Social Connectedness and Social Isolation in Nursing Home Residents

疗养院居民的社会联系和社会孤立

• 批准号: 10414934
• 负责人: Kate L Lapane
• 金额: $ 86.07万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-06-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10414934
• 关键词: Address; Adult; Affect; Aggressive behavior; Aging; Alzheimer' s disease related dementia; Anxiety; Area; Attenuated; Behavioral Symptoms; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 pandemic effects; Caring; Cessation of life; Characteristics; Cognitive; Communication; Communities; Coupled; Crowding; Data; Data Set; Data Sources; Dementia; Development; Elderly; Eligibility Determination; Emotional; Environment; Evaluation; Evolution; Facial Expression; Funding; Goals; Health; Healthcare Systems; Heart Diseases; Home; Hospitalization; Hypertension; Impaired cognition; Individual; Intervention; Lead; Link; Loneliness; Long-Term Effects; Longitudinal Studies; Measures; Medicare; Mental Depression; National Institute on Aging; Natural experiment; Nursing Homes; Outcome; PF4 Gene; Pattern; Personal Satisfaction; Persons; Pharmaceutical Preparations; Physical Function; Policies; Population; Posture; Process; Quality of Care; Research; Risk; Social Network; Social isolation; Socialization; Societies; Strategic Planning; Stroke; Testing; Underserved Population; United States; United States National Institutes of Health; Work; advanced analytics; base; contagion; contextual factors; design; experience; functional status; indexing; knowledge base; loved ones; neglect; novel; nursing home length of stay; pandemic disease; pandemic preparedness; racial and ethnic; segregation; social; social vulnerability; virtual

This proposal is responsive to PAR-19-373 and the National Institute on Aging Strategic Plan Goals B and C. Social connectedness, the relationship people have with others, contributes to thriving in nursing homes. Loneliness is prevalent in nursing homes, and more so in residents with Alzheimer’s disease and related dementias (ADRD). In the community, loneliness spreads through a contagious process. Nursing homes provide congregate living for older adults where such spread of loneliness has not been studied. The proposed R01 explores the longitudinal evolution of lack of social connectedness throughout the nursing home stay, describes the interdependence of social isolation and lack of social connectedness within congregate living environments, and identify individual and contextual factors that exacerbate or attenuate its spread. Understanding who is at risk for lack of social connectedness and the health consequences of “being alone in a crowd” will inform interventions to address this important determinant of health and well-being in nursing home residents. The importance of this R01 is underscored by the impact of the COVID-19 pandemic on nursing home residents. Necessary policies introduced unprecedented social disruption to nursing homes (e.g., no visitors, residents restricted to their rooms), coupled with devastating COVID-19 illnesses and deaths leaving no resident, loved one, or nursing home staff unaffected. The horrific COVID-19 “natural experiment” allows the study of the downstream ripple effects of the policies to contain COVID-19 in nursing homes on social isolation and connectedness. The proposed R01 builds from our novel NIH-funded work to develop and test indices of social connectedness and social isolation using the Minimum Data Set 3.0 (MDS). We leverage an in-house longitudinal national MDS-based data source (2011-2018, extended to 2021) which includes area-based and facility characteristics, COVID-19 related data (e.g., policies, cases, deaths), and Medicare eligibility and claims data. These data enable the evaluation of deaths, hospitalizations and other validated outcomes. Our specific aims are to: 1) Extend our social connectedness/isolation MDS measure development and testing to residents without ADRD; 2) Evaluate the “natural course” of social connectedness in nursing homes and identify individual and contextual factors that modulate its spread; 3) Quantify the effect of social connectedness and isolation on health outcomes and evaluate factors that moderate its impact; 4) Estimate the impact of the pandemic on the lack of social connectedness in nursing home residents and the corresponding ripple effects of lack of social connectedness on resident health and well-being; 5) Identify characteristics of nursing homes that altered the impact of COVID-19 on the lack of social connectedness and its associated health effects among residents. The project develops a knowledge base regarding the broader impact of social isolation and COVID-19 on outcomes in nursing homes. The research will inform policies for the care of a rapidly growing segment of an aging society and guidance nursing home pandemic preparedness.

该提案对19-373帕尔和美国国家衰老战略计划目标B和C的响应有反应。 人们与他人之间的关系，社会联系，有助于在护士之家中繁荣发展。 孤独感在护士之家中普遍存在，而在患有阿尔茨海默氏病及相关居民的居民中也是如此 痴呆症（ADRD）。在社区中，孤独感通过传染性过程传播。疗养院提供 在尚未研究这种孤独的老年人的生活中。拟议的R01 描述 社会隔离和在聚集生活环境中缺乏社会联系的相互依存关系， 并确定加剧或减弱其传播的个人和上下文因素。了解谁在 缺乏社会联系的风险和“独自在人群中”的健康后果将告知 干预措施以解决护士居民中健康和福祉的重要决定者。 这款R01的重要性是由Covid-19的大流行对护士居民的影响强调的。 必要的政策引入了护士房屋前所未有的社会干扰（例如，没有访客，居民 仅限于他们的房间），再加上毁灭性的共同疾病和死亡，没有居民，被爱 一个或护士家庭工作人员不受影响。可怕的Covid-19“自然实验”允许研究 政策的下游连锁反应在护士房屋中包含共同隔离和社会隔离和 连接。拟议的R01是根据我们新颖的NIH资助的作品建立的，以发展和测试社会索引 使用最小数据集3.0（MDS）的连接性和社会隔离。我们利用内部 基于纵向国家MDS的纵向数据来源（2011- 2018年，扩展到2021年），其中包括基于区域的和 设施特征，COVID-19相关数据（例如政策，案件，死亡）以及Medicare资格和索赔 数据。这些数据可以评估死亡，住院和其他经过验证的结果。我们的具体 目的是：1）扩展我们的社会联系/隔离性MDS测量和测试向居民 没有adrd; 2）评估护士家庭中社会联系的“自然过程”并确定个人 以及调节其传播的上下文因素； 3）量化社会联系和孤立对 健康结果并评估适度其影响的因素； 4）估计大流行对 护士居民缺乏社交联系以及缺乏社会的相应连锁反应 与居民健康和福祉的联系； 5）确定改变的护士房屋的特征 Covid-19对居民缺乏社会联系及其相关的健康影响的影响。 项目建立了有关社会隔离和COVID-19对结果的广泛影响的知识基础 在护士房屋中。该研究将为政策提供依据，以照顾一个衰老社会的快速增长 和指导护士家庭大流行准备。