Social Isolation and Loneliness due to COVID-19: Effect on Cognitive, Physical, and Mental Health in Older Adults in the SAGES Study

项目摘要/摘要 年，随着SARS-CoV-2病毒和相关的冠状病毒病19号(新冠肺炎)抵达美国 2020年3月，日常生活发生了非同寻常的变化。社交距离(SD)和就地避难(SIP)， 虽然在对抗新冠肺炎的斗争中至关重要，但它们为老年人的健康和福祉带来了独特的挑战 老年人，特别是患有轻度认知障碍(MCI)和阿尔茨海默病及相关疾病的人 痴呆症(ADRD)。对于许多居住在社区的老年人来说，社会化程度的下降导致了 孤独感和孤独感，许多研究表明，这两种感觉都会导致不利的 结果。对于这份补充申请，《新冠肺炎引发的社会孤立和孤独：对 老年人的认知、身体和心理健康在SAGES研究中，我们提出了两个相关的子项 项目：子项目1将考察新冠肺炎相关孤独对认知、身体和心理健康的影响 择期手术后成功老龄患者的心理健康(SAGES I)研究(NIA Grant P01 AG031720，Pi. 正在进行的前瞻性队列研究对315名平均年龄为84岁的老年人进行了研究， 在择期大型非心脏手术后进行了一系列认知、身体和功能方面的随访 措施。我们将利用这个特征良好的队列来(1)检验导致孤独的潜在预测因素 从社会距离来看，(2)考察了孤独对有孤独和无孤独的人认知功能的影响 MCI或ADRD，以及(3)检查孤独对患有和 没有MCI或ADRD。我们假设由于SARS-CoV-2大流行导致的SIP订单将增加 老年人的孤独感，以及那些先前存在MCI和ADRD的人，孤独感将与 与那些没有MCI和ADRD的人相比，他们在认知、身体和精神健康方面的下降更大。在……里面 除了他们既定的年度访问，所有圣人后续参与者将接受额外的电话 为这个项目进行了两次访谈，两次在研究开始时，两次在6个月后。采访内容将包括 衡量孤独感、社交网络规模、社交和体力活动、技术使用、预先存在 认知和功能或行动能力障碍、认知、焦虑、抑郁和新冠肺炎感染或 曝光。住院、就诊、跌倒、养老院安置、新的处方药使用以及 死亡将会被决定。子项目2将允许我们将研究程序转换为远程评估 在新冠肺炎期间；协调和验证SAGES神经心理评估 通过电话、视频会议和面对面模式进行管理。这项研究将在统计上产生 在我们的方法中检查认知轨迹随时间变化的可比分数。意义：这项研究 使我们能够评估新冠肺炎相关孤独对认知、身体和心理健康的影响 老年人和患有MCI或ADRD的人。此外，这项研究将使我们能够调整我们的研究程序 在新冠肺炎期间进行远程评估，并通过电话和面对面模式交叉验证我们的远程评估。

PROJECT SUMMARY/ABSTRACT With the arrival of the SARS-CoV-2 virus and associated Coronavirus Disease 19 (COVID-19) to the U.S. in March 2020 came an extraordinary shift in daily living. Social distancing (SD) and sheltering in place (SIP), while essential in the fight against COVID-19, have created unique challenges for the health and well-being of older adults, and in particular those with mild cognitive impairment (MCI) and Alzheimer’s disease and related dementia (ADRD). Decreased socialization for many community-dwelling older adults has led to increased feelings of isolation and loneliness, both of which has been shown in numerous studies to lead to adverse outcomes. For this supplement application, “Social Isolation and Loneliness due to COVID-19: Effect on Cognitive, Physical, and Mental Health in Older Adults in the SAGES Study, we propose two related sub- projects: Sub-Project 1 will examine the effects of COVID-19 related loneliness on cognitive, physical, and mental health in the Successful Aging After Elective Surgery (SAGES I) Study (NIA grant P01 AG031720, PI Inouye), an ongoing prospective cohort study of 315 older adults with an average age of 84 years old, who have been followed after elective major non-cardiac surgery with serial cognitive, physical and functional measures. We will use this well-characterized cohort to (1) Examine potential predictors of loneliness resulting from social distancing, (2) Examine the effect of loneliness on cognitive function in persons with and without MCI or ADRD, and (3) Examine the effect of loneliness on physical and mental health in persons with and without MCI or ADRD. We hypothesize that the SIP order due to the SARS-CoV-2 pandemic will increase loneliness in older adults, and for those with pre-existing MCI and ADRD, loneliness will be associated with greater declines in cognitive, physical and mental health compared to those without MCI and ADRD. In addition to their established annual visit, all SAGES follow-up participants will undergo extra telephone interviews for this project, two at the start of the study and two 6 months later. The interview will include measures of loneliness, social network size, social and physical activities, technology use, pre-existing cognitive and functional or mobility impairment, cognition, anxiety, depression, and COVID-19 infection or exposure. Hospitalizations, medical visits, falls, nursing home placement, new prescription medication use, and death will be determined. Sub-Project 2 will allow us to convert study procedures to remote assessments during the time of COVID-19; and to harmonize and validate the SAGES neuropsychological assessment administered via telephone, videoconferencing, and in-person modes. This study will generate statistically comparable scores across our approaches to examine cognitive trajectories over time. Significance: This study will allow us to evaluate the effect of COVID-19 related loneliness on cognitive, physical, and mental health in older adults and in those with MCI or ADRD. Moreover, this study will allow us to adapt our study procedures to remote during COVID-19 and to cross-validate our remote assessment with phone and in-person modes.