Cognitive and Emotional Resilience to the COVID-19 pandemic among older adults at risk for Alzheimer's disease

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ABSTRACT The COVID-19 pandemic disproportionately affects older adults, not only because they are at increased risk for severe illness from SARS-CoV-2 infection, but also because they have to socially distance more strictly to keep themselves safe. Age is a well-known risk factor for Alzheimer’s disease and related dementias; however, both COVID-19 infection and lack of social support may further increase the risk for cognitive decline and accelerate the onset of Alzheimer’s disease in already vulnerable older adults. Although many studies focus on risk factors for Alzheimer’s disease and cognitive decline, few explore resilience. This supplement will examine cognitive and emotional resilience to the COVID-19 pandemic, as a function of genetic and social factors, among older adults at risk for Alzheimer’s disease and related dementias. The LonGenity study at Einstein is composed of a unique longitudinal cohort of older adults who have been followed with annual neurocognitive testing for a median of 9 years and who are genetically enriched for resilience to Alzheimer’s disease because half of them are offspring of centenarians. We propose to test the hypothesis that cognitive and emotional resilience to the stress of social distancing and to SARS-CoV-2 infection will be observed in older adults who are genetically resilient to Alzheimer’s disease and who have robust social support. We will apply epidemiologic and genetic approaches to: (1) Determine the effect of genetic and social factors on cognitive and emotional resilience in older adults subjected to the social distancing requirement; and (2) Determine the effect of genetic and social factors on resilience to Alzheimer’s disease and related dementias and cognitive decline post COVID-19 infection in older adults. Genetic factors that will be considered include parental history of longevity and attenuated function of the somatotropic pathway as measured by the genetic somatotropic score, as both parental longevity and reduced somatotropic signaling have been associated with resilience to Alzheimer’s disease and are evaluated in the parent grant. Social contributors include social support and network measures prior to and during the period of the pandemic. Questionnaire and antibody test for exposure to SARS-CoV-2 virus will identify LonGenity subjects who contracted SARS-CoV-2 infection. We will continue to follow the LonGenity participants with annual neurocognitive testing as described in the parent grant to determine the long-term impact of social distancing and COVID-19 on cognitive decline and resilience to Alzheimer’s disease and related dementias in this group. In addition, in a subgroup of individuals, we will conduct neurocognitive testing during the social distancing period to evaluate the acute impact of social distancing on cognitive function and emotional health. The proposal has the potential to determine whether inherited resilience factors, such as parental longevity or favorable genetic somatotropic score, and modifiable resilience factors, such as robust social network and support, may mitigate the negative impact of social distancing and SARS-CoV-2 infection on Alzheimer’s disease and related dementias, cognitive functioning, and emotional well-being in older adults.