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Objectives. Among people over the age of 65, the prevalence of olfactory disorders can reach nearly 14%. The buildup of beta-amyloid plaques and tau neurofibrillary tangles in neurons in the hippocampus and entorhinal cortex causes olfactory dysfunction, a decline in memory and learning processes, and, eventually, Alzheimer's disease. According to current research, people aged 57 to 85 who have hyposmia are twice as likely to develop dementia within five years as people of the same age who do not have hyposmia. Anosmia is one of the most common COVID-19 symptoms. Methodology. An 81-year-old female patient is referred to the psychiatry clinic by her family physician after presenting with a two-year history of panic attacks, anxiety, and anosmia following the SARS-CoV-2 infection. At the first visit, the patient was examined neurologically, psychiatrically, and neurocognitively with the Mini-Mental State Examination-2 and Cognitive Reserve Questionnaire. The patient was recommended for laboratory tests, magnetic resonance imaging scan, and a complex neuropsychological evaluation. Results. The score on the Mini-Mental State Examination-2 (standard version) was 28/30, with fluent language, high cognitive reserve (score of 168), normal muscle tone and strength, and no evidence of cerebellar dysfunction or balance impairment with a normal gait. The extensive neuropsychological evaluation scores were: Mini-Mental State Examination-2 (extended version) 42/90; three words from 25 retained from short story recall; Montreal Cognitive Assessment 20/30; poor verbal fluency (patient was able to produce only six animal names and one word that starts with the letter F in one minute); and impaired visuospatial and executive abilities. Brain imaging results reveal moderate cortical atrophy, cerebral microangiopathy modifications with leukoaraiosis, and cerebral lacunarism. Conclusions. Olfactory impairment is a possible sign of prodromal dementia. Infection with the SARS-Cov-2 virus has worsened cognitive decline in patients with Alzheimer's disease. |
