Cognitive rehabilitation therapy may help older adults clear COVID-19-related brain fog

Medical centres in the US have started referring older patients with long COVID-19-related symptoms for cognitive rehabilitation in order to combat ‘brain fog’.

According to the Centers for Disease Control and Prevention (CDCP), around 1 in 4 older adults who survive COVID-19 have at least one persistent symptom, including problems with attention, language, information processing, memory, and visual-spatial orientation.

Emerging evidence also shows that older people are more likely to experience ‘brain fog’ post-COVID-19 than younger people. This is thought to be because older people tend to have additional medical conditions, with cognitive challenges being a result of small blood clots, chronic inflammation, abnormal immune responses, viral persistence, brain injuries, and neurodegeneration caused by COVID-19.

Faith Gunning, a neuropsychologist at Weill Cornell Medicine (WCM), and her colleagues reported that 81% of the 57 of recovering COVID-19 patients who were referred for neuropsychological evaluation before their hospital discharge had cognitive impairment.

Cognitive rehabilitation is therapy usually used for patients whose brains have been injured due to concussions, traumatic brain injury (TBI), strokes, or neurodegenerative conditions such as Parkinson’s disease. Services can include speech and occupational therapists, neuropsychologists, and neurorehabilitation experts.

However, even simple exercises such as tapping a finger on a table once or twice, then repeating it multiple times, can help improve attention. This is known as restorative cognitive rehabilitation.

“It isn’t easy because it’s so monotonous and someone can easily lose attentional focus. But it’s a kind of muscle building for the brain,’ says Joe Giacino, a Professor of Physical Medicine and Rehabilitation at Harvard Medical School.

Once a patient is comfortable with that, a therapist might ask them to do two things at once, such as repeat the tapping while answering questions. “Now the brain has to split attention — a much more demanding task — and you’re building connections…” Giacino furthered.

James Spargo