Alzheimer's Disease Research Center Determinants of health seeking behaviors during COVID-19 in persons with MCI/ADRD and their caregivers

最近的严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）或冠状病毒疾病的大流行 （COVID-19），已经扰乱了世界上的许多事情。纽约市和哥伦比亚大学欧文医学中心 一直是新冠疫情国家和国际中心的医院。社会心理和功能 COVID-19对本地人口的影响是多方面的。受轻度认知障碍影响的人群 损伤和痴呆（包括阿尔茨海默病（AD）和阿尔茨海默病相关痴呆 （ADRD））面临着高病死率和在必要的社会距离政策后护理的重大中断 高危人群。这些变化带来了新的和意想不到的个人和专业护理人员 菌株具体而言，以下情况发生在我们中心提供护理的人群中： a）由于他们自己的社会距离，失去与专业照顾者的潜在直接接触 要求，新的人承担责任，个人疾病 B）出于对感染COVID-19的担忧，在当地环境中进行有限的短途旅行，以及 （c）结束各种正式和非正式的社交日活动。 因此，在社会隔离期间，痴呆症患者基本上被束缚在家中， 他们被混乱所迷惑，并感知和表达他们的家庭成员所经历的压力。而且很多 这些家庭照顾者必须平衡远程工作责任和家庭照顾，通常在 同一个家。不幸的是，其中一些情况是站不住脚的，并导致疾病， 我们的一些患者和研究参与者以及他们的家庭成员的住院和死亡。 本提案将探讨的经验，知识，态度，就医行为， 与纽约COVID-19疫情相关的心理社会支持，特别是在认知正常的成年人中 在ADRC以及那些患有病理性认知老化的人的护理伙伴中， 作为社会经济的决定因素。据推测，许多成年人将经历不良后果， 在他们的个人和专业护理人员的期望受到影响，并证明COVID-19 特定的健康寻求行为，以及护理受到影响，特别是那些年龄增长或护理 对于其他年龄较大的人，少数民族和弱势社会经济群体。 更好地了解当地COVID-19期间和之后的就医行为和决定因素 流行病在当地和可能在全球任何社区传播增长的地方都有潜在的影响。 一个有效的调查工具，有目的地设计的模块，以捕捉多代影响， 与未来一段时间有关，直到目前的大流行过去，以及未来的大流行或其他 限制社会参与和人口流动的紧急情况。

The recent pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or coronavirus disease (COVID-19), has disrupted much in the world. New York City and Columbia University Irving Medical Center have been the hospital at the COVID national and international epicenter. The psychosocial and functional implications of COVID-19 on our local population are myriad. The population affected by mild cognitive impairment and dementia (including Alzheimer’s Disease (AD) and Alzheimer Disease-related dementias (ADRD)) faces high case fatality rates and major disruptions in care following necessary social distancing polices for high risk persons. These changes have imposed new and unexpected personal and professional caregiver strains. Specifically, the following have occurred in the population for whom our center provides care: a) the loss of potential direct contact with professional caregivers due to their own social distancing requirements, new person caregiving responsibilities, personal illnesses b) limited excursions in the local environment out of concerns, for contracting COVID-19, and c) closure of myriad social day activities, both formal and informal. As a result, during periods of social isolation, persons with dementia are largely bound to their homes, confused by the chaos, and perceive and express the stress their family members experience. Moreover, many of these same family caregivers must balance remote work responsibilities and family caregiving, often within the same home. Unfortunately, some of these circumstances are untenable and have led to illness, hospitalization, and death of some of our patients and research participants, as well as their family members. This proposal will explore the experiences, knowledge, attitudes, healthcare-seeking behaviors, and psychosocial support related to the NYC COVID-19 epidemic, particularly among adults with normal cognition being followed in the ADRC as well as care partners for those persons with pathological cognitive aging, as well as socioeconomic determinants. It is hypothesized that many adults will have experienced adverse outcomes, been impacted in their personal and professional caregiver expectations, and variably demonstrate COVID-19 specific health seeking behaviors, as well as had care impacted, particularly those of advancing age or caring for others with advancing age, in ethnic minorities, and disadvantaged socioeconomic groups. Better understanding health-seeking behaviors and determinants during and after the local COVID-19 epidemic has potential implications both locally and potentially globally wherever community spread is growing. An effective survey instrument, with modules purposefully designed to be capture multigenerational effects may be relevant to some time to come, until the current pandemic has passed, as well as future pandemics or other emergencies which restrict social engagement and population movement.