The impact of social isolation on aging health in schizophrenia

社会隔离对精神分裂症老年健康的影响

• 批准号: 10522303
• 负责人: ABRAHAM REICHENBERG
• 金额: $ 76.41万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10522303
• 关键词: Age; Age-Years; Aging; Antipsychotic Agents; Behavior; Biological Markers; Body mass index; COVID-19; COVID-19 pandemic; Characteristics; Clinical; Cognition; Country; Data; Depressed mood; Diagnosis; Diet; Disease; Ethnic Origin; Ethnic group; Europe; Exhibits; General Population; Goals; Government; Health; Individual; Institutes; Life; Loneliness; Longevity; Measures; Medical; Medical Records; Mental Depression; Natural experiment; Outcome; Participant; Patients; Pattern; Phenotype; Physicians; Premature Mortality; Preventive; Process; Psychotic Disorders; Race; Research; Resources; Risk; Risk Factors; Schizophrenia; Severity of illness; Siblings; Smoke; Smoking; Social Network; Social isolation; Socialization; Stress; Subgroup; Symptoms; Testing; Time; Unhealthy Diet; Vulnerable Populations; Work; age related; cohort; comorbidity; coronavirus disease; design; digital; follow-up; health data; health difference; human old age (65+); longitudinal database; longitudinal design; middle age; mortality; neuropsychiatry; pandemic disease; physical conditioning; physical inactivity; premature; prevent; racial and ethnic; secondary analysis; sex; social contact; symptomatology; targeted treatment; unhealthy lifestyle

PROJECT SUMMARY Individuals diagnosed with schizophrenia and related psychotic disorders (SZ) exhibit a markedly elevated risk of premature mortality, with a 10–20-year shorter lifespan relative to the general population. Increased mortality rates in SZ are largely attributable to the early manifestation of medical conditions that normally occur later in life, a process known as ‘accelerated aging’. While unhealthy lifestyle behaviors, such as smoking and unhealthy diet, account, in part, for accelerated aging in SZ, the excess of physical comorbidities cannot be solely attributed to these factors. Remarkably, the direct adverse health effects of key clinical characteristics of SZ have rarely been considered. In the general population, the absence of social contact is known to pose enormous challenges for physical health, especially at older ages. Given that social isolation is a persistent and disabling feature of SZ, it is possible that this behavior may contribute to the premature manifestation of health conditions in SZ. Building on rich pilot data pointing to significant associations between social isolation and long-term perceived health in SZ, our overarching goal is to test whether and how social isolation contributes to the health challenges of individuals with SZ as they age. With participants from Europe (EU-GEI) and the US (Olin Neuropsychiatry Research Center), we will create a longitudinal database of 650 participants, including 500 individuals with SZ, and 150 of their unaffected siblings. We will apply an accelerated longitudinal design by re- assessing and by examining medical records of research participants who were first evaluated between the ages of 30-50 and are now 50-65 years of age, a period when many medical conditions and health problems tend to manifest. We will determine the age-related association between social isolation and adverse health outcomes in SZ, test for familiality, directionality, and factors moderating this association, and determine the extent to which the COVID-19 pandemic and the resulting imposed lockdowns impacted health in SZ. We will consider generalizability across countries, sexes, and race/ethnicities. The rationale for the proposed research is that in order to facilitate much-needed targeted therapies to prevent early mortality in SZ, we need to better understand factors that contribute to the excess of medical comorbidities in SZ. Our central hypothesis is that social isolation, a common and persistent characteristic of SZ, contributes to the excess of physical comorbidities in SZ. To meet our overall goal, we will pursue the following aims: (1) Determine the association between social isolation and adverse health outcomes in SZ; (2) Test for the directionality, and moderating factors, of the association between social isolation and health outcomes in SZ, and; (3) Examine whether the COVID-19 pandemic modified associations between social isolation and health outcome in SZ. This study will be the first to comprehensively examine the health impact of social isolation in SZ. The project may show that in SZ socialization in midlife can reduce the risk for poor health outcomes and ultimately facilitate much-needed preventive targeted therapies to reduce early-age mortality in SZ.

项目摘要 被诊断为精神分裂症和相关精神障碍（SZ）的个体表现出明显升高的风险， 过早死亡率高，寿命比一般人群短10 - 20年。死亡率增加 深圳的发病率在很大程度上归因于通常发生在晚期的医疗状况的早期表现， 这是一个被称为“加速老化”的过程。而不健康的生活方式行为，如吸烟和不健康的 饮食，部分原因是SZ加速老化，不能仅仅归因于过多的身体合并症 这些因素。值得注意的是，SZ的主要临床特征的直接不良健康影响很少 被考虑。在一般人群中，缺乏社会接触是众所周知的巨大挑战 身体健康，尤其是老年人。鉴于社会孤立是一个持久的和残疾的特点， 深圳，这种行为可能会导致深圳健康状况的过早表现。 基于丰富的试点数据，这些数据表明社会孤立与长期感知之间存在显著关联， 在深圳的健康，我们的首要目标是测试是否以及如何社会隔离有助于健康 随着年龄的增长，SZ患者面临的挑战。来自欧洲（EU-GEI）和美国（Olin）的参与者 神经精神病学研究中心），我们将创建一个包含650名参与者的纵向数据库， SZ患者和150名未受影响的兄弟姐妹。我们将采用加速纵向设计， 评估和检查研究参与者的医疗记录，这些参与者在两次评估之间首次接受评估。 年龄在30 - 50岁之间，现在是50 - 65岁，这一时期许多医疗条件和健康问题 倾向于显现。我们将确定社会孤立和不良健康之间的年龄相关性 SZ的结果，测试熟悉性，方向性和调节这种关联的因素，并确定 2019冠状病毒病大流行及其导致的封城措施对深圳健康的影响程度。我们将 考虑国家、性别和种族/民族之间的普遍性。拟议研究的理由 为了促进急需的靶向治疗，以防止SZ的早期死亡，我们需要更好地 了解导致SZ医疗合并症过多的因素。我们的核心假设是， 社会隔离是深圳的一个普遍而持久的特征， SZ的合并症。为了实现我们的总体目标，我们将追求以下目标：（1）确定协会 社会隔离与深圳市不良健康结果之间的关系;（2）方向性检验， 因素，社会隔离和深圳的健康结果之间的关联，和;（3）检查是否 2019冠状病毒病大流行改变了深圳社会隔离与健康结果之间的关联。本研究将 率先全面研究深圳社会隔离对健康的影响。该项目可能表明， 在深圳，中年社会化可以降低健康状况不佳的风险，并最终促进急需的 预防性靶向治疗，以降低SZ的早期死亡率。