Consequences of social isolation during the COVID-19 pandemic in older adults with and without Alzheimer's disease

COVID-19 大流行期间社交隔离对患有和不患有阿尔茨海默病的老年人的影响

• 批准号: 10585667
• 负责人: Andrew Budson
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585667
• 关键词: Address; Adult; Affect; Alzheimer' s Disease; Alzheimer' s disease risk; Anxiety; Behavior; Belief; COVID-19 pandemic; COVID-19 pandemic effects; Cessation of life; Cognition; Cognitive; Cognitive Science; Complex; Data; Dementia; Elderly; Environment; Feeling; Future; Goals; Grant; Guidelines; Health; Hippocampus; Home; Impaired cognition; Individual; Light; Loneliness; Measures; Memory Loss; Mental Depression; Misinformation; Modernization; Moods; Neighborhoods; Neuropsychological Tests; Outcome; Participant; Personality; Personality Character; Persons; Procedures; Prospective Studies; Psyche structure; Questionnaires; Recommendation; Reporting; Research; Resources; Sampling; Security; Shapes; Social Behavior; Social Distance; Social isolation; Social support; Stereotyping; Surveys; Techniques; Testing; Time; United States; Variant; Veterans; behavior change; built environment; cognitive function; cognitive testing; coping; coronavirus disease; dementia risk; design; effective intervention; emotional factor; experience; follow-up; human old age (65+); improved; long term consequences of COVID-19; mild cognitive impairment; military veteran; neuroinflammation; pandemic disease; pandemic response; physical conditioning; protective effect; psychosocial; recruit; social cognition; social contact; social factors; social relationships; time interval; video chat

The COVID-19 pandemic has caused over half a million deaths in the United States alone. Even for those individuals whose physical health and financial security have not been impacted, the consequences of pandemic-induced isolation on mental and cognitive health may be far-reaching— especially for our Veterans. Prior to the pandemic, approximately 10% of older Veterans reported feeling lonely often and 40% indicated feeling lonely some of the time. Due to social distancing guidelines and other measures that limit social contact, loneliness during the pandemic has likely been far greater than these estimates. Decades of research have supported the protective effect of social relationships on cognition in older adulthood; thus, the disruption of social support related to the pandemic may impact cognitive function in the older Veteran population. To address this possibility, we propose a prospective study to examine the relationships between isolation in the pandemic and subsequent cognitive function in healthy older adult Veterans and in older Veterans with Alzheimer’s disease (AD) (Aim 1). In addition, forced isolation is likely not the only factor with important consequences in the pandemic. We propose investigating two other pandemic-related contexts that may either mitigate the effects of isolation in the pandemic or exacerbate the consequences of cognitive impairment on health-related outcomes for older Veterans. First, older Veterans may be able to cope with isolation through use of features of the built environment, such as porches, window views, and public neighborhood space. However, the extent the built environment may be able to mitigate pandemic-related loneliness in older adults is unknown. In Aim 2, we test the hypothesis that built environment factors will mitigate or contribute to social isolation in older Veterans with and without AD. In addition, individuals’ cognition may be impacted by their belief in misconceptions related to social isolation itself. In Aim 3, we test the relationship between cognitive function and the ability to correct misconceptions related to social isolation and AD—and whether such corrections engender changes in behavior. To accomplish Aims 1-3, we will apply questionnaires and neuropsychological tests administered during the first wave of the pandemic (June 2020-June 2021) to 196 participants over three additional one-year time intervals from October 2022 to September 2025. In Aim 1, we will test the relationship between social isolation in the pandemic and cognitive function one, two, and three years later. In Aim 2, we will test whether older Veterans with fewer built environment resources will demonstrate a worsening of social isolation, loneliness, depression, anxiety, and cognition over time. In Aim 3, two objectives will be tested. First, we will determine the extent that individuals with and without cognitive impairment due to AD can successfully change their belief in misconceptions related to social isolation and AD through a correction procedure over time. Second, we will test whether corrections related to changes in behavior at delayed intervals of 1 and 2 years. Preliminary cross-sectional data from our already recruited final sample of older adults (N=196) with and without AD support the relationships between social isolation and cognitive impairment (Aim 1), the built environment and social isolation (Aim 2), and cognitive impairment and misconception correction (Aim 3). As the ramifications of the pandemic continue to unfold for years—possibly decades—it is imperative that we understand the relationship between social isolation and future cognitive impairment in Veterans with and without Alzheimer’s disease.

COVID-19大流行仅在美国就造成超过50万人死亡。即使对于 那些身体健康和财务安全没有受到影响的人， 大流行引起的隔离对心理和认知健康的影响可能是深远的- 特别是对我们的退伍军人。在大流行之前，大约10%的老年退伍军人报告说， 经常感到孤独，40%表示有时感到孤独。社交距离 由于限制社交接触的指导方针和其他措施，大流行期间的孤独感可能会增加， 远远超过这些估计。几十年的研究都支持 社会关系对老年人认知的影响;因此，与 大流行可能影响老年退伍军人群体的认知功能。为了解决这个 的可能性，我们提出了一个前瞻性的研究，以检查隔离之间的关系， 健康老年退伍军人和老年退伍军人的流行病和随后的认知功能 阿尔茨海默病（AD）（Aim 1）。此外，强迫隔离可能不是唯一的因素， 大流行的重要后果。我们建议调查另外两个与流行病有关的 可能减轻大流行中隔离的影响或加剧 认知障碍对老年退伍军人健康相关结果的影响。第一，年龄大 退伍军人可能能够通过使用建筑环境的特征来科普隔离，例如 门廊，窗户景观和公共邻里空间。然而，建筑环境 可能能够减轻老年人与流行病相关的孤独感，目前尚不清楚。在目标2中，我们测试 假设建筑环境因素将减轻或有助于老年退伍军人的社会孤立 有和没有AD此外，个人的认知可能会受到他们的信仰的影响 与社会隔离本身有关的误解。在目标3中，我们测试了认知与 功能和纠正与社会隔离和AD相关的误解的能力，以及是否 这种矫正会引起行为上的改变。为了实现目标1-3，我们将 大流行第一波期间进行的问卷调查和神经心理测试 (June 2020年至2021年6月），196名参与者从10月开始的三个额外的一年时间间隔 2022年至2025年9月。在目标1中，我们将测试社会隔离与 大流行和认知功能的影响。在目标2中，我们将测试老年人是否 拥有较少建筑环境资源的退伍军人将表现出社会孤立的恶化， 孤独、抑郁、焦虑和认知。在目标3中，将检验两个目标。第一、 我们将确定患有和不患有AD认知障碍的个体在多大程度上可以 成功地改变了他们对社会孤立和AD的误解， 随着时间的推移，纠正措施。第二，我们将测试是否更正有关的变化， 延迟1年和2年的行为。初步的横截面数据，从我们已经 招募的最终老年人样本（N=196）与无AD支持之间的关系， 社会隔离和认知障碍（目标1），建筑环境和社会隔离（目标2）， 认知障碍和误解纠正（目标3）。作为大流行病的后果， 持续数年--可能数十年--我们必须了解这种关系 有和没有阿尔茨海默病的退伍军人的社会隔离和未来认知障碍之间的关系 疾病