For many months, I’ve been getting anxious texts and pulled aside in conversations by friends who are worried about their memory or ability to focus, or who want to talk about a parent who is suddenly declining cognitively. Because I work in cognitive health, they’ve turned to me with a terrifying question: “Ever since I had Covid-19, I feel like my memory isn’t as sharp. I thought it was Covid brain fog but do I have signs of Alzheimer’s?” If you’re one of nearly 20% of Americans still experiencing long Covid symptoms after a Covid infection, you may be worrying whether these symptoms will ever go away and what this means for the long term ability.
Unfortunately, my friends’ fears are all too valid. Two bombshell studies quantify the cause for concern: A study of more than six million people aged 65-85 who were infected with Covid-19 showed a 50%-80% higher risk of developing Alzheimer’s Disease within a year of getting infected. Second, people aged 45-65, have shown an 18% increase in the incidence of Alzheimer’s. Traditionally, the high-risk threshold for Alzheimer’s has been 65; the increasing rates of diagnosis in younger people are unsettling. While researchers are relatively sure that Covid-19 doesn’t cause Alzheimer’s, they suspect it may speed its onset in people who are at high risk or in the early stages of the disease at the time of infection.
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Covid-19 in the general population can cause a range of symptoms, such as difficulty thinking, feeling mentally slow, confused, or forgetful — the so-called “brain fog.” The Lancet Psychiatry published a study of more than a million patients with Covid-19 which found an increased risk for neurological conditions even after two years, creating concern that the symptoms may be permanent.
With the FDA’s recent approval of Leqembi, which, in clinical trials, showed hopeful results for slowing cognitive decline in people with early stage Alzheimer’s, further interest has spiked for brain health and what can be done to preserve it. While Leqembi may provide hope for certain people it comes with complexity and some safety concerns that will make prescribing it at scale difficult.
For millions of families like my own, an Alzheimer’s diagnosis and the painful decline of a loved one were characterized by helplessness and a frustrated desire to take action. Medical science seemed to offer nothing to combat this death sentence. For children of people with Alzheimer’s, the haunting disease contributed to its own sense of hereditary destiny — a sense that “it’s coming for me” — with every small moment of forgetfulness interpreted as a sign of illness.
However, as the impact of Covid-19 lingers, the growing distress has a silver lining: it is creating a need, and a willingness, to talk about Alzheimer’s. What is finally becoming more mainstream is the understanding that brain health is health, like heart health or diabetes health, and while persistent cognitive symptoms are scary, there are actions you can take today to help in the short term and protect your long-term brain health.
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Here’s what I’m telling my friends: First, knowledge is power; get tested. Second, there’s a lot you can do — starting now — to reduce your risk.
There have been breakthroughs in digital diagnostic technology for assessing cognitive health. New evidenced-based digital tools are replacing the former pen-and-pencil method, making it faster and easier for your primary care physician to test your cognitive health in the office. That’s a major advancement if you want to know about your brain health.
To reduce the risk of dementia including Alzheimer’s, changing your habits can save your health. By some estimates, lifestyle — activity, diet, sleep, exercise, environment — impacts at least 70 percent of people’s risk for chronic disease, and a flood of studies show correlations between lifestyle factors and cognitive health. To start, ask yourself five questions:
- Do you exercise regularly? It doesn’t need to be much. Stretching, balance and range-of-motion exercises may work as well as aerobics to fight cognitive decline. Lifting those weights sitting in your garage can also strengthen your cognitive health. Weightlifting at least twice a week has been shown to improve cognition and function in older adults
- Do you still cook with canola or vegetable oil? It’s time to stock your cupboard with olive oil. Regular consumption of extra virgin olive oil has been shown to be protective and improve cognitive function.
- How much alcohol and sugar do you consume? I love a glass of wine with dinner, but what makes me feel good may be harming my cognitive health. Consumption of more than one drink a day has been linked to increased iron levels in the brain that may contribute to cognitive decline.
- How is your sleep? Do you sleep eight hours a night? Is your sleep interrupted? Turn off the TV, your phone, your laptop and get to bed. The relationship between inadequate sleep and cognitive decline is clear. Your brain needs regular, restful sleep to reduce the risk of long-term decline.
- How much stress do you have? This is a tough one to change, but it’s vital. Consistent stress can elevate cortisol levels that contribute to cognitive decline. Exercise (#1) and sleep (#4) will help reduce your stress, too.
Just as we’re learning more about the possible causes of Alzheimer’s, we also understand more clearly how to mitigate the disease progression. Finding out you may be at higher risk for dementia in your 40s or 50s is terrifying, but it is also empowering.
We may not fully understand the link between Covid-19 and Alzheimer’s, but we already have the scientific research and tools to address people’s fears, support their cognitive health journey, and reverse the increase of Alzheimer’s. Precise assessment and healthy habits can lower dementia risk. Not only do I have encouraging answers for my friends, you’ve got the same opportunity to help yourself.
Photo: Andreus, Getty Images
Elli Kaplan is co-founder and CEO of Neurotrack, a digital health company on a mission to transform the diagnosis and management of dementia and Alzheimer's disease.
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