The evidence that viruses attacking the nervous system promote Alzheimer's disease is pretty well established. Think herpes, the virus causing cold sores and shingles. We've discussed this here before and also in Beating the Dementia Monster. But what about viruses that don't directly attack the nervous system ... like covid? There's interesting and troubling news on this front.
In research recently published in Nature Medicine, "Plasma proteomic evidence for increased β-amyloid pathology after SARS-CoV-2 infection," researchers examined a cohort of 1,252 people who had been infected with covid-19. This was in the UK, and the researchers had access to previous blood test results for Alzheimer's biomarkers for these individuals. So, for these people, and a for similar cohort of people who had not been infected (a control group), they compared biomarker evidence for Alzheimer's. Test participants ranged in age from 46 to 80 years of age. Many of those infected had mild cases, but some had infections serious enough to have been hospitalized.
What did they find?
People who had serious infections, especially serious enough to be hospitalized, showed increased biomarker evidence of Alzheimer's pathology. They also did less well on cognitive and memory tests. The specific biomarker they measured was the ratio of two forms of beta amyloid peptide that signal the disease. The researchers estimated that a serious covid infection was the equivalent of a four-year advance of the disease.
The age of the participants was a factor -- the older, the more vulnerable -- but the presence of high blood pressure was also a factor.
In Beating the Dementia Monster, we discussed the production of a form of beta amyloid that is water soluble and of one that is not. Both are produced in everyone. The one that is soluble dissolves innocuously, but the one that is not soluble clumps on to nerve cells and apparently kills them. Measuring the ratio of these two forms in fluid from a spinal tap or from a blood sample provides strong indication as to whether or not the Alzheimer's pathology is progressing. So this is what the researchers measured.
Covid-19 is not known to attack nerve cells directly, but it does precipitate "cytokine storms" -- inflammation. (We discussed this back in 2020.) Inflammation and oxidation are two fundamental environmental factors in promotion of the disease. The genetic promoters, notably the APOE4 gene, seem to work by creating an inflammatory environment in the brain. No one seems to be claiming this with certainty, but it seems likely that any infection that causes inflammation in the brain can promote Alzheimer's. While it's not yet well understood, there are ways in which inflammation outside the brain can sometimes cross the blood-brain barrier and cause inflammation inside the brain. So a covid infection in the lungs may precipitate a cytokine storm and cause inflammation in the brain.
The good news is that the varieties of covid now in circulation are not causing the severe disease that covid was causing a few years ago. Nevertheless, many of us recovered from serious infections a few years ago and may now be more vulnerable to developing Alzheimer's disease.