of Health. 

Researchers ran brain imaging scans and conducted cognitive tests on several patients with different forms of dementia, including Alzheimer’s disease, Parkinson’s disease dementia, vascular dementia, and frontotemporal dementia, all of whom contracted COVID over the course of the study. They found that, “despite having different types of dementia, these patients developed similar dementia symptoms after having COVID-19 [and] experienced rapid structural and functional brain deterioration after COVID-19 infection.”

It is possible that the same cell damage that can lead to brain fog in long COVID patients can worsen cognitive symptoms in dementia patients. More research may be needed to better understand the link between the two conditions. 

Support for COVID dementia or cognitive impairment

Having dementia or caring for a loved one with dementia can take a toll on your mental health, with or without the added complication of COVID-19 symptoms. Talking to a licensed mental health professional can be beneficial in these situations. However, dementia can sometimes complicate attending in-person therapy appointments, as there may be concerns about driving safety for a patient, or, for a caregiver, leaving their loved one home alone. In these instances, online therapy could be a helpful alternative. 

Benefits of online therapy

Research has indicated that attending therapy sessions online can be just as beneficial as attending traditional appointments in person. One study specifically examined the effect of online therapy on dementia caregivers and found that completing a course of therapy usually reduced caregivers’ symptoms of depression and anxiety. 

Effectiveness of online therapy for dementia caregivers

If you are looking for additional support in coping with dementia symptoms for you or a loved one, online therapy may be an accessible resource.