Measurement of Cognitive Function in Older Adults with Sensory Loss

感觉丧失老年人认知功能的测量

• 批准号: 10305408
• 负责人: JENNIFER Anne DEAL
• 金额: $ 16.38万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10305408
• 关键词: 2019-nCoV; Accident and Emergency department; Affect; Age; Alzheimer' s Disease; Alzheimer' s disease related dementia; American; Americas; Area; Baltimore; COVID-19; COVID-19 patient; COVID-19 severity; Caring; Clinic; Clinical; Communication; Communities; Coronavirus; Critical Care; Data; Disabled Persons; Elderly; Electronic Health Record; Emergency Department patient; Emergency department visit; Epidemiologist; Gender; Geriatrics; Goals; Health; Health Care Research; Healthcare; Hospital Mortality; Hospitalization; Impairment; Institutes; Intubation; Life Cycle Stages; Link; Location; Lung; Measurement; Medical; Nursing Homes; Outcome; Patient-Focused Outcomes; Patients; Population; Prevalence; Public Health; Race; Registries; Research; Risk; SARS-CoV-2 infection; Sensory; Shapes; Specialist; Testing; Time; United States Agency for Healthcare Research and Quality; Vulnerable Populations; Washington; Work; World Health Organization; care outcomes; cognitive function; comorbidity; data resource; disability; disability leave; health care availability; health care disparity; health care service utilization; hospitalization rates; improved; innovation; medical services inaccessibility; mortality; multidisciplinary; negative affect; pandemic disease; parent project; patient safety; precision medicine; response; secondary analysis; secondary outcome; social group; social vulnerability; telehealth; welfare

ABSTRACT This urgent competing revision of NIA R21AG060243 is in response to NOT-AG-20-022 and aims to examine 2019 coronavirus (COVID-19) clinical outcomes and the impact of the COVID-19 pandemic on healthcare utilization for older adults with disabilities, including those with sensory impairments and Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD). While data indicate that COVID-19 has disproportionately affected nursing home populations, urgent questions remain about how COVID-19 has impacted healthcare outcomes and utilization for older adults with disabilities, leaving an urgent, yet unaddressed, gap in response efforts. This work is an extension of the parent project that focuses on assessing ADRD and sensory impairments among older adults and leverages a unique data resource linking electronic health record (EHR) information from Johns Hopkins Medical Institute Emergency Department (ED) patients (across 5 locations in the Baltimore/Washington, DC area) to data from the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry (JH-CROWN). Aim 1 will test our hypotheses that patients with disabilities are more likely to have severe COVID-19 disease, assessed using scores on the World Health Organization (WHO) COVID-19 disease severity scale, and compare COVID-19 outcomes between patients with disability who are 65 years and older to patients under 65 years. Secondary outcomes will include hospital admission and in-hospital mortality, as well as examine COVID-19 outcomes by gender, race, and disability type. Aim 2 will investigate the impact of the COVID-19 pandemic on health care utilization by patient disability status and age, and testing hypotheses that: (1) ED visit rates (non-COVID related) are lower among patients with disabilities during the COVID-19 pandemic [Jan 1, 2020 to Dec 31, 2020]; (2) preventable hospitalization rates, determined using AHRQ metrics, are higher among patients with disabilities during the pandemic; and (3) ED visit rates are lower and preventable hospitalization rates are higher during the pandemic [Jan 1 to Dec 31, 2020] then in the year prior among patients with disabilities. Analyses will examine potential interactions between age and disability status and compare results across health-adjusted strata. This work fills an urgent gap in the COVID-19 response, as there remains limited data on the healthcare implications of the pandemic for older adults with disabilities.

抽象的 NIA R21AG060243 的紧急竞争修订版是为了响​​应 NOT-AG-20-022，旨在审查 2019 年冠状病毒 (COVID-19) 临床结果以及 COVID-19 大流行对医疗保健的影响 供残疾老年人使用，包括那些患有感觉障碍和阿尔茨海默病的老年人 和阿尔茨海默病相关的痴呆症 (AD/ADRD)，而数据表明 COVID-19 已发生。 尽管疗养院人口受到了不成比例的影响，但关于 COVID-19 如何影响疗养院人口的紧迫问题仍然存在 影响残疾老年人的医疗保健结果和利用，留下了一个紧迫但尚未解决的问题 未解决的响应工作中的差距这项工作是侧重于父项目的延伸。 评估老年人的 ADRD 和感觉障碍，并利用独特的数据资源链接 来自约翰·霍普金斯医学院急诊科 (ED) 的电子健康记录 (EHR) 信息 患者（巴尔的摩/华盛顿特区 5 个地点）获取来自约翰·霍普金斯大学 COVID-19 的数据 精准医学分析平台注册中心 (JH-CROWN) 目标 1 将检验我们的假设，即患者患有以下疾病： 根据世界卫生组织的评分进行评估，残疾人更有可能患上严重的 COVID-19 疾病 组织 (WHO) COVID-19 疾病严重程度量表，并比较患者之间的 COVID-19 结果 65 岁及以上的残疾患者和 65 岁以下的患者的次要结果将包括住院。 入院和院内死亡率，以及按性别、种族和残疾情况检查 COVID-19 结果 目标 2 将调查 COVID-19 大流行对患者残疾的医疗保健利用的影响。 状况和年龄，并检验假设：(1) 患者的急诊就诊率（非新冠肺炎相关）较低 COVID-19 大流行期间有残疾 [2020 年 1 月 1 日至 2020 年 12 月 31 日] (2) 可预防的住院治疗； 使用 AHRQ 指标确定的患病率在大流行期间残疾患者中较高； (3) 疫情期间急诊就诊率较低，可预防的住院率较高 [1 月 1 日至 12 月 2020 年 3 月 31 日] 然后在前一年对残疾患者进行分析以检查潜在的相互作用。 这项工作填补了年龄和残疾状况之间的差距，并比较了健康调整阶层的结果。 由于有关大流行对医疗保健影响的数据仍然有限，因此 COVID-19 应对措施存在差距 对于残疾老年人。