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: 10680522
• 负责人: ABRAHAM REICHENBERG
• 金额: $ 64.44万
• 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/10680522
• 关键词: Acceleration; 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; Elderly; Environment; Ethnic Origin; Ethnic Population; Europe; Exhibits; General Population; Goals; Government; Health; Individual; Life; Loneliness; Longevity; Measures; Medical; Medical Records; Mental Depression; Natural experiment; Outcome; Participant; Patients; Pattern; Phenotype; Physically Challenged; Physicians; Premature Mortality; Preventive; Process; Psychotic Disorders; Race; Research; Resources; Risk; Risk Factors; Risk Reduction; 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; medical examination; middle age; mortality; neuropsychiatry; physical conditioning; physical inactivity; poor health outcome; post-pandemic; premature; prevent; racial population; 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.

项目总结 被诊断为精神分裂症和相关精神障碍(SZ)的个体的风险显著增加 与一般人口相比，过早死亡的寿命短10-20年。死亡率上升 深圳的发病率很大程度上归因于通常发生在#年后期的医疗状况的早期表现。 生命，一个被称为“加速衰老”的过程。而不健康的生活方式行为，如吸烟和不健康 饮食在一定程度上是深圳加速衰老的原因，不能完全归因于身体合并症的过度 这些因素。值得注意的是，SZ的主要临床特征对健康的直接不利影响很少 被考虑过了。众所周知，在普通人群中，缺乏社会联系会带来巨大的挑战。 对于身体健康，特别是在较年长的年龄。鉴于社交孤立是一种持久且令人无法接受的特征 SZ，这一行为可能是导致SZ健康状况过早显现的原因之一。 建立在丰富的试点数据基础上，指出社会孤立和长期感知之间的显著关联 在深圳的健康，我们的首要目标是测试社会孤立是否以及如何有助于健康 随着年龄的增长，SZ患者面临的挑战。参与者来自欧洲(EU-GEI)和美国(OLINE 神经精神病学研究中心)，我们将创建包含650名参与者的纵向数据库，其中包括500名参与者 患有SZ的个人及其150名未受影响的兄弟姐妹。我们将通过重新设计来应用加速纵向设计 评估并通过检查研究参与者的医疗记录，这些参与者在 30-50岁，现在50-65岁，这是一个许多疾病和健康问题的时期 倾向于显露。我们将确定与年龄相关的社交隔离和不良健康之间的联系 在SZ的结果，测试熟悉度、方向性和调节这种联系的因素，并确定 新冠肺炎疫情和随之而来的封锁对深圳健康的影响程度。我们会 考虑跨国家、性别和种族/民族的概括性。建议进行这项研究的理由 是为了促进急需的靶向治疗以防止深圳的早期死亡，我们需要更好地 了解导致深圳医疗合并症过多的因素。我们的中心假设是 社交隔离是深圳常见且持久的特征，也是导致身体过度紧张的原因之一 深圳的合并症。为实现总体目标，我们将追求以下目标：(1)确定协会 社会隔离与深圳地区不良健康后果之间的关系；(2)定向测验和调节 在深圳，社会隔离与健康结果之间的联系；以及；。(3)研究 在深圳，新冠肺炎大流行改变了社会隔离与健康结果之间的关联。这项研究将 在深圳率先全面考察社会隔离对健康的影响。该项目可能会显示出 在深圳，中年的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深圳的早期死亡率。