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

项目概要/摘要 随着SARS-CoV-2病毒和相关的冠状病毒疾病19（COVID-19）于2009年抵达美国， 2020年3月，日常生活发生了巨大的变化。社交距离（SD）和就地庇护（SIP）， 虽然在抗击COVID-19方面至关重要，但也为人们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老年人， 痴呆（ADRD）。许多居住在社区的老年人社会化程度降低， 孤立和孤独的感觉，这两种感觉在许多研究中都被证明会导致不利的影响。 成果。对于此补充申请，“COVID-19导致的社会隔离和孤独：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系统， 项目：子项目1将研究与COVID-19相关的孤独感对认知、身体和心理的影响。 选择性手术后成功老化（SAGES I）研究中的心理健康（NIA资助P01 AG 031720，PI Inouye），这是一项正在进行的前瞻性队列研究，研究对象为315名平均年龄为84岁的老年人， 在选择性重大非心脏手术后进行了一系列认知，身体和功能 措施我们将使用这个特征良好的队列来（1）检查孤独感的潜在预测因素， 从社会距离，（2）检查孤独对认知功能的影响，在人与不 MCI或ADRD，以及（3）检查孤独感对患有和 没有MCI或ADRD。我们假设，由于SARS-CoV-2大流行，SIP订单将增加 老年人的孤独感，以及那些预先存在MCI和ADRD的人，孤独感将与 与没有MCI和ADRD的人相比，认知，身体和心理健康的下降幅度更大。在 除了既定的年度访视外，所有SAGES随访参与者将接受额外的电话访视 本项目的访谈，两次在研究开始时，两次在6个月后。采访将包括 孤独感、社交网络规模、社交和身体活动、技术使用、先前存在的 认知和功能或行动障碍、认知、焦虑、抑郁和COVID-19感染，或 exposure.住院、医疗访视、福尔斯、疗养院安置、新处方药使用，以及 死亡将被确定。子项目2将允许我们将研究程序转换为远程评估 协调和验证SAGES神经心理学评估 通过电话、视频会议和面对面模式进行管理。这项研究将产生统计数据， 比较我们的方法来检查随着时间的推移认知轨迹的分数。意义：本研究 将使我们能够评估与COVID-19相关的孤独感对认知、身体和心理健康的影响， 老年人和MCI或ADRD患者。此外，这项研究将使我们能够调整我们的研究程序， 在COVID-19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.