COVID-19 Supplement to LitCog IV: Health Literacy and Cognitive Function Among Older Adults

我们正在寻求对我们正在进行的研究(LitCog；R01AG030611)的补充，以便进行两个平行的、 新冠肺炎对老年人生活方式行为长期影响的补充调查， 心理和生理功能、社会经济环境、医疗保健使用、获得和遵守 治疗和健康结果。首先，我们将扩大目前的调查范围，以确定LitCog是否 认知障碍的参与者在获得护理和管理方面面临着更大的挑战 新冠肺炎导致的个人健康状况与认知能力“正常”的成年人相比。这样的自然实验是可能的 LitCog；自2007年以来，我们跟踪了认知能力的下降，以及认知障碍的开始，以及 由此对不同社区居住的老年人的慢性病自我管理产生影响。我们 将利用我们最近的续订奖励，从活跃患者(N=776)、涉及护理人员的数据中捕获数据 (n=100)、电子健康(EHR)和药房记录，并每4次增加5次电话采访 几个月来实现以下主要目标： 目的1调查新冠肺炎暴发前认知功能较差或轻度认知障碍是否 与医疗保健服务使用不足和/或健康状况较差有关。 其次，我们还将扩大我们与LitCog相关的芝加哥新冠肺炎合并症(C3)队列研究。在三月份 2020年，随着新冠肺炎病例在芝加哥不断涌现，我们的团队迅速做出反应，发起了一项调查 了解患有慢性病的老年人，患新冠肺炎并发症的风险更高 应对并采取行动(或不采取行动)以防止感染和疾病传播。LitCog参与者(n=153)，AS 以及在其他四项活动研究(N=673)中登记的患者，并对大量患者进行统一的数据收集 因素和类似的访问电子病历和药房记录被招募。采访是在 芝加哥新冠肺炎暴发阶段(3月13日至20日)、快速加速期(3月27日至4月3日)和高峰 阶段(5月1日至19日)。我们的发现显示，许多高危成年人缺乏新冠肺炎症状的关键知识 而预防伤害的方法，感觉不会受到病毒的影响，感觉对疫情毫无准备，不是社会性的 疏远或确保他们有足够的处方药供应。差距显露；黑人 那些生活在贫困线以下、健康素养较低、认知能力较差的成年人准备得较少。搬家 在未来，C3队列也将作为AIM 1中的LitCog队列进行跟踪，使我们能够合并这两个队列 更直接地调查新冠肺炎带来的压力对人们健康和行为的长期影响 患有慢性病的成年人。我们的次要目标是： 目的2考察成年人在新冠肺炎上感受到的压力及其与生活方式和自我的关系 随着时间的推移，管理行为、医疗保健使用、患者报告和临床结果。

We are seeking a supplement to our ongoing study (‘LitCog’; R01AG030611) in order to conduct two parallel, complementary investigations of the longer-term impact of COVID-19 on older adults’ lifestyle behaviors, psychological & physical function, socioeconomic circumstances, healthcare use, access & adherence to treatment, and health outcomes. First, we will extend our current inquiries to now determine whether LitCog participants with cognitive impairment are experiencing greater challenges in accessing care and managing personal health due to COVID-19 compared to cognitively ‘normal’ adults. Such a natural experiment is possible with LitCog; since 2007 we have tracked declines in cognition, as well as onset of cognitive impairment, and the resulting impact on self-management of chronic conditions among diverse, community dwelling, older adults. We will leverage our recent renewal award, with data capture from active patients (N=776), involved caregivers (N=100), electronic health (EHR) and pharmacy records, and add 5 telephone interviews conducted every 4 months to address the following primary aim: Aim 1 Investigate whether poorer cognitive function or MCI prior to the COVID-19 outbreak is associated with inadequate use of healthcare services and/or poorer health status. Second, we will also extend our LitCog-linked, Chicago COVID-19 Comorbidities (C3) cohort study. In March 2020, as cases of COVID-19 were emerging in Chicago, our team rapidly responded by launching a survey to understand how older adults with chronic conditions, at greater risk for COVID-19 complications, were responding and taking action (or not) to prevent infection and disease spread. LitCog participants (n=153), as well as patients enrolled in four other active studies (N=673) with uniform data collection for a large set of patient factors and similar access to EHR and pharmacy records were recruited. Interviews were conducted during Chicago’s COVID-19 outbreak phase (March 13-20), rapid acceleration phase (March 27-April 3), and apex phase (May 1-19). Our findings revealed many high risk adults lacked critical knowledge of COVID-19 symptoms and ways to prevent harm, did not feel susceptible to the virus, felt unprepared for the outbreak, were not social distancing or ensuring they had adequate supplies of prescribed medications. Disparities were revealed; black adults, those living below poverty level, with low health literacy and poorer cognition were less prepared. Moving forward, the C3 cohort will also be followed as the LitCog cohort in Aim 1, allowing us to combine both cohorts and more directly investigate the longer-term impact of stress due to COVID-19 on the health and behaviors of adults with chronic conditions. Our secondary aim is to: Aim 2 Examine adults’ perceived stress from COVID-19 and its associations with lifestyle & self- management behaviors, healthcare use, patient-reported and clinical outcomes over time.