Aging in Place since the COVID-19 Pandemic Onset: A Study of Neighborhoods and Cognitive Health among Older Americans

自 COVID-19 大流行爆发以来的就地老龄化：美国老年人的社区和认知健康研究

• 批准号: 10876573
• 负责人: Jessica Marie Finlay
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10876573
• 关键词: Acute; Address; Adult; Aerobic; Affect; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; American; Area; Businesses; COVID-19; COVID-19 pandemic; COVID-19 survivors; Coffee; Cognitive; Cognitive aging; Communities; Community Services; Crowding; Data; Development; Disease Outbreaks; Elderly; Environment; Fellowship; Foundations; Friends; Funding; Future; Geographic Locations; Gerontology; Goals; Health; Health Policy; Health Services; Health and Retirement Study; Impaired cognition; Impairment; Infrastructure; Intervention; Knowledge; Libraries; Life; Link; Long-Term Care; Measures; Mental Health; Mentors; Mentorship; Methods; Michigan; Modeling; Muscle Weakness; Museums; Neighborhoods; Outcome; Personal Satisfaction; Phase; Physical activity; Policy Maker; Population; Public Health; Quality of life; Research; Research Methodology; Research Personnel; Resources; Risk; Risk Factors; Risk Reduction; Sampling; Services; Shapes; Social Distance; Social Interaction; Social isolation; Socialization; Source; Training; Transportation; Trauma; Travel; Universities; aged; aging in place; career; career development; cognitive function; data archive; dementia risk; design; experimental study; healthy aging; innovation; longitudinal analysis; novel; pandemic disease; population based; prevent; programs; protective factors; resilience; risk mitigation; service providers; skills; social; social determinants; social implication; walkability

ABSTRACT Although the majority of Americans with Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD) live independently, the neighborhood contexts in which they develop and navigate cognitive decline and impairment are largely ignored. Living in neighborhoods with opportunities for social interaction (e.g., coffee shops, senior centers), intellectual stimulation (e.g., museums, libraries) and physical activity (e.g., parks, walkable streets) may slow rates of cognitive decline and reduce risk for AD/ADRD. However, with the onset of the COVID-19 pandemic, many neighborhood resources that are critical sources of socialization, stimulation, and activity are closed or tightly restricted. Avoiding crowded places, isolating, limiting travel, and permanent business closures likely have profound consequences for cognitive impairment and AD/ADRD risk due to disruptions in daily life; impacts on mental health; and loss of opportunities for social, intellectual, and physical activities. This research addresses a critical knowledge gap on neighborhood contexts of cognitive decline before and after the pandemic onset. It is one of few studies to utilize both qualitative and quantitative data from the nationally-representative Health and Retirement Study (HRS) of US adults aged 51+. Aim 1 (K99 phase: 2021- 23) identifies neighborhood features associated with cognitive trajectories in the HRS before the pandemic onset. Aim 2 (R00 phase: 2023-25) uses an advanced mixed-methods approach and novel HRS experimental module to investigate how the collective trauma of COVID-19 has fundamentally changed neighborhood landscapes and ways of aging in place. This will inform where to focus Aim 3 analyses (R00 phase: 2024-26) to identify which neighborhood features are associated with risk and resiliency for cognitive impairment among older adults after the March 2020 pandemic onset. Findings will build evidence for a new concept of `cognability', an innovative theoretical approach to indicate how supportive a geographic area is to cognitive health for aging residents through specific neighborhood resources and amenities. The K99/R00 fellowship will facilitate Dr. Finlay's career development and future as a successful independent health researcher. It extends her expertise in environmental gerontology, mixed-methods, and cognitive function with advanced training in longitudinal analysis; cognitive decline, impairment, and AD/ADRD; and acute illness among aging adults. A strong interdisciplinary mentorship team and outstanding supportive training environment at the University of Michigan provide a foundation for Dr. Finlay to fill an important scientific niche on neighborhood vulnerability and resilience for cognitive decline and AD/ADRD. She has a unique vantage point to advance research on social determinants of AD/ADRD, identify neighborhood features that affect health and well-being, and inform public health policy and health services. Her long-term goal is to establish an R01-funded, mixed-methods research program that informs neighborhood interventions and community services to support the needs, health, and well-being of older adults aging in place.

抽象的 尽管大多数美国人患有阿尔茨海默病和阿尔茨海默病相关痴呆症 (AD/ADRD) 独立生活，他们在社区环境中发展并应对认知能力下降 和减值在很大程度上被忽略。居住在有社交互动机会的社区（例如喝咖啡 商店、老年中心）、智力刺激（例如博物馆、图书馆）和体育活动（例如公园、 适合步行的街道）可能会减缓认知能力下降的速度并降低 AD/ADRD 的风险。然而，随着疫情的爆发 COVID-19 大流行期间，许多社区资源是社交、刺激、 活动被关闭或严格限制。避免去人群密集的地方，进行隔离、限制出行、永久隔离 企业倒闭可能会对认知障碍和 AD/ADRD 风险产生深远的影响，因为 日常生活受到干扰；对心理健康的影响；以及社交、智力和身体方面机会的丧失 活动。这项研究解决了之前关于认知能力下降的邻里环境的关键知识差距 以及疫情爆发后。这是利用定性和定量数据的少数研究之一 针对 51 岁以上美国成年人的全国代表性健康与退休研究 (HRS)。目标1（K99阶段：2021年- 23）在大流行爆发之前确定了与 HRS 中的认知轨迹相关的邻里特征。 目标 2（R00 阶段：2023-25）采用先进的混合方法和新颖的 HRS 实验模块 调查 COVID-19 的集体创伤如何从根本上改变了社区景观 就地养老的方式。这将告知目标 3 分析（R00 阶段：2024-26）的重点，以确定哪些 社区特征与老年人认知障碍的风险和弹性相关 2020 年 3 月大流行爆发。研究结果将为“认知能力”这一新概念提供证据，这是一种创新 表明地理区域对老年居民认知健康的支持程度的理论方法 通过特定的社区资源和便利设施。 K99/R00 奖学金将促进 Finlay 博士的职业生涯 作为一名成功的独立健康研究员的发展和未来。它扩展了她在环境方面的专业知识 老年学、混合方法和认知功能以及纵向分析高级培训；认知的 衰退、损伤和 AD/ADRD；以及老年人的急性疾病。强大的跨学科指导 密歇根大学的团队和出色的支持性培训环境为博士的发展奠定了基础。 芬利填补了关于社区脆弱性和认知能力下降恢复力的重要科学空白 AD/ADRD。她拥有独特的优势来推进 AD/ADRD 社会决定因素的研究，确定 影响健康和福祉并为公共卫生政策和卫生服务提供信息的社区特征。她 长期目标是建立一个由 R01 资助的混合方法研究项目，为社区提供信息 干预措施和社区服务，以支持就地老龄化老年人的需求、健康和福祉。