Loneliness in Aging with Schizophrenia

精神分裂症患者老年时的孤独感

• 批准号: 10415094
• 负责人: Barton W. Palmer
• 金额: $ 74.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10415094
• 关键词: Accounting; Activities of Daily Living; Acute; Address; Adult; Adverse effects; Affect; Age; Aging; Alcohol consumption; Awareness; Biological; Biological Markers; Cellular Phone; Cigarette; Cognition; Cognitive; Data; Data Analyses; Development; Diabetes Mellitus; Diagnosis; Disease; Ecological momentary assessment; Elderly; Ensure; Epidemic; Factor Analysis; Gender; General Population; Gold; Health; Health behavior; High Prevalence; Impaired cognition; International; Life Cycle Stages; Loneliness; Measurement; Measures; Medical; Mental Depression; Moods; Nature; Obesity; Outcome; Pathology; Patient Care; Pattern; Personal Satisfaction; Persons; Physical activity; Physiological; Populations at Risk; Prevalence; Psychopathology; Research; Rest; Risk; Risk Factors; Schizophrenia; Severities; Smoking; Social isolation; Surgeon; Testing; Time; Visit; aged; base; cognitive function; comorbidity; data reduction; depressive symptoms; design; follow-up; health related quality of life; individualized medicine; individualized prevention; innovation; middle age; mortality; mortality risk; personalized care; physical conditioning; prevent; psychological distress; skills; social; theories; time use; trait

In recent years there has been increased awareness and concern about the “epidemic of loneliness” among older adults and other general population, but the prevalence is even higher among people with schizophrenia. Loneliness is a significant risk factor for medical comorbidity, cognitive dysfunction, reduced functional capacity, lower well-being, and earlier mortality. The mortality risk associated with loneliness is double that for obesity, and equivalent to smoking 15 cigarettes per day. Notably, many of the deleterious effects associated with loneliness parallel those associated with schizophrenia and aging. This convergence raises a question of whether loneliness significantly contributes to the deficits in health, cognition and functional capacity, physiologic function, and well-being among middle-aged and older adults with schizophrenia. The proposed project is the first comprehensive study of the nature, longitudinal stability, and deleterious impact of loneliness in schizophrenia. Given recent conceptualizations of schizophrenia as a systemic disorder resulting in accelerated aging, and the manner in which loneliness may evolve over the life-course, the focus for this study will be on the effects of loneliness with age among middle-aged and older adults with schizophrenia (n=120) as well as age-comparable non-psychiatric comparison (NC) subjects (n=90). The study employs a longitudinal burst design, with in-person visits and assessments of key variables at baseline, 6-, and 12-months. For seven days following each of the three primary study visits, smartphone-based Ecological Momentary Assessment (EMA) will be used to measure loneliness, social activity, and mood in real-time. Our primary aims include determining the associations of schizophrenia and aging with persistent loneliness, and the degree to which the associations are independent of social isolation and depressive symptoms. The other primary aim is to determine the association of persistent loneliness over 6- and 12-months with levels and patterns of biological markers of health, medical comorbidity, cognitive dysfunction, functional capacity, and health-related quality of life. Hypotheses predict schizophrenia being associated with worse and more persistent loneliness, and that persistent loneliness will be associated with worse biological markers of health and other outcomes. We also expect these associations to increase with advancing age. Stability and temporal relationships between acute loneliness, social activity, and mood measured in real-time using EMA, and associations of these patterns with those from the standard in-person measures will also be assessed. The data from this project will fill a critical unmet need for empirical data to guide the content and focus of efforts to prevent and reduce deleterious biological and longer-term health outcomes and diminished well-being in older adults with schizophrenia. Together, this study represents a significant and innovative step in furthering efforts toward more effective, comprehensive, individualized prevention and treatment of loneliness and its adverse effects in middle-aged and older adults with schizophrenia.

近年来，人们对“孤独流行”的认识和关注不断增强。 老年人和其他一般人群，但精神分裂症患者的患病率更高。 孤独是合并症、认知功能障碍、功能下降的重要危险因素 与孤独相关的死亡风险是孤独的两倍。 肥胖，相当于每天吸 15 支烟，值得注意的是，许多有害影响都与之相关。 孤独感与精神分裂症和衰老相关。这种趋同提出了一个问题： 孤独是否会显着导致健康、认知和功能能力的缺陷， 中老年精神分裂症患者的生理功能和健康状况。 该项目是第一个对孤独的性质、纵向稳定性和有害影响进行全面研究的项目 鉴于最近将精神分裂症概念化为一种系统性疾病，导致 加速衰老，以及孤独感在生命历程中可能演变的方式，是本研究的重点 对中老年精神分裂症患者 (n=120) 的孤独感随年龄的影响如下： 以及年龄相当的非精神病学比较 (NC) 受试者 (n=90)。 突发设计，对基线、6 个月和 12 个月的关键变量进行面对面访问和评估。 三次主要研究访问后的天数，基于智能手机的生态瞬时评估 (EMA) 将用于实时测量孤独感、社交活动和情绪，我们的主要目标包括。 确定精神分裂症和衰老与持续孤独感之间的关系，以及这种关系的程度 这些关联独立于社会孤立和抑郁症状。 确定 6 个月和 12 个月内持续的孤独感与生物水平和模式之间的关系 健康标志、合并症、认知功能障碍、功能能力以及与健康相关的质量 假设预测精神分裂症与更严重和更持久的孤独感有关。 持续的孤独感与健康和其他结果的生物学指标较差有关。 预计这些关联会随着年龄的增长而增加。急性之间的稳定性和时间关系。 使用 EMA 实时测量孤独感、社交活动和情绪，以及这些模式与 来自标准亲自测量的数据也将受到评估，该项目的数据将填补关键。 对经验数据的需求未得到满足，以指导预防和减少有害物质的工作内容和重点 患有精神分裂症的老年人的生物学和长期健康结果以及幸福感下降。 总之，这项研究代表了进一步努力实现更有效、更有效的迈出的重要创新一步。 中年孤独感及其不良影响的综合个体化防治 以及患有精神分裂症的老年人。