The impact of social isolation on aging health in schizophrenia

社会隔离对精神分裂症老年健康的影响

• 批准号: 10522303
• 负责人: ABRAHAM REICHENBERG
• 金额: $ 76.41万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10522303
• 关键词: Age; Age-Years; Aging; Antipsychotic Agents; Behavior; Biological Markers; Body mass index; COVID-19; COVID-19 pandemic; Characteristics; Clinical; Cognition; Country; Data; Depressed mood; Diagnosis; Diet; Disease; Ethnic Origin; Ethnic group; Europe; Exhibits; General Population; Goals; Government; Health; Individual; Institutes; Life; Loneliness; Longevity; Measures; Medical; Medical Records; Mental Depression; Natural experiment; Outcome; Participant; Patients; Pattern; Phenotype; Physicians; Premature Mortality; Preventive; Process; Psychotic Disorders; Race; Research; Resources; Risk; Risk Factors; Schizophrenia; Severity of illness; Siblings; Smoke; Smoking; Social Network; Social isolation; Socialization; Stress; Subgroup; Symptoms; Testing; Time; Unhealthy Diet; Vulnerable Populations; Work; age related; cohort; comorbidity; coronavirus disease; design; digital; follow-up; health data; health difference; human old age (65+); longitudinal database; longitudinal design; middle age; mortality; neuropsychiatry; pandemic disease; physical conditioning; physical inactivity; premature; prevent; racial and ethnic; secondary analysis; sex; social contact; symptomatology; targeted treatment; unhealthy lifestyle

PROJECT SUMMARY Individuals diagnosed with schizophrenia and related psychotic disorders (SZ) exhibit a markedly elevated risk of premature mortality, with a 10–20-year shorter lifespan relative to the general population. Increased mortality rates in SZ are largely attributable to the early manifestation of medical conditions that normally occur later in life, a process known as ‘accelerated aging’. While unhealthy lifestyle behaviors, such as smoking and unhealthy diet, account, in part, for accelerated aging in SZ, the excess of physical comorbidities cannot be solely attributed to these factors. Remarkably, the direct adverse health effects of key clinical characteristics of SZ have rarely been considered. In the general population, the absence of social contact is known to pose enormous challenges for physical health, especially at older ages. Given that social isolation is a persistent and disabling feature of SZ, it is possible that this behavior may contribute to the premature manifestation of health conditions in SZ. Building on rich pilot data pointing to significant associations between social isolation and long-term perceived health in SZ, our overarching goal is to test whether and how social isolation contributes to the health challenges of individuals with SZ as they age. With participants from Europe (EU-GEI) and the US (Olin Neuropsychiatry Research Center), we will create a longitudinal database of 650 participants, including 500 individuals with SZ, and 150 of their unaffected siblings. We will apply an accelerated longitudinal design by re- assessing and by examining medical records of research participants who were first evaluated between the ages of 30-50 and are now 50-65 years of age, a period when many medical conditions and health problems tend to manifest. We will determine the age-related association between social isolation and adverse health outcomes in SZ, test for familiality, directionality, and factors moderating this association, and determine the extent to which the COVID-19 pandemic and the resulting imposed lockdowns impacted health in SZ. We will consider generalizability across countries, sexes, and race/ethnicities. The rationale for the proposed research is that in order to facilitate much-needed targeted therapies to prevent early mortality in SZ, we need to better understand factors that contribute to the excess of medical comorbidities in SZ. Our central hypothesis is that social isolation, a common and persistent characteristic of SZ, contributes to the excess of physical comorbidities in SZ. To meet our overall goal, we will pursue the following aims: (1) Determine the association between social isolation and adverse health outcomes in SZ; (2) Test for the directionality, and moderating factors, of the association between social isolation and health outcomes in SZ, and; (3) Examine whether the COVID-19 pandemic modified associations between social isolation and health outcome in SZ. This study will be the first to comprehensively examine the health impact of social isolation in SZ. The project may show that in SZ socialization in midlife can reduce the risk for poor health outcomes and ultimately facilitate much-needed preventive targeted therapies to reduce early-age mortality in SZ.

项目摘要 被诊断患有精神分裂症和相关精神病（SZ）的人暴露了明显升高的风险 过早死亡率，相对于一般人群的寿命短10-20年。死亡率增加 SZ的速率主要归因于通常在以后发生的医疗状况的早期表现 生活，一个被称为“加速衰老”的过程。而生活方式不健康的行为，例如吸烟和不健康 饮食，部分原因是SZ的加速衰老，不能完全归因于物理合并症 这些因素。值得注意的是，SZ关键临床特征的直接不良健康影响很少 被考虑。在一般人群中，缺乏社会接触会构成巨大的挑战 为了身体健康，尤其是在年龄较大的年龄。鉴于社会隔离是一个持久而残疾的特征 SZ，这种行为可能有助于SZ健康状况的过早表现。 以丰富的飞行员数据为基础，指出社会隔离与长期感知之间的重要关联 在SZ的健康状况，我们的总体目标是测试社会隔离是否以及如何对健康贡献 随着年龄的增长，SZ的个人面临的挑战。与来自欧洲（欧盟）和美国的参与者（奥林） 神经精神病学研究中心），我们将创建一个由650名参与者组成的纵向数据库，其中包括500个 患有SZ的人，还有150个未受影响的兄弟姐妹。我们将通过重新应用加速的纵向设计 评估并检查首先评估研究参与者的病历 年龄为30-50岁，现在已经50-65岁，这是许多医疗状况和健康问题的时期 倾向于表现。我们将确定社会隔离与不利健康之间与年龄相关的关联 SZ的结果，对家庭的测试，方向性和主持这种关联的因素，并确定 共同-19大流行和由此产生的锁定的程度影响了SZ的健康。我们将 考虑各国，性别和种族/种族的普遍性。拟议研究的理由 是为了促进急需的目标疗法以防止SZ早期死亡，我们需要更好 了解导致SZ医学合并症过多的因素。我们的中心假设是 社会隔离是SZ的常见和持久的特征，有助于过多 SZ合并症。为了满足我们的整体目标，我们将追求以下目标：（1）确定协会 在SZ的社会隔离和不良健康结果之间； （2）测试方向性和调节性 SZ社会隔离与健康成果之间的关联因素，以及； （3）检查是否 Covid-19-SZ中社会隔离与健康结果之间的大流行相关。这项研究会 成为第一个全面研究社会隔离在SZ中的健康影响的人。该项目可能表明 在中年的SZ社会化中，可以降低健康状况不佳的风险，并最终友好急需 预防靶向疗法以降低SZ的早期死亡率。