Millions are still living with the effects of Long COVID and new research shows that for older adults, the consequences may be profound and lasting.

In part one of a special two-part series on “Conversations on Health Care,” Dr. Gabriel de Erausquin, a neurologist and leading Long COVID researcher at the University of Texas Health San Antonio, shares groundbreaking findings from his global study of over 3,500 patients. His work reveals a troubling connection: many Long COVID patients over 60 show cognitive decline that mirrors early signs of dementia.

“The parts of the brain that are affected by COVID overlap significantly with those that are affected early in the course of Alzheimer’s….the changes overlap, but they are not identical.”

His team is now studying brain imaging and biomarkers to understand the link between COVID-related cognitive decline and traditional neurodegenerative diseases like Alzheimer’s disease.

Dr. de Erausquin also explains how persistent loss of smell — a hallmark COVID symptom — may be the strongest predictor of ongoing cognitive issues, and how genetic sequencing is helping uncover inherited risk.

He highlights a dual reality: while many Long COVID patients show biological changes, others had prior diagnoses of depression, anxiety, or chronic fatigue — a nuance often missing from public conversations.

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