Pathways from Health Insurance to Subjective Well-Being and Psychological Health at Older Ages

项目摘要/摘要 美国65岁以上的人口正在迅速增长，这将导致痴呆症人数的急剧上升 案例(Hebert等人2003年)。认知障碍，即使在没有痴呆症诊断的情况下，通常也是 与个人工作、管理财务和处理日常活动能力的限制有关， 可能会对心理健康产生影响。增加不确定性，损害老年人的心理 健康反过来可能导致更快的认知衰退(Goveas等人，2011年)和痴呆症的发病。 新冠肺炎大流行，以及减缓它的措施造成的干扰，可能会加强 心理健康与痴呆症的关系。就像有潜在健康状况的人一样， 老年人对新冠肺炎和死亡发生严重反应的风险更高。此外，老年人有更陡峭的 认知能力下降可能会因为增加的不确定性和相关的健康风险而加速 大流行，对痴呆症流行有影响。因此，迫切需要了解 这种流行病对老年人的负面认知和心理健康影响， 亚群是最脆弱的，以及可以做些什么来减轻这种影响。尤其重要的是， 要了解像联邦医疗保险这样的大型社会计划在减少由 大流行病和减轻其后果。 在这份行政补充文件中，我们建议收集数据以调查联邦医疗保险在延误方面的作用 认知能力下降--以及随之而来的痴呆症--和改善老年人的心理健康 美国人。特别是，我们将记录医疗保险在提供医疗保险和医疗保险方面的作用 在新冠肺炎大流行期间，医疗保健以及由此产生的任何影响都发生了变化。有问题的是 通过提供医疗保险，医疗保险是否可以降低认知和幸福感 大流行的后果。 这一补充符合我的K父母赠款的总体目标，即了解医疗保险如何 影响老年人的主观幸福感和心理健康。上面列出的目标与父母的拨款密切相关 目标，但现在利用这个机会也了解大流行是如何极大地增加不确定性， 认知功能受损与痴呆的发病。我的计划是在最初的队列之后建立一个长期的小组 的受访者随着时间的推移，以捕捉认知变化，痴呆诊断，自我报告的健康状况 以及这一重要人口群体的心理健康状况。要做到这一点，我会申请一辆R01。数据 这本补充资料支持的集合将增加我作为 PI，这是我仍然需要实现的为数不多的K01目标之一。最后，所有收集的数据都将公之于众 在主要研究结果公布后，可供研究界使用。

Project Summary/Abstract The American population over 65 is growing rapidly, which will lead to a steep rise in the number of dementia cases (Hebert et al. 2003). Cognitive impairment, even in the absence of a dementia diagnosis, is often associated with limitations in an individual's ability to work, manage finances, and deal with routine activities, with possible implications for psychological well-being. Increased uncertainty that harms senior psychological health might, in turn, result in faster cognitive decline (Goveas et al., 2011) and dementia onset. The COVID-19 pandemic, as well as the disruptions caused by measures to slow it, might reinforce the relationship between psychological well-being and dementia. Like individuals with underlying health conditions, older adults are at higher risk of serious reactions to COVID-19 and death. In addition, seniors have steeper cognitive decline that might be accelerated by the increased uncertainty and health risks associated with the pandemic, with implications for the prevalence of dementia. As a result, there is an urgent need to understand the negative cognitive and psychological well-being effects of the pandemic among seniors, which subpopulations are most vulnerable, and what can be done to mitigate such effects. In particular, it is important to understand the role of large social programs such as Medicare in reducing the uncertainty generated by the pandemic and alleviating its consequences. In this administrative supplement, we propose to collect data to investigate the role of Medicare in delaying cognitive decline – and the consequent onset of dementia -- and improving psychological well-being of older Americans. In particular, we will document how the role of Medicare in providing access to health insurance and health care, as well was any consequent effects, changed during the COVID-19 pandemic. In question is whether, by providing access to health insurance, Medicare can reduce the cognition and well-being consequences of the pandemic. This supplement fits in with the overall goal of my K parent grant, which is to understand how health insurance affects the SWB and mental health of the elderly. The aims listed above are closely related to the parent grant's aims, but now use the opportunity to also understand how the pandemic, which greatly increased uncertainty, affected cognition and the onset of dementia. My plan is to develop a long-run panel following this initial cohort of respondents over time in order to capture changes in the cognition, dementia diagnosis, self-reported health and psychological well-being of this important demographic group. To do so, I will apply for a R01. The data collection supported by this supplement will increase my chances of writing a successful R01 application as a PI, one of the few K01 objectives that I still need to achieve. Finally, all collected data will be made publicly available for the research community after the publication of main findings.