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“孤独的流行”的认识和关注 老年人和其他普通人群，但精神分裂症患者的患病率更高。 孤独是医疗合并症，认知功能障碍，功能降低的重要危险因素 能力，福祉降低和早期死亡率。与孤独相关的死亡风险是两倍 肥胖，相当于每天抽15支香烟。值得注意的是，许多相关的已删除效果 孤独感与精神分裂症和衰老相关的孤独感。这种融合提出了一个问题 孤独是否显着促进健康，认知能力和功能能力的缺陷， 患有精神分裂症的中年和老年人的生理功能以及幸福感。提议 项目是对孤独的性质，纵向稳定性和有害影响的首次全面研究 在精神分裂症中。鉴于精神分裂症的最新概念是一种系统性疾病，导致 加速衰老，孤独感可能在生命过程中发展的方式，这是这项研究的重点 中年和老年人患有精神分裂症（n = 120）的孤独感会随着年龄的影响而 以及年龄相比的非精神病学比较（NC）受试者（n = 90）。研究员工纵向 爆发设计，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。七个 三个主要研究访问中的每一个几天，基于智能手机的生态瞬时评估 （EMA）将用于实时衡量孤独，社交活动和情绪。我们的主要目的包括 确定精神分裂症和衰老与持续孤独的关联，以及 协会独立于社会隔离和抑郁症状。另一个主要目的是 确定6个月和12个月以上的持续孤独与生物学水平和模式的关联 健康标志，医疗合并症，认知功能障碍，功能能力和与健康相关的质量 生活。假设预测精神分裂症会与更糟，更持久的孤独感相关，并且 持续的孤独感将与健康和其他结果的生物学标志更糟糕。我们也是 期望这些协会随着年龄的增长而增加。急性之间的稳定性和临时关系 使用EMA实时衡量的孤独，社交活动和情绪，以及这些模式的关联 从标准面对面措施的人也将进行评估。该项目的数据将填充一个关键 对经验数据的需求未满足，以指导内容和努力的重点，以防止和减少有害 精神分裂症老年人的生物学和长期健康结果，并减少了幸福感。 总之，这项研究代表了进一步努力更有效的迈出的重要一步 全面的，个性化的预防和对孤独感的治疗及其对中年的不利影响 和患有精神分裂症的老年人。