“Neurocovid”: An Analysis of the Impact of Covid-19 on the Older Adults. Evolving Psychological and Neuropsychological Understanding

When SARS-CoV-2 began to spread, older adults experienced disproportionately greater adverse effects from the pandemic, including exacerbation of pre-existing physical and cognitive frailty conditions. More severe complications, higher mortality, and concerns about disruptions to their daily routines and access to care. Knowledge about the impact of COVID-19 on the brain is rapidly accumulating and this is reflected in the increasing use of the term “neurocovid”. Co-involvement of the central and peripheral nervous system had already been observed in SARS patients, but COVID-19 seems to invade it with greater affinity than other coronaviruses. This chapter provides an overview of the expanding understanding of the multiple ways in which COVID-19 affects the human brain, discuss the likelihood of long-term sequelae of neurocovid, and their implications for cognitive functions and behaviors in the elderly.

COVID-19, the Brain, and the Future: Is Infection by the Novel Coronavirus a Harbinger of Neurodegeneration?

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527321666211222162811 ◽

2021 ◽

Vol 21 ◽

Author(s):

Adejoke Onaolapo ◽

Olakunle Onaolapo

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Severe Acute Respiratory Syndrome ◽

Neurodegenerative Diseases ◽

Central Nervous System Involvement ◽

The Novel ◽

Novel Coronavirus ◽

The Impact ◽

: The possible impact of viral infections on the development or pathogenesis of neurodegenerative disorders remains largely unknown. However, there have been reports associating the influenza virus pandemic and long-term infection with the Japanese encephalitis virus with the development of post-encephalitic Parkinsonism or von Economo encephalitis. In the last one year plus, there has been a worldwide pandemic arising from infection with the novel coronavirus or severe acute respiratory syndrome coronavirus (SARS-CoV)-2 which causes a severe acute respiratory syndrome that has become associated with central nervous system symptoms or complications. Its possible central nervous system involvement is in line with emerging scientific evidence which shows that the human respiratory coronaviruses can enter the brain, infect neural cells, persist in the brain, and cause activation of myelin-reactive T cells. Currently, there is a dearth of scientific information on the acute or possible long-term impact of infection with SARS-CoV-2 on the development of dementias and/or neurodegenerative diseases. This is not unrelated to the fact that the virus is ‘new’, and its effects on humans are still being studied. This narrative review examines extant literature for the impact of corona virus infections on the brain; as it considers the possibility that coronavirus disease 2019 (COVID-19) could increase the risk for the development of neurodegenerative diseases or hasten their progression.

Effects of Long-Term Exposure to L-Band High-Power Microwave on the Brain Function of Male Mice

BioMed Research International ◽

10.1155/2021/2237370 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Yanyun Lin ◽

Peng Gao ◽

Yichen Guo ◽

Qin Chen ◽

Haiyang Lang ◽

...

Keyword(s):

Nervous System ◽

Power Density ◽

High Power ◽

Brain Function ◽

High Power Microwave ◽

L Band ◽

The Impact ◽

The Brain ◽

Power Microwave

Currently, the impact of electromagnetic field (EMF) exposure on the nervous system is an increasingly arousing public concern. The present study was designed to explore the effects of continuous long-term exposure to L-band high-power microwave (L-HPM) on brain function and related mechanisms. Forty-eight male Institute of Cancer Research (ICR) mice were exposed to L-HPM at various power densities (0.5, 1.0, and 1.5 W/m2) and the brain function was examined at different time periods after exposure. The morphology of the brain was examined by hematoxylin-eosin (HE) and deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. Furthermore, cholinergic markers, oxidative stress markers, and the expression of c-fos were evaluated to identify a “potential” mechanism. The results showed that exposure to L-HPM at 1.5 W/m2 can cause generalized injuries in the hippocampus (CA1 and CA3) and cerebral cortex (the first somatosensory cortex) of mice, including cell apoptosis, cholinergic dysfunction, and oxidative damage. Moreover, the deleterious effects were closely related to the power density and exposure time, indicating that long-term and high-power density exposure may be detrimental to the nervous system.

Neuroimmune multi-hit perspective of coronaviral infection

Journal of Neuroinflammation ◽

10.1186/s12974-021-02282-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Shawn Hayley ◽

Hongyu Sun

Keyword(s):

The Elderly ◽

Inflammatory Factors ◽

Psychological Stressors ◽

Global Pandemic ◽

Microbial Infections ◽

Neuronal Processes ◽

To Come ◽

The Impact ◽

AbstractIt is well accepted that environmental stressors experienced over a one’s life, from microbial infections to chemical toxicants to even psychological stressors, ultimately shape central nervous system (CNS) functioning but can also contribute to its eventual breakdown. The severity, timing and type of such environmental “hits”, woven together with genetic factors, likely determine what CNS outcomes become apparent. This focused review assesses the current COVID-19 pandemic through the lens of a multi-hit framework and disuses how the SARS-COV-2 virus (causative agent) might impact the brain and potentially interact with other environmental insults. What the long-term consequences of SAR2 COV-2 upon neuronal processes is yet unclear, but emerging evidence is suggesting the possibility of microglial or other inflammatory factors as potentially contributing to neurodegenerative illnesses. Finally, it is critical to consider the impact of the virus in the context of the substantial psychosocial stress that has been associated with the global pandemic. Indeed, the loneliness, fear to the future and loss of social support alone has exerted a massive impact upon individuals, especially the vulnerable very young and the elderly. The substantial upswing in depression, anxiety and eating disorders is evidence of this and in the years to come, this might be matched by a similar spike in dementia, as well as motor and cognitive neurodegenerative diseases.

The Geriatric Medication Game to Raise Community Pharmacists’ Awareness on Older Adults’ Day-to-Day Challenges

Saudi Journal of Health Systems Research ◽

10.1159/000516346 ◽

2021 ◽

pp. 1-6

Author(s):

Aisha F. Badr

Keyword(s):

Older Adults ◽

Saudi Arabia ◽

Learning Process ◽

Community Pharmacists ◽

The Elderly ◽

Learning Activity ◽

Simulation Games ◽

Self Reflection ◽

Satisfaction Rate ◽

Introduction: In Saudi Arabia; it is estimated that the elderly (aged 60 and above) would reach up to (22.9%) by 2050, compared to (5.6%) in 2017. Simulation games have proven to be a useful and effective method of education in pharmacy schools, as it actively involves participants in the learning process. The objective of this study was to examine the impact of the modified geriatric medication game on community pharmacists’ awareness and attitudes toward older adults with common disabilities. Methods: A modified geriatric medication game was adopted to stimulate both physical and sensory disabilities in older adults. A total of 9 community pharmacists were gathered in 1 room and were asked to play 2 scenarios each. Self-reflection was assessed and ground theories were analyzed. Results: All pharmacists felt frustration and anger playing the game (100%), followed by becoming more aware of the extra time and guidance needed with older adults and realized how disabling chronic diseases could be, and felt they needed to improve common perceived attitude towards the elderly (88.89%). Pharmacists also felt empathy, sympathy, and compassion towards this population, needed improvement of common perceived attitude towards older adults, and felt the need to double check with older adults if they have any disabilities before counseling (77.78%). Finally, over half pharmacists (55.5%) wished they had more training on geriatrics during pharmacy school and the need for further review of Beer’s criteria. All pharmacists were satisfied with the game and recommended it to all community pharmacists. Conclusion: Simulation games are a great way to strengthen awareness and change practice accordingly. Pharmacists improved their awareness and attitude towards the elderly and reported a positive perceived value of this learning activity; with a 100% satisfaction rate. Adding a geriatric course with simulation component is recommended for better geriatric care.

Health risk assessment and countermeasure analysis of the elderly population exposed to PM2.5 microenvironment

Work ◽

10.3233/wor-205361 ◽

2021 ◽

pp. 1-11

Author(s):

Yan Xu ◽

Wantian Cui

Keyword(s):

Mental Health ◽

Health Risk ◽

Elderly Population ◽

Mental Health Problems ◽

Negative Impact ◽

The Elderly ◽

Exposure Concentration ◽

Physical Diseases ◽

BACKGROUND: China’s atmospheric PM2.5 pollution is serious, and PM2.5 exerts a negative impact on the human respiratory system, cardiovascular, and mental health, and even more serious health risk for the elderly with weak immunity. OBJECTIVE: This work aims to analyse the impacts of PM2.5 microenvironment exposure on the health of the elderly and provide corresponding countermeasures. METHODS: The survey subjects are 118 retired elderly people in the community. PM2.5 exposure concentrations are monitored in summer (June 10 ∼ July 10, 2019) and winter (November 25 ∼ December 25, 2019). RESULTS: The exposure concentration in winter is higher than that in summer, with statistical difference (P < 0.05). Under the impact of PM2.5 microenvironment exposure, smoking in the elderly can increase the concentration of PM2.5, and long-term exposure to PM2.5 in the elderly can cause mental health problems. CONCLUSION: Long-term exposure of the elderly to the PM2.5 microenvironment leads to physical diseases and even psychological problems, which requires attention.

Impact of Frailty on Medical and Long-Term Care Expenditures for the Elderly Age 75 or Over in Japan

Innovation in Aging ◽

10.1093/geroni/igaa057.569 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 176-176

Author(s):

Hiroto Yoshida ◽

Yuriko Kihara

Keyword(s):

Long Term Care ◽

The Elderly ◽

Elderly Age ◽

Term Care ◽

Intentional Weight Loss ◽

Long Term Care Insurance ◽

And Gender ◽

Abstract This study examined the impact of frailty on medical and long-term care expenditures in an older Japanese population. The subjects were those aged 75 years and over who responded to the survey (March 2018) in Bibai, Hokkaido, Japan (n=1,203) and have never received certification of long-term care insurance at the survey. We followed up 867 individuals (72.1%) until the end of December 2018 (10 month-period). We defined frailty as a state in performing 4 items and over of 15 items which were composed of un-intentional weight loss, history of falls, etc. Among 867 subjects, 233 subjects (26.9%) were judged to be frailty group, and 634 subjects (73.1%) non-frailty group. We compared period to the new certification of long-term care insurance (LTCI), accumulated medical and long-term care expenditures adjusted for age and gender between the two groups during the follow-up period. Cox proportional hazard models were used to examine the association between baseline frailty and the new certification of LTCI. The relative hazard ratio (HR) was higher in frailty group than non-frailty group (HR=3.51, 95% CI：1.30-9.45, P=.013). The adjusted mean accumulated medical and long-term care expenditures per capita during the follow-up were significantly (P=.002) larger for those in the frailty group (629,699 yen), while those in the non-frailty group were 450,995 yen. We confirmed strong economic impact of frailty in the elderly aged 75 or over in Japan.

The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.2148 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 629-629

Author(s):

Silke Metzelthin ◽

Sandra Zwakhalen ◽

Barbara Resnick

Keyword(s):

Older Adults ◽

The Netherlands ◽

Home Care ◽

Acute Care ◽

Long Term Care ◽

Functional Decline ◽

Term Care ◽

The Us ◽

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

Use of Music Therapy as an Audiological Rehabilitation Tool in the Elderly Population: A Mini-Review

Frontiers in Neuroscience ◽

10.3389/fnins.2021.662087 ◽

2021 ◽

Vol 15 ◽

Author(s):

Anne Sophie Grenier ◽

Louise Lafontaine ◽

Andréanne Sharp

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Music Therapy ◽

Cognitive Decline ◽

Social Participation ◽

Cognitive Abilities ◽

Elderly Population ◽

Vestibular Function ◽

The Elderly ◽

It is well known and documented that sensory perception decreases with age. In the elderly population, hearing loss and reduced vestibular function are among the most prevalently affected senses. Two important side effects of sensory deprivation are cognitive decline and decrease in social participation. Hearing loss, vestibular function impairment, and cognitive decline all lead to a decrease in social participation. Altogether, these problems have a great impact on the quality of life of the elderly. This is why a rehabilitation program covering all of these aspects would therefore be useful for clinicians. It is well known that long-term music training can lead to cortical plasticity. Behavioral improvements have been measured for cognitive abilities and sensory modalities (auditory, motor, tactile, and visual) in healthy young adults. Based on these findings, it is possible to wonder if this kind of multisensory training would be an interesting therapy to not only improve communication but also help with posture and balance, cognitive abilities, and social participation. The aim of this review is to assess and validate the impact of music therapy in the context of hearing rehabilitation in older adults. Musical therapy seems to have a positive impact on auditory perception, posture and balance, social integration, and cognition. While the benefits seem obvious, the evidence in the literature is scarce. However, there is no reason not to recommend the use of music therapy as an adjunct to audiological rehabilitation in the elderly when possible. Further investigations are needed to conclude on the extent of the benefits that music therapy could bring to older adults. More data are needed to confirm which hearing abilities can be improved based on the many characteristics of hearing loss. There is also a need to provide a clear protocol for clinicians on how this therapy should be administered to offer the greatest possible benefits.

The Causes and Long-Term Consequences of Viral Encephalitis

Frontiers in Cellular Neuroscience ◽

10.3389/fncel.2021.755875 ◽

2021 ◽

Vol 15 ◽

Author(s):

Karen Bohmwald ◽

Catalina A. Andrade ◽

Nicolás M. S. Gálvez ◽

Valentina P. Mora ◽

José T. Muñoz ◽

...

Keyword(s):

Viral Encephalitis ◽

Viral Infections ◽

Immune Cell ◽

Clinical Symptoms ◽

Brain Inflammation ◽

High Morbidity ◽

Stiff Neck ◽

The Impact ◽

Reports regarding brain inflammation, known as encephalitis, have shown an increasing frequency during the past years. Encephalitis is a relevant concern to public health due to its high morbidity and mortality. Infectious or autoimmune diseases are the most common cause of encephalitis. The clinical symptoms of this pathology can vary depending on the brain zone affected, with mild ones such as fever, headache, confusion, and stiff neck, or severe ones, such as seizures, weakness, hallucinations, and coma, among others. Encephalitis can affect individuals of all ages, but it is frequently observed in pediatric and elderly populations, and the most common causes are viral infections. Several viral agents have been described to induce encephalitis, such as arboviruses, rhabdoviruses, enteroviruses, herpesviruses, retroviruses, orthomyxoviruses, orthopneumovirus, and coronaviruses, among others. Once a neurotropic virus reaches the brain parenchyma, the resident cells such as neurons, astrocytes, and microglia, can be infected, promoting the secretion of pro-inflammatory molecules and the subsequent immune cell infiltration that leads to brain damage. After resolving the viral infection, the local immune response can remain active, contributing to long-term neuropsychiatric disorders, neurocognitive impairment, and degenerative diseases. In this article, we will discuss how viruses can reach the brain, the impact of viral encephalitis on brain function, and we will focus especially on the neurocognitive sequelae reported even after viral clearance.

A three-step model of stress management for health leaders

Healthcare Management Forum ◽

10.1177/0840470417751157 ◽

2018 ◽

Vol 31 (3) ◽

pp. 81-86

Author(s):

Elizabeth Hartney

Keyword(s):

Nervous System ◽

Stress Management ◽

Healthcare System ◽

Stressful Environment ◽

Step Model ◽

System Functioning ◽

Managing Stress ◽

The Individual ◽

The Impact ◽

The current healthcare system is often as highly stressful environment for patients, their families, and for the employees of the system. Health leaders also experience stress, which can have profound repercussions if not well managed. This article describes the impact of stress on the brain and nervous system functioning of health leaders, then, drawing on evidence from the literature, presents a three-step model for managing stress at the individual, team/organizational, and system levels.