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: 10680522
• 负责人: ABRAHAM REICHENBERG
• 金额: $ 64.44万
• 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/10680522
• 关键词: Acceleration; 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; Elderly; Environment; Ethnic Origin; Ethnic Population; Europe; Exhibits; General Population; Goals; Government; Health; Individual; Life; Loneliness; Longevity; Measures; Medical; Medical Records; Mental Depression; Natural experiment; Outcome; Participant; Patients; Pattern; Phenotype; Physically Challenged; Physicians; Premature Mortality; Preventive; Process; Psychotic Disorders; Race; Research; Resources; Risk; Risk Factors; Risk Reduction; 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; medical examination; middle age; mortality; neuropsychiatry; physical conditioning; physical inactivity; poor health outcome; post-pandemic; premature; prevent; racial population; 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.

项目概要 被诊断患有精神分裂症和相关精神病 (SZ) 的个体表现出明显升高的风险 过早死亡，与一般人群相比，寿命缩短 10-20 年。 深圳的发病率很大程度上归因于通常在晚些时候出现的医疗状况的早期表现 生活中，一个被称为“加速衰老”的过程是不健康的生活方式，例如吸烟和不健康的行为。 饮食，在一定程度上是深圳加速衰老的原因，过多的身体合并症不能仅仅归因于 值得注意的是，SZ 的关键临床特征很少对健康产生直接的不良影响。 对于普通人群来说，缺乏社会接触会带来巨大的挑战。 对于身体健康，尤其是老年人来说，社会孤立是一个持续存在的、令人丧失能力的特征。 SZ，这种行为可能会导致 SZ 的健康状况过早显现。 丰富的试点数据表明社会孤立与长期感知之间存在显着关联 深圳的健康，我们的首要目标是测试社会隔离是否以及如何影响健康 来自欧洲 (EU-GEI) 和美国 (Olin) 的参与者随着年龄的增长而面临的挑战。 神经精神病学研究中心），我们将创建一个包含 650 名参与者的纵向数据库，其中 500 患有 SZ 的个体及其 150 名未受影响的加速兄弟姐妹我们将通过重新应用纵向设计。 评估并检查研究参与者的医疗记录，这些参与者在 30-50岁和现在的50-65岁，这个时期是许多医疗状况和健康问题的时期 我们将确定社会孤立与不良健康之间的年龄相关性。 SZ 的结果，测试熟悉度、方向性和调节这种关联的因素，并确定 COVID-19 大流行以及由此产生的封锁对深圳健康的影响程度我们将予以关注。 考虑跨国家、性别和种族/民族的普遍性 拟议研究的基本原理。 是为了促进急需的靶向治疗以预防深圳的早期死亡，我们需要更好地 了解导致深圳出现过多医疗合并症的因素 我们的中心假设是： 社会孤立是深圳的一个普遍且持久的特征，导致身体活动过度 为了实现我们的总体目标，我们将追求以下目标： (1) 确定关联。 深圳的社会隔离与不良健康结果之间的关系；（2）测试方向性和调节性 深圳的社会孤立与健康结果之间的关联因素，以及 (3) 检查是否 COVID-19 大流行改变了深圳的社会隔离与健康结果之间的关联。 成为第一个全面研究深圳社会隔离对健康影响的项目。 在深圳，中年社会化可以降低不良健康结果的风险，并最终促进急需的 预防性靶向治疗可降低深圳的早期死亡率。