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.

仅在美国，199年的大流行就造成了超过半百万的死亡。甚至是 那些没有影响身体健康和金融安全的个人， 大流行引起的孤立对心理和认知健康的后果可能是深远的 - 特别是对于我们的退伍军人。大流行之前，约有10％的老兵报告 经常感到孤独，40％的人表明有时会感到孤独。由于社会疏远 指南和其他限制社会接触的措施，大流行期间的孤独感可能 远大于这些估计。数十年的研究支持了 成年时期认知的社会关系；因此，与 大流行可能会影响老年退伍军人人口的认知功能。解决这个问题 可能性，我们提出了一项前瞻性研究，以研究隔离之间的关系 健康的老年退伍军人和老年退伍军人的大流行和随后的认知功能 患有阿尔茨海默氏病（AD）（AIM 1）。另外，强制隔离可能不是 大流行的重要后果。我们提出研究其他两个大流行有关的 可以减轻大流行中隔离的影响或加剧的环境 认知障碍对老年退伍军人的健康相关结果的后果。首先，年龄较大 退伍军人可能能够通过使用建筑环境的特征来应对隔离，例如 门廊，窗户视图和公共邻里空间。但是，建筑环境的程度 可能能够减轻老年人大流行有关的孤独感。在AIM 2中，我们测试 假设建立的环境因素将减轻或有助于老年退伍军人的社会隔离 有和没有广告。此外，个人的认知可能会受​​到他们对 与社会隔离本身有关的误解。在AIM 3中，我们测试认知之间的关系 功能和纠正与社会隔离和广告有关的失误的能力以及是否 这样的校正会导致行为变化。为了完成目标1-3，我们将申请 大流行期间进行的问卷和神经心理学测试 （2020年6月至6月2021年）至196个参与者，超过三个10月的一年间隔 2022年至2025年9月。在AIM 1中，我们将测试社会隔离之间的关系 大流行和认知功能一，两年和三年。在AIM 2中，我们将测试是否更老 建筑环境资源很少的退伍军人将表现出对社会隔离的担忧， 随着时间的流逝，孤独，沮丧，焦虑和认知。在AIM 3中，将测试两个目标。第一的， 我们将确定由于AD而导致认知障碍的个人可以 成功地改变了他们对与社会隔离有关的失误的信念，并通过一个 随着时间的推移校正程序。其次，我们将测试与更改有关的更正是否相关 延迟间隔为1和2年的行为。来自我们已经的初步横截面数据 招募了老年人的最终样本（n = 196），有或没有广告支持 社会隔离和认知障碍（AIM 1），建筑环境和社会隔离（AIM 2）， 以及认知障碍和误解纠正（AIM 3）。作为大流行的后果 多年来继续展开（可能是几十年），我们必须了解这种关系 在有和没有阿尔茨海默氏症的退伍军人的社会隔离和未来的认知障碍之间 疾病。