Preventing Deaths Among Older Americans with Alzheimer’s Disease and Other Related Dementias Exposed to Hurricanes

预防遭受飓风影响的患有阿尔茨海默病和其他相关痴呆症的美国老年人死亡

• 批准号: 10739038
• 负责人: Susan Anne Bell
• 金额: $ 210.77万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10739038
• 关键词: Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Area; Assisted Living Facilities; Cause of Death; Censuses; Cessation of life; Communities; County; Data; Dedications; Dementia; Dependence; Dimensions; Disasters; Disorientation; Elderly; Elements; Emergency Situation; Environment; Environmental Wind; Event; Excess Mortality; Exposure to; Face; Failure to Thrive; Floods; Future; Goals; Health; Health Personnel; Health Services Accessibility; Healthcare; Healthcare Systems; Hurricane; Infection; Infrastructure; Intention; Knowledge; Measures; Nursing Homes; Older Population; Outcome; Pattern; Personal Satisfaction; Pharmaceutical Preparations; Policies; Policy Maker; Population; Productivity; Rain; Readiness; Recommendation; Recording of previous events; Research; Resources; Risk; Sampling; Services; Time; Tornadoes; Weather; Work; analytical method; caregiving; climate disaster; cohort; comorbidity; coping; design; experience; extreme storms; falls; functional decline; improved; indexing; innovation; insight; meteorological data; mortality; mortality risk; novel; prevent; programs; severe weather; social vulnerability; temporal measurement; vulnerable community; weather-related disaster

PROJECT ABSTRACT Background: There is a critical need to understand how disasters such as hurricanes affect older adults living with Alzheimer’s disease and related dementias (ADRD). For older adults living with ADRD, the disruption in critical supportive services and overall normal patterns of daily living caused by a disaster can be highly disorienting and result in immediate changes in health and well-being, leading to functional decline and even death. Our existing program of research is dedicated to examining the effects of disasters on health outcomes among older adults, with the goal of improving disaster preparedness and planning policy. Our previous work has shown that deaths increase among older adults living with ADRD in the months after hurricane exposure. Our Goal: The central objective of this proposed project is to determine the extent to which exposure to hurricanes affects mortality among older adults living with ADRD – focused on identifying ways to reduce deaths. We hypothesize that an increase in all-cause mortality following hurricane exposure will be due to specific causes of death (i.e., infection, falls, failure to thrive), excess mortality will differ by living environment, and social vulnerability will influence population-level mortality. Our Approach: Using a unique combination of administrative healthcare, death, and weather data to study a sample of hurricanes between 2001-2018, we will pursue the following aims: Aim 1 will examine all-cause mortality following hurricane exposure and identify associated causes of death among older adults living with ADRD; Aim 2 will determine the living environment associated with the most deaths among older adults living with ADRD who are exposed to a hurricane; and Aim 3 will determine the effects of exposure to multiple (sequential) disasters on excess mortality among the ADRD population, within the context of social vulnerability. Unique Features and Innovation: This project is innovative for several reasons; it will: (1) generate/use small area estimates of severe weather exposure that are multi-dimensional (i.e., type of weather) and both highly spatially and temporally resolved; (2) be among the first to identify cause of death using the National Death Index, as well as timing of death among the ADRD population following hurricane exposure; and (3) examine the cumulating effects of disasters on excess mortality within the context of community vulnerability. Anticipated Impact: The overall goal of this project is to develop knowledge around ADRD deaths following hurricane exposure with the intention of informing disaster preparedness policy for the ADRD population. Recommendations generated from this work will support policymakers, healthcare providers, and emergency planners as they refine policies regarding disaster management for older adults living with ADRD.

项目摘要 背景：迫切需要了解诸如飓风等灾难如何影响老年人生活 患有阿尔茨海默氏病和相关痴呆症（ADRD）。对于与Adrd一起生活的老年人 关键的支持服务和由灾难引起的日常生活的总体正常模式可能是高度的 迷失方向并导致健康和福祉的立即变化，导致功能下降甚至 死亡。我们现有的研究计划致力于研究灾难对健康结果的影响 在老年人中，目的是改善灾难准备和计划政策。我们以前的工作 已经表明，在飓风暴露后的几个月中，死亡的老年人的死亡人数增加。 我们的目标：该提议的项目的核心目标是确定暴露于多大程度上的程度 飓风会影响ADRD居住的老年人的死亡率 - 专注于确定减少的方法 死亡人数。我们假设飓风暴露后全因死亡率的增加将是由于 死亡的具体原因（即感染，跌倒，不繁衍），超过死亡率会因生活环境而异， 社会脆弱性将影响人口水平的死亡率。 我们的方法：使用行政医疗保健，死亡和天气数据的独特组合来研究 在2001 - 2018年之间的飓风样本，我们将追求以下目标：AIM 1将检查全因 飓风暴露后的死亡率并确定与之相关的老年人的死亡原因 adrd; AIM 2将确定与居住老年人死亡最多有关的生活环境 与暴露于飓风的阿德德； AIM 3将确定暴露于多个的影响 在社会背景下，（顺序的）灾难造成了ADRD人口的过度死亡率 脆弱性。 独特的功能和创新：由于几个原因，该项目具有创新性；它将：（1）生成/使用小 多维（即天气类型）的恶劣天气暴露的面积估计值和高度 在空间和暂时解决； （2）成为第一个使用民族死亡确定死亡原因的人之一 飓风暴露后，索引以及死亡人口的死亡时间； （3）检查 在社区脆弱性的背景下，灾难对过度死亡的累积影响。 预期的影响：该项目的总体目标是围绕Adrd死亡发展知识 飓风暴露是为了为阿德德人口提供灾难准备政策。 这项工作产生的建议将支持决策者，医疗保健提供者和紧急情况 规划师在完善有关ADRD居住的老年人灾难管理的政策。