Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community

摘要 非洲的健康与老龄化：南非INDEPTH社区的纵向研究（HAALSI） 一项研究调查了疾病的生物、社会和经济决定因素及其对功能、健康和健康的影响。 南非老龄化人口的认知结果。COVID-19疫情的出现 在过去的9个月里，它对南非产生了深远的影响，导致政府严格封锁， SARS-CoV-2的广泛社区传播。COVID-19已被证明具有特殊风险 世界各地的老年人，特别是那些患有痴呆症等潜在疾病的人， 心脏代谢疾病收集有关COVID-19的数据，并说明这一重要公众影响 健康危机对个人和人口健康的影响对于实现HAALSI P01父母补助金的目标至关重要。 特别是，项目1的目标集中在阿尔茨海默病和相关疾病的预测因素和后果。 痴呆症（ADRD），试图确定增加认知风险的疾病和社会条件， 减值和下降。通过利用HAALSI队列的纵向数据深度，包括 关于社会和经济状况、生物标志物、认知功能、包括艾滋病毒/艾滋病在内的慢性病的数据 和心脏代谢疾病，遗传风险，以及一个核磁共振成像和深度痴呆的子样本， 评估，我们有一个独特的机会，新的研究之间的因果关系痴呆症和 新冠肺炎。我们的研究将有助于更好地了解谁有COVID-19的风险，为什么，以及 长期影响可能是对群体的认知健康。我们有两个具体的分析目标，以支持 这些目标：（1）评估与ADRD相关的认知和遗传因素如何影响SARS-CoV-2的风险 感染和COVID-19严重程度;以及（2）评估生物和社会经济途径， COVID-19大流行可能会影响认知功能、认知变化和痴呆事件。满足这些 我们将利用计划中的第3波调查来获取认知结果，并补充现有的HAALSI 数据包括（1）电话调查，以收集COVID-19大流行期间的个人经历;及（2） 血清学检测以评估SARS-CoV-2感染。统一了电话调查工具 与HRS姐妹研究COVID模块一起，允许对COVID-19暴露、健康 行为和社会后果。将在以下期间采集用于SARS-CoV-2血清学检测的静脉血： 计划在2021年进行HAALSI Wave 3实地考察，使用已经在阿金库尔进行的经过验证的实践， 在南非进行实地考察我们希望，该项目将提供深入了解的机制， 痴呆和APOE基因型导致SARS-CoV-2感染和严重疾病，并深入了解生物学 以及COVID-19大流行可能影响认知功能的社会经济途径， 变化和痴呆症的发生。我们的数据收集和分析将有助于更好地了解 2019冠状病毒病对南非、地区和世界各地的弱势群体造成了影响。

Abstract The Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) study examines biological, social, and economic determinants of disease and their effects on functional, health and cognitive outcomes among an aging population in South Africa. The emergence of the COVID-19 pandemic has profoundly impacted South Africa over the last 9 months, leading to stringent government lockdowns and widespread community transmission of SARS-CoV-2. COVID-19 has been demonstrated to be of particular risk to older adults around the world, especially those with underlying conditions including dementia and cardiometabolic disease. Gathering data on COVID-19 and accounting for the impact of this important public health crisis on personal and population health will be essential to fulfill the aims of the HAALSI P01 parent grant. In particular, Project 1’s aims focus on predictors and consequences of Alzheimer’s disease and related dementias (ADRD), attempting to identify diseases and social conditions that increase risk for cognitive impairment and decline. By leveraging the depth of longitudinal data available on the HAALSI cohort, including data on social and economic conditions, biomarkers, cognitive function, chronic conditions including HIV/AIDS and cardiometabolic disease, and genetic risks, as well as a subsample with MRIs and in-depth dementia assessments, we have a unique opportunity for novel research on causal relationships between dementia and COVID-19. Our research will facilitate better understanding of who is at risk of COVID-19 and why, and what the longer-term impacts might be on cognitive health of the cohort. We have two specific analytic aims to support these goals: (1) To assess how cognitive and genetic factors related to ADRD influence risk for SARS-CoV-2 infection and COVID-19 severity; and (2) To evaluate biological and socioeconomic pathways through which the COVID-19 pandemic may influence cognitive function, cognitive change, and incident dementia. To fulfill these aims we will utilize our planned Wave 3 survey to capture cognitive outcomes, and supplement existing HAALSI data with (1) a telephone survey to capture individual experiences during the COVID-19 pandemic; and (2) serological assays to assess SARS-CoV-2 infection. The telephone survey instrument has been harmonized with HRS sister study COVID modules to allow for cross national comparisons on COVID-19 exposures, health behaviors, and social consequences. Venous blood for SARS-CoV-2 serological assays will be collected during the planned HAALSI Wave 3 fieldwork in 2021, using tried-and-tested practices already in place in the Agincourt, field setting, in South Africa. We expect that this project will provide insight into mechanisms through which dementia and APOE genotype leads to SARS-CoV-2 infection and severe illness, and insight into the biological and socioeconomic pathways through which the COVID-19 pandemic may influence cognitive function, cognitive change and incident dementia. Our data collection and analyses will contribute to a better understanding of how COVID-19 impacts vulnerable populations in South Africa, regionally and around the world.