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

项目摘要 2019冠状病毒病（COVID-19），由严重急性呼吸系统综合征冠状病毒2型引起 （SARS-CoV-2）于2020年3月11日被世界卫生组织宣布为大流行病。 许多受COVID-19疫情影响的国家发现， 在过去的几个月里，由于患有严重疾病的人需要住院。最后几个月的 COVID-19疫情导致大量出版物。我们确定了三大领域， 未开发，是当前项目的重点。1)重症急性胰腺炎危险因素识别研究 COVID-19（住院或死亡）基于住院时评估的有限风险因素， 主要是单变量分析。2)COVID-19主要是一种呼吸道疾病;它可以对 肾脏、肝脏、心脏、大脑，或许还有身体中的其他器官系统。这种影响很难 确定以前的人缺乏功能状态。3)虽然ADRD是最常见的 在COVID-19死亡中，这两种疾病之间的交叉点尚不清楚。 我们的目标是通过增加纵向成分来研究COVID-19的风险因素，从而增加现有知识 及其对老龄化的影响。该项目的三个目标是解决文献中的关键空白。要求1 将使用各种风险构建不利COVID-19（住院或死亡）的风险评分 因素进一步的分析将检查这些在ADRD/认知障碍患者中是否不同。 损伤目标2将量化COVID-19及其严重程度对肺、心血管、肾脏、 在白厅COVID-19子研究中对2000名参与者进行的身体和认知功能研究，以及 评估这些变化是否在ADRD/认知障碍患者中被放大。目标3将 比较有和没有ADRD/认知障碍的患者中的严重COVID-19（住院和死亡率） 损伤APOE基因型和危险因素（社会行为，生物）的作用，以解释这些 将审查差异。这一目标的另一个组成部分是研究COVID-19的作用 （住院和死亡率）在认知障碍患者和无认知障碍患者中向ADRD过渡的情况 疫情前认知障碍

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