Measurement of Cognitive Function in Older Adults with Sensory Loss

摘要 NIA R21 AG 060243的这一紧急竞争修订版是对NOT-AG-20-022的回应，旨在检查 2019冠状病毒（COVID-19）临床结果和COVID-19大流行对医疗保健的影响 残疾老年人的利用，包括那些有感觉障碍和阿尔茨海默病的老年人 和阿尔茨海默病相关痴呆（AD/ADRD）。虽然数据显示，COVID-19 不成比例地影响养老院人口，迫切的问题仍然是COVID-19如何 影响了老年残疾人的医疗保健结果和利用率， 应对工作中的差距未得到解决。这项工作是父项目的扩展，重点是 评估老年人的ADRD和感觉障碍，并利用独特的数据资源， 来自约翰霍普金斯医学研究所急诊科（艾德）的电子健康记录（EHR）信息 患者（巴尔的摩/华盛顿地区的5个地点）与约翰霍普金斯COVID-19的数据 精准医学分析平台注册（JH-CROWN）。目标1将检验我们的假设， 残疾人更有可能患有严重的COVID-19疾病，使用世界卫生组织的评分进行评估 组织（WHO）COVID-19疾病严重程度量表，并比较患者之间的COVID-19结果 65岁及以上的残疾患者和65岁以下的患者。次要结局将包括医院 入院率和住院死亡率，以及按性别、种族和残疾检查COVID-19结果 类型.目标2将调查COVID-19大流行对残疾患者医疗保健利用的影响 状态和年龄，并检验假设：（1）患者的艾德就诊率（非COVID相关）较低 2020年1月1日至2020年12月31日期间的残疾人;（2）可预防的住院治疗 使用AHRQ指标确定的患病率在大流行期间残疾患者中较高;以及 (3)在大流行期间，艾德就诊率较低，可预防的住院率较高[1月1日至12月 2020年12月31日，在残疾人中，分析将检查潜在的相互作用 年龄和残疾状况之间的差异，并比较健康调整后的分层结果。这项工作填补了一个紧迫的 COVID-19应对措施的差距，因为有关该流行病对医疗保健影响的数据仍然有限 for elderly老年adults成人with disabilities残疾.

ABSTRACT This urgent competing revision of NIA R21AG060243 is in response to NOT-AG-20-022 and aims to examine 2019 coronavirus (COVID-19) clinical outcomes and the impact of the COVID-19 pandemic on healthcare utilization for older adults with disabilities, including those with sensory impairments and Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD). While data indicate that COVID-19 has disproportionately affected nursing home populations, urgent questions remain about how COVID-19 has impacted healthcare outcomes and utilization for older adults with disabilities, leaving an urgent, yet unaddressed, gap in response efforts. This work is an extension of the parent project that focuses on assessing ADRD and sensory impairments among older adults and leverages a unique data resource linking electronic health record (EHR) information from Johns Hopkins Medical Institute Emergency Department (ED) patients (across 5 locations in the Baltimore/Washington, DC area) to data from the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry (JH-CROWN). Aim 1 will test our hypotheses that patients with disabilities are more likely to have severe COVID-19 disease, assessed using scores on the World Health Organization (WHO) COVID-19 disease severity scale, and compare COVID-19 outcomes between patients with disability who are 65 years and older to patients under 65 years. Secondary outcomes will include hospital admission and in-hospital mortality, as well as examine COVID-19 outcomes by gender, race, and disability type. Aim 2 will investigate the impact of the COVID-19 pandemic on health care utilization by patient disability status and age, and testing hypotheses that: (1) ED visit rates (non-COVID related) are lower among patients with disabilities during the COVID-19 pandemic [Jan 1, 2020 to Dec 31, 2020]; (2) preventable hospitalization rates, determined using AHRQ metrics, are higher among patients with disabilities during the pandemic; and (3) ED visit rates are lower and preventable hospitalization rates are higher during the pandemic [Jan 1 to Dec 31, 2020] then in the year prior among patients with disabilities. Analyses will examine potential interactions between age and disability status and compare results across health-adjusted strata. This work fills an urgent gap in the COVID-19 response, as there remains limited data on the healthcare implications of the pandemic for older adults with disabilities.