Education, socioeconomic status and Aging: transitions from multimorbidity to functional limitations and mortality

项目摘要 冠状病毒病2019年(新冠肺炎)，由严重急性呼吸综合征冠状病毒2引起 (SARS-CoV-2)于2020年3月11日被世界卫生组织宣布为大流行。 许多受新冠肺炎疫情影响的国家发现，他们的医疗服务在2008年不堪重负 过去几个月因重症患者需要住院治疗。过去的几个月里 新冠肺炎的流行导致了大量的出版物。我们确定了以下三个主要领域 尚未开发，是当前项目的重点。1)重型肝炎危险因素识别研究 新冠肺炎(住院或死亡)是基于住院时评估的一组有限的风险因素， 主要是在单变量分析中。新冠肺炎主要是一种呼吸道疾病，它会对人造成严重破坏 肾脏、肝脏、心脏、大脑，也许还有身体的其他器官系统。这种影响在很大程度上很难 确定没有人员以前的职能地位。3)尽管ADRD是最常见的 新冠肺炎死亡中的共病这两种疾病之间的交集尚不清楚。 我们的目的是通过增加一个纵向组成部分来研究新冠肺炎的风险因素，以增加现有的知识 及其对老龄化的影响。这个项目的三个目标解决了文献中的重大空白。目标1 将使用多种风险构建不良新冠肺炎(住院或死亡)的风险评分 各种因素。进一步的分析将检验这些在ADRD/认知型患者中是否不同 减损。AIM 2将量化新冠肺炎对肺、心血管、肾脏、 在拟议的白厅新冠肺炎分研究中对2000名参与者的身体和认知功能，以及 评估这些变化在ADRD/认知障碍患者中是否被放大。目标3将 比较患有和不患有不良反应/认知障碍患者的严重新冠肺炎(住院率和死亡率) 减损。载脂蛋白E基因和危险因素(社会行为、生物)对这些的解释作用 我们将考察不同之处。这一目标的另一个组成部分是审查新冠肺炎的作用 (住院和死亡率)在有认知障碍和无认知障碍的人中过渡到ADRD 疫情前的认知障碍

Project Summary Corona virus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared to be a pandemic on 11th of March, 2020 by the World Health Organization. Many countries affected by COVID-19 epidemic have found their health care services overwhelmed in the past few months due to need for hospitalization in people with severe disease. The last few months of the COVID-19 epidemic have led to a large number of publications. We identify three broad areas that remain unexplored and are the focus of the current project. 1) Research on identification of risk factors for severe COVID-19 (hospitalization or death) being based on a limited set of risk factor assessed at hospitalization, primarily in univariate analyses. 2) COVID-19 is primarily a respiratory disease; it can wreak havoc on the kidneys, liver, heart, brain, and perhaps other organ systems in the body. Much of this impact is difficult to ascertain for the lack of previous functional status of persons. 3) Although ADRD is the most common comorbidity in COVID-19 deaths the intersection between these two diseases is unclear. We aim to add to current knowledge by adding a longitudinal component to study risk factors for COVID-19 and its consequences on ageing. The three aims of this project address crucial gaps in the literature. Aim 1 will construct a risk score for adverse COVID-19 (hospitalization or mortality) using a wide array of risk factors. Further analyses will examine whether these are different in those with ADRD/cognitive impairment. Aim 2 will quantify the impact of COVID-19 and its severity on lung, cardiovascular, kidney, physical and cognitive function in the proposed Whitehall COVID-19 sub-study on 2000 participants, and assess whether these changes are magnified in persons with ADRD/cognitive impairment. Aim 3 will compare severe COVID-19 (hospitalization and mortality) in those with and without ADRD/cognitive impairment. The role of APOE genotype and risk factors (social behavioral, biologic) to explain these differences will be examined. A further component of this aim is to examine the role of COVID-19 (hospitalization and mortality) in transitions to ADRD in those with cognitive impairment and those free of cognitive impairment before the epidemic