What the latest science tells us about treatment, prevention, and the impact of COVID-19 on the brain.
When Dr. Maria Carrillo was a graduate student in neuroscience at Northwestern University, she spent hours with her eye to a microscope, looking into the brains of laboratory rats. What she witnessed was astonishing.
“I realized that what I was seeing was a memory being biologically encoded,” she says. “I was watching nerve cells talk to each other.”
But when she and the research team looked at the brains of aging rats, they saw a dramatic difference. New memories didn’t “stick.” They were somehow vulnerable to quick erasure in a way that older memories weren’t.
Why? This is the question that drives dementia research. And it has driven Dr. Carrillo all her professional life.
As Chief Science Officer for the Alzheimer’s Association, Dr. Carrillo’s job is to set the strategic vision for the global research program of the organization, which is the world’s largest nonprofit funder of Alzheimer’s research. In 2020, this meant quickly ramping up a study on the long-term neurological and cognitive impacts of COVID-19.
“We will look at data from 25 different countries, which will give us information on every patient who tests positive for COVID-19, so that we can see what neurological symptoms are still occurring a year later,” Dr. Carrillo says. “People have seen neurological impacts from a COVID-19 infection. There’s something that’s impacting the brain.”
Symptoms include “delirium, headaches, dizziness and memory loss, and there are reports that these don’t resolve as quickly as the virus resolves itself.” She adds that the infection also infiltrates inflammatory cells. “Unless we start studying this today, we’re not going to be able to get results,” says Dr. Carillo.
Dr. Carrillo also voiced her concerns about how the pandemic has isolated people living with dementia. Without the positive stimuli of visitors, they’re at risk of more rapid cognitive decline. She has been a leader in urging long-term care facilities to find ways for people to maintain connections with their loved ones.
Under Dr. Carrillo, the Alzheimer’s Association is launching the U.S. POINTER study, a $100 million, five-site initiative inspired by a groundbreaking study that began in Finland. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was the first randomized controlled trial to show that it is possible to prevent cognitive decline through multi-pronged lifestyle modifications, in particular physical and cognitive exercise, changes in diet (more fresh vegetables, fruits, and lean proteins, and fewer saturated fats and sugars) and monitoring of cardiovascular risk factors. The FINGER trial interventions reduced cognitive decline in participants by 30 percent. Now known as the WW-FINGERS Network, “this has turned into a global movement,” Dr. Carrillo says. “There are now 20 countries that are launching studies like this.” The Alzheimer’s Association has just added POINTER sites in 13 Latin American countries.
The POINTER study fits with the association’s ongoing research focus on what Dr. Carrillo calls middle age risk factors: midlife waist circumference, blood pressure, cholesterol, and smoking. The goal is to “create a recipe” for people in middle age and beyond that will give us all the power to decrease our own risk factors for cognitive decline by making changes in our daily lives. The POINTER study is expected to provide confirmation of what researchers have long believed—what’s good for your heart is good for your brain.
Possible Drug Treatments
The Alzheimer’s Association is also a major funder of drug research, including studies of Biogen’s Aducanumab, the first disease-modifying Alzheimer’s treatment to be considered by the United States Food and Drug Administration. Though the FDA has asked for another Phase 3 trial, which will delay access to Aducanumab for up to four years, Dr. Carrillo sees this type of drug as part of a future in which lifestyle changes plus medication could make Alzheime