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Zegarra-Valdivia J, Arana-Nombera H, Perez-Fernandez L, Alamo-Medina R, Casimiro MDR, Bustamante-Delgado D, Matallana-Sanchez M, Gallegos-Manayay V, Álvarez-Bravo E, Arteaga-Cancino T, Abanto-Saldaña E, Oliva-Piscoya MDR, Cruz-Ordinola MC, Chavarry P, Chino-Vilca B, Paredes-Manrique C, Chirinos C, Custodio N, Ibañez A. The impact of COVID-19 post-infection on the cognition of adults from Peru. Front Psychol 2024; 15:1325237. [PMID: 38984273 PMCID: PMC11232419 DOI: 10.3389/fpsyg.2024.1325237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/10/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction The COVID-19 pandemic, with over 83 million confirmed cases and 1.8 million deaths, has raised concerns about long-term cognitive issues, especially in populations facing disparities. Despite a few years since Peru's first COVID-19 wave, the cognitive effects on adults remain unclear. This study is the first in Peru to explore COVID-19's impact on general cognition and executive function. Methods A retrospective cross-sectional study compared individuals with COVID-19 history to controls, assessing general cognition, verbal fluency, attention, and executive function. Among 240 assessed, 154 met the study inclusion criteria, with about 60% female and an average age of 38.89 ± 16.001 years. Groups included controls (n = 42), acute phase (AP, n = 74) (1-14 days of symptoms), and hyperinflammatory phase (HP, n = 38) (>14 days of symptoms). Results Significant cognitive differences were observed. The HP group exhibited lower general cognitive performance (p = 0.02), working memory (p = 0.01), and executive function (planning; p < 0.001; flexibility; p = 0.03) than controls. Those with <14 days of illness (AP vs. HP) had deficits in general cognitive performance (p = 0.02), working memory (p = 0.02), and planning (p < 0.001), mainly during the hyperinflammatory phase, showing differences in working memory (p = 0.003) and planning (p = 0.01). Gender differences emerged, with males in the HP phase having poorer working memory (p = 0.003) and planning (p = 0.01). Discussion This study underscores COVID-19's negative impact on cognitive function, even in mild cases, with potential heightened effects in men during acute or hyperinflammatory phases. The findings provide Peru's first evidence, highlighting the vulnerability of populations facing socioeconomic disparities.
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Affiliation(s)
| | | | | | - Reyna Alamo-Medina
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | | | | | | | | | | | | | | | | | | | - Patricia Chavarry
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | - Brenda Chino-Vilca
- Achucarro Basque Center for Neuroscience, Leioa, Biscay, Spain
- Center of Cognitive and Computational Neuroscience-UCM, Madrid, Spain
| | | | - Carlos Chirinos
- Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo, Peru
| | - Nilton Custodio
- Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Agustín Ibañez
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
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Montesinos R, Custodio B, Malaga M, Chambergo-Michilot D, Verastegui-Aranda G, Agüero K, Alejos-Zirena J, Andamayo-Villalba L, Seminario G W, Custodio N. Influence of Behavioral and Psychological Symptoms on Caregiver Burden for Different Types of Dementia: Clinical Experience in Lima, Peru. Dement Geriatr Cogn Disord 2024:1-8. [PMID: 38768581 DOI: 10.1159/000539335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION People caring for patients with dementia are prone to suffering from burden. Behavioral and psychological symptoms of dementia (BPSD) may have an impact on caregiver burden. In Latin American countries, there is a lack of research on caregiver burden. We aimed to determine which BPSD have the greatest impact on caregiver burden among Peruvian patients with dementia and to compare the effects of BPSD on caregiver burden across different types of dementia. METHODS A cross-sectional study was conducted on 231 patients living with Alzheimer's dementia (AD), behavioral variant frontotemporal dementia (bvFTD), dementia with Lewy bodies (DLB), and vascular dementia (VD) and their caregivers who attended a Peruvian memory clinic. BPSD were assessed with the Neuropsychiatric Inventory (NPI). Caregiver burden was assessed with the Zarit Burden Inventory. We used analysis of variance to compare the AD, bvFTD, DLB, and VD groups. Correlations between Zarit Burden Inventory and NPI subscale scores were assessed with Spearman's correlation. RESULTS DLB caregivers had significantly higher levels of burden than the other patient groups (p < 0.05) and higher total NPI scores than caregivers for other patient groups (p < 0.05). bvFTD caregivers had significantly higher total NPI scores than AD and VD caregivers (p < 0.05). Hallucinations, aberrant motor behavior, and apathy were the symptoms most significantly correlated with caregiver burden in those caring for DLB, bvFTD, and AD patients, respectively. CONCLUSION Neuropsychiatric symptoms are higher in DLB caregivers. Hallucinations, aberrant motor behavior, and apathy are the main symptoms correlated with burden.
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Affiliation(s)
- Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Belen Custodio
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Marco Malaga
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Grupo de Investigación Neurociencia Efectividad Clínica y Salud Pública, Universidad Científica del Sur, Lima, Peru
| | - Diego Chambergo-Michilot
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Universidad Científica del Sur, Lima, Peru
| | - Graciet Verastegui-Aranda
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Katherine Agüero
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | | | | | - Wendy Seminario G
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Hospital IV EsSalud Augusto Hernández Mendoza, Ica, Peru
| | - Nilton Custodio
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
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Whitson HE, Banks WA, Diaz MM, Frost B, Kellis M, Lathe R, Schmader KE, Spudich SS, Tanzi R, Garden G. New approaches for understanding the potential role of microbes in Alzheimer's disease. Brain Behav Immun Health 2024; 36:100743. [PMID: 38435720 PMCID: PMC10906156 DOI: 10.1016/j.bbih.2024.100743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Alzheimer's disease (AD) involves a complex pathological process that evolves over years, and its etiology is understood as a classic example of gene-environment interaction. The notion that exposure to microbial organisms may play some role in AD pathology has been proposed and debated for decades. New evidence from model organisms and -omic studies, as well as epidemiological data from the recent COVID-19 pandemic and widespread use of vaccines, offers new insights into the "germ hypothesis" of AD. To review new evidence and identify key research questions, the Duke/University of North Carolina (Duke/UNC) Alzheimer's Disease Research Center hosted a virtual symposium and workshop: "New Approaches for Understanding the Potential Role of Microbes in Alzheimer's disease." Discussion centered around the antimicrobial protection hypothesis of amyloid accumulation, and other mechanisms by which microbes could influence AD pathology including immune cell activation, changes in blood-brain barrier, or direct neurotoxicity. This summary of proceedings reviews the content presented in the symposium and provides a summary of major topics and key questions discussed in the workshop.
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Affiliation(s)
- Heather E. Whitson
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Busse Bldg Rm 3502, Durham, NC, 27710, USA
- Durham VA Medical Center, Geriatric Research Education and Clinical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - William A. Banks
- Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA, 98108, USA
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, 170 Manning Dr, CB 7025, Chapel Hill, NC, 27599, USA
| | - Bess Frost
- Barshop Institute for Longevity & Aging Studies, 4939 Charles Katz Rm 1041, University of Texas Health San Antonio, San Antonio, TX, 78229, USA
| | - Manolis Kellis
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, 32 Vassar St., Cambridge, MA, 02139, USA
| | - Richard Lathe
- Division of Infection Medicine, University of Edinburgh Medical School, Edinburgh BioQuarter, Little France, Edinburgh, EH16 4SB, UK
| | - Kenneth E. Schmader
- Duke Center for the Study of Aging and Human Development, Duke University School of Medicine, Busse Bldg Rm 3502, Durham, NC, 27710, USA
- Durham VA Medical Center, Geriatric Research Education and Clinical Center, 508 Fulton Street, Durham, NC, 27705, USA
| | - Serena S. Spudich
- Department of Neurology, Yale University School of Medicine, 300 George Street, Room 8300, New Haven, CT, 06510, USA
| | - Rudolph Tanzi
- Genetics and Aging Research Unit, Massachusetts General Hospital, 114 16th Street, Charlestown, MA, 02129, USA
| | - Gwenn Garden
- University of North Carolina - Dept of Neurology, 170 Manning Drive, Campus Box 7025, Chapel Hill, NC, 27599-7025, USA
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Diaz MM, Bailey M, Garcia B, Aguilar XR, Sanchez DC. Mental health impact of the COVID-19 pandemic on patients with neurodegenerative diseases and perceived family caregiver burden in Lima, Peru. Brain Behav 2024; 14:e3361. [PMID: 38236201 PMCID: PMC10761328 DOI: 10.1002/brb3.3361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Neurodegenerative diseases lead to difficulties with functional activities. In Peru, most caregivers are family members. Little is known about the COVID-19 pandemic's effect on caregivers in Peru. METHODS This was a cross-sectional, prospective study of family caregivers of dependent patients with dementia or Parkinson's Disease in Lima, Peru. A caregiver burden and mental health questionnaire was administered to the caregiver. RESULTS We enrolled 48 caregivers (65% females, mean ± SD age 49.0 ± 12.3 years); 70% of patients had dementia. Nearly 40% of caregivers reported having full-time jobs, and 82% felt overwhelmed with almost 75% dedicating more time to caregiving during the pandemic. Caregivers perceived patients felt lonelier (52%), had an increase in hallucinations (50%), or forgetfulness (71%) compared to pre-pandemic. CONCLUSIONS Our study highlights that perceived caregiver burden and patient behavioral symptoms may have been exacerbated during the pandemic. In countries such as Peru, more caregiving resources and interventions are needed.
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Affiliation(s)
- Monica M. Diaz
- Department of NeurologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Maisie Bailey
- School of MedicineOregon Health Sciences UniversityPortlandOregonUSA
| | - Bettsie Garcia
- Department of NeurologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Ximena R. Aguilar
- Department of Neurodegenerative DiseasesInstituto Nacional de Ciencias Neurologicas PeruLimaPeru
| | - Danilo Coronel Sanchez
- Department of Neurodegenerative DiseasesInstituto Nacional de Ciencias Neurologicas PeruLimaPeru
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Manfredini A, Pisano F, Incoccia C, Marangolo P. The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4889. [PMID: 36981800 PMCID: PMC10049620 DOI: 10.3390/ijerph20064889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic severely affected people's mental health all over the world. This review aims to present a comprehensive overview of the literature related to the effects of COVID-19 lockdown measures and COVID-19 infection on cognitive functioning in both healthy people and people with neurological conditions by considering only standardized tests. We performed a narrative review of the literature via two databases, PUBMED and SCOPUS, from December 2019 to December 2022. In total, 62 out of 1356 articles were selected and organized into three time periods: short-term (1-4 months), medium-term (5-8 months), and long-term (9-12 months), according to the time in which the tests were performed. Regardless of the time period, most studies showed a general worsening in cognitive performance in people with neurological conditions due to COVID-19 lockdown measures and in healthy individuals recovered from COVID-19 infection. Our review is the first to highlight the importance of considering standardized tests as reliable measures to quantify the presence of cognitive deficits due to COVID-19. Indeed, we believe that they provide an objective measure of the cognitive difficulties encountered in the different populations, while allowing clinicians to plan rehabilitation treatments that can be of great help to many patients who still, nowadays, experience post-COVID-19 symptoms.
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Affiliation(s)
- Alessio Manfredini
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | - Francesca Pisano
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
| | | | - Paola Marangolo
- Department of Humanities Studies, University Federico II, 80133 Naples, Italy
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Kumaria A, Noah A, Kirkman MA. Does covid-19 impair endogenous neurogenesis? J Clin Neurosci 2022; 105:79-85. [PMID: 36113246 DOI: 10.1016/j.jocn.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/14/2022] [Accepted: 09/03/2022] [Indexed: 10/31/2022]
Abstract
Endogenous neural stem cells are thought to continue to generate new neurons throughout life in the human brain. Endogenous neurogenesis has been proposed to contribute to physiological roles in maintaining and regenerating olfaction, as well as promoting normal cognition, learning and memory. Specific impairments in these processes in COVID-19 - impaired olfaction and cognition - may implicate the SARS-CoV-2 virus in attenuating neurogenesis. Furthermore, neurogenesis has been linked with neuroregeneration; and impaired neuroregeneration has previously been linked with neurodegenerative diseases. Emerging evidence supports an association between COVID-19 infection and accelerated neurodegeneration. Also, structural changes indicating global reduction in brain size and specific reduction in the size of limbic structures - including orbitofrontal cortex, olfactory cortex and parahippocampal gyrus - as a result of SARS-CoV-2 infection have been demonstrated. This paper proposes the hypothesis that SARS-CoV-2 infection may impair endogenous neural stem cell activity. An attenuation of neurogenesis may contribute to reduction in brain size and/or neurodegenerative processes following SARS-CoV-2 infection. Furthermore, as neural stem cells are thought to be the cell of origin in glioma, better understanding of SARS-CoV-2 interaction with tumorigenic stem cells is indicated, with a view to informing therapeutic modulation. The subacute and chronic implications of attenuated endogenous neurogenesis are explored in the context of long COVID. Modulating endogenous neurogenesis may be a novel therapeutic strategy to address specific neurological manifestations of COVID-19 and potential applicability in tumour virotherapy.
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Affiliation(s)
- Ashwin Kumaria
- Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Abiodun Noah
- Anaesthesia and Critical Care, Academic Unit of Injury, Inflammation and Recovery Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Matthew A Kirkman
- Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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