In the short term, sepsis can injure patients’ lungs and kidneys, trigger problems with blood clotting and cause the liver and other organs to fail. But in the long term, patients who overcome sepsis may face other health issues. Particularly, sepsis survivors are more likely to develop long-term changes in learning and memory, and they may show signs of dementia earlier and to a more severe degree.
Scientists don’t yet grasp the intricacies of the relationship between sepsis and dementia. Candice Brown, an assistant professor in West Virginia University’s School of Medicine and Rockefeller Neuroscience Institute, is studying that relationship in order to bring about insights that help prevent or mitigate the neurological impact of sepsis.
Brown, who is also a member of the WVU Center for Basic and Translational Stroke Research and the WVU Department of Microbiology, Immunology and Cell Biology, is investigating how sepsis and dementia interact with each other on a cellular and molecular level, potentially making both diseases’ symptoms more intense and their onset premature.
“There are two key issues: Sepsis can increase the age of onset and severity of dementia, but does dementia increase the onset of sepsis? Are patients becoming septic because their brain function is impaired and, therefore, other systems aren’t working properly, or does sepsis cause cognitive impairment? It’s like a chicken and egg scenario. We don’t know, but we know the outcomes are not favorable. Few researchers or clinicians have addressed this long-term neurological outcome,” Brown said.
She is concerned that as Baby Boomers get older, sepsis and dementia will converge with greater frequency because the risk for both disorders increases with age. The effect could be especially pronounced in West Virginia, which has the third-highest concentration of seniors in the country. The prevalence of diabetes, cardiovascular disease and stroke among West Virginians may also amplify the problem: All three conditions make individuals more susceptible to sepsis.
“Most people normally would develop some type of dementia by their 80s or 90s, but the onset of sepsis in their 50s and 60s could accelerate the process so that dementia develops in their 60s and 70s instead. That’s an additional public health issue we may need to address,” Brown said.
The country’s growing opioid epidemic may exacerbate the problem. More young people are developing sepsis infections due to opioid-induced heart inflammation and soft-tissue infections at injection sites.
“If we’re thinking about this effect on neurological function that starts in your 20s or 30s, imagine what the long-term effects are going to be. It’s kind of this downward spiral,” Brown said.
The pilot studies that formed the basis of Brown’s current project were funded by the National Institutes of Health, the West Virginia Clinical and Translational Science Institute and the WVU Department of Emergency Medicine. WVU’s Initiation to Research Opportunities summer research program, part of the WVU Office of Graduate Research and Education, funded first-year medical students’ involvement with the project.
WVU’s Initiation to Research Opportunities summer research program, mutually funded by the Health Sciences Center Vice President’s Office and the Office of Research and Graduate Education, supported first-year medical students’ involvement with this project.