Global Study to Track COVID-19's Impact
on the Brain

Megan Brooks

July 31, 2020

At its annual meeting this week, the Alzheimer's Association announced the launch of a global study to examine the impact of COVID-19 on the brain, as well as policy recommendations to better address the COVID-19 crisis in long-term care facilities.

The study will be led by researchers at the Alzheimer's Association and the University of Texas Health San Antonio, with participation from more than 30 countries and technical guidance from the World Health Organization.

The research will track and evaluate the short- and long-term impact of the novel coronavirus on the brain, including cognition, behavior, and function. The target sample size is 20,000 to 40,000 total participants.

Maria C. Carrillo, PhD, chief science officer for the Alzheimer's Association, announced the study's launch during a COVID-19-focused panel discussion at the Alzheimer's Association International Conference (AAIC) 2020, which was held online this year because of the ongoing pandemic.

"To build a strong foundation for this research, we will align with existing studies, such as the Framingham Heart Study, and clinicians from around the world on how the data are going to be collected, obtained, and shared. We are going to have cross-study collaborations to understand the impact of the virus on the brain directly," said Carrillo.

"We will have some very good data to present next year at AAIC," she predicted.

"Frightening" Headlines

As previously reported by Medscape Medical News, mounting evidence suggests that SARS-CoV-2 invades the central nervous system (CNS), causing a wide range of neurologic and neuropsychiatric complications, including stroke, psychosis, altered mental state, and dementia-like syndrome. 

It's likely that "dementia does not increase the risk for COVID-19, just like dementia does not increase risk for the flu. But increased age, being in a long-term care setting, and common health conditions that often accompany dementia may increase the risk," Carrillo said.

Panel member Beth Kallmyer, MSW, vice president of care and support at the Alzheimer's Association, spoke about the ongoing challenges long-term care facilities are facing during the pandemic.

"You've all seen the headlines, and they're frightening, frankly," Kallmyer said. An estimated 59,000 residents and employees of long-term care have died as a result of COVID-19, which is 42% of all US deaths, she noted. 

The long-term care community is being impacted at "significantly greater rates than the rest of society and yet we don't have things in place to protect them. We also know that individuals living with dementia make up a large percentage of those that are living in long-term care," Kallmyer said.

She noted that infection control is always a challenge in long-term care settings, but infection control during a pandemic "takes it to a whole other level."

She pointed out that quarantining is hard for anyone, "but when you layer dementia on top of that we have a real challenge." One long-term care provider told Kallmyer: "We might be saving them from COVID, but we're losing them to social isolation and cognitive decline."

New Recommendations

Kallmyer outlined new policy recommendations from the Alzheimer's Association to address the COVID-19 crisis in long-term and community-based care settings. They include:

  • Testing every resident, employee and visitor each time they leave and come back, so residents would not need to be confined to their own rooms

  • Having a single portal that is easy and efficient for reporting cases

  • Developing "surge activation" protocols to respond to hot spots, including the possibility of "strike teams" that go in and help during an outbreak.

  • Making sure all long-term care providers have full access to all needed personal protective equipment (PPE).

"Five months in and long-term care providers still don't have adequate PPE. This is unacceptable," said Kallmyer. "We have to be able to provide them with PPE."

Panel member Gregory A. Jicha, MD, PhD, Sanders-Brown Center on Aging, University of Kentucky, Lexington, spoke about the critical need to continue Alzheimer's research during the pandemic, noting that the number of promising targets for Alzheimer's disease and related dementias has "never been higher or more comprehensive."

Measures to ensure safety of researchers and participants include screening for symptoms (50% effective), social distancing (93% effective), minimizing exposure time (50% effective), limiting staff to 50% (50% effective), cloth/paper masks (80% effective), and testing (99.25% effective), Jicha noted.

With no safety measures in place, the risk of getting COVID-19 from a research visit is 1 in 20, he said; when all these safety measures are combined, the risk is 1 in over 1.5 million, so "we can essentially eradicate or minimize the risks for COVID to less that of a lightning strike," he said.

Carrillo, Kallmyer, and Jicha have disclosed no relevant financial relationships.

Alzheimer's Association International Conference (AAIC) 2020: The Impact of COVID-19 and the Global Pandemic on Alzheimer's Research, Long-Term Care and the Brain. Panel discussion presented July 29, 2020.

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