Consequences of social isolation during the COVID-19 pandemic in older adults with and without Alzheimer's disease

COVID-19 大流行期间社交隔离对患有和不患有阿尔茨海默病的老年人的影响

• 批准号: 10585667
• 负责人: Andrew Budson
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585667
• 关键词: Address; Adult; Affect; Alzheimer' s Disease; Alzheimer' s disease risk; Anxiety; Behavior; Belief; COVID-19 pandemic; COVID-19 pandemic effects; Cessation of life; Cognition; Cognitive; Cognitive Science; Complex; Data; Dementia; Elderly; Environment; Feeling; Future; Goals; Grant; Guidelines; Health; Hippocampus; Home; Impaired cognition; Individual; Light; Loneliness; Measures; Memory Loss; Mental Depression; Misinformation; Modernization; Moods; Neighborhoods; Neuropsychological Tests; Outcome; Participant; Personality; Personality Character; Persons; Procedures; Prospective Studies; Psyche structure; Questionnaires; Recommendation; Reporting; Research; Resources; Sampling; Security; Shapes; Social Behavior; Social Distance; Social isolation; Social support; Stereotyping; Surveys; Techniques; Testing; Time; United States; Variant; Veterans; behavior change; built environment; cognitive function; cognitive testing; coping; coronavirus disease; dementia risk; design; effective intervention; emotional factor; experience; follow-up; human old age (65+); improved; long term consequences of COVID-19; mild cognitive impairment; military veteran; neuroinflammation; pandemic disease; pandemic response; physical conditioning; protective effect; psychosocial; recruit; social cognition; social contact; social factors; social relationships; time interval; video chat

The COVID-19 pandemic has caused over half a million deaths in the United States alone. Even for those individuals whose physical health and financial security have not been impacted, the consequences of pandemic-induced isolation on mental and cognitive health may be far-reaching— especially for our Veterans. Prior to the pandemic, approximately 10% of older Veterans reported feeling lonely often and 40% indicated feeling lonely some of the time. Due to social distancing guidelines and other measures that limit social contact, loneliness during the pandemic has likely been far greater than these estimates. Decades of research have supported the protective effect of social relationships on cognition in older adulthood; thus, the disruption of social support related to the pandemic may impact cognitive function in the older Veteran population. To address this possibility, we propose a prospective study to examine the relationships between isolation in the pandemic and subsequent cognitive function in healthy older adult Veterans and in older Veterans with Alzheimer’s disease (AD) (Aim 1). In addition, forced isolation is likely not the only factor with important consequences in the pandemic. We propose investigating two other pandemic-related contexts that may either mitigate the effects of isolation in the pandemic or exacerbate the consequences of cognitive impairment on health-related outcomes for older Veterans. First, older Veterans may be able to cope with isolation through use of features of the built environment, such as porches, window views, and public neighborhood space. However, the extent the built environment may be able to mitigate pandemic-related loneliness in older adults is unknown. In Aim 2, we test the hypothesis that built environment factors will mitigate or contribute to social isolation in older Veterans with and without AD. In addition, individuals’ cognition may be impacted by their belief in misconceptions related to social isolation itself. In Aim 3, we test the relationship between cognitive function and the ability to correct misconceptions related to social isolation and AD—and whether such corrections engender changes in behavior. To accomplish Aims 1-3, we will apply questionnaires and neuropsychological tests administered during the first wave of the pandemic (June 2020-June 2021) to 196 participants over three additional one-year time intervals from October 2022 to September 2025. In Aim 1, we will test the relationship between social isolation in the pandemic and cognitive function one, two, and three years later. In Aim 2, we will test whether older Veterans with fewer built environment resources will demonstrate a worsening of social isolation, loneliness, depression, anxiety, and cognition over time. In Aim 3, two objectives will be tested. First, we will determine the extent that individuals with and without cognitive impairment due to AD can successfully change their belief in misconceptions related to social isolation and AD through a correction procedure over time. Second, we will test whether corrections related to changes in behavior at delayed intervals of 1 and 2 years. Preliminary cross-sectional data from our already recruited final sample of older adults (N=196) with and without AD support the relationships between social isolation and cognitive impairment (Aim 1), the built environment and social isolation (Aim 2), and cognitive impairment and misconception correction (Aim 3). As the ramifications of the pandemic continue to unfold for years—possibly decades—it is imperative that we understand the relationship between social isolation and future cognitive impairment in Veterans with and without Alzheimer’s disease.

仅在美国，COVID-19 大流行就已造成超过 50 万人死亡。 那些身体健康和财务安全未受到影响的个人， 大流行引起的隔离对心理和认知健康的影响可能是深远的—— 尤其是对于我们的退伍军人来说，在大流行之前，大约 10% 的老年退伍军人报告说。 经常感到孤独，40% 的人表示有时会因为社交距离而感到孤独。 限制社交接触的指导方针和其他措施，大流行期间的孤独感可能会增加 远远大于这些估计，数十年的研究证明了其保护作用。 社会关系对老年认知的影响；因此，与社会支持相关的破坏 大流行可能会影响老年退伍军人的认知功能。 可能性，我们提出了一项前瞻性研究来检验孤立性之间的关系 健康老年退伍军人和老年退伍军人的流行病和随后的认知功能 阿尔茨海默病 (AD)（目标 1）此外，强制隔离可能不是唯一的因素。 我们建议调查另外两个与大流行相关的重要后果。 可能会减轻大流行中隔离的影响或加剧的情况 认知障碍对老年退伍军人健康相关结果的影响首先，老年退伍军人。 退伍军人也许能够通过使用建筑环境的特征来应对孤立，例如 门廊、窗景和公共邻里空间。 是否能够减轻老年人与大流行相关的孤独感尚不清楚。在目标 2 中，我们测试了。 假设建筑环境因素将减轻或加剧老年退伍军人的社会孤立 此外，无论是否患有AD，个人的认知可能会受​​到他们的信念的影响。 与社会孤立本身相关的误解 在目标 3 中，我们测试了认知之间的关系。 纠正与社会孤立和AD相关的误解的功能和能力——以及是否 为了实现目标 1-3，我们将采取此类纠正措施来改变行为。 第一波大流行期间进行的问卷调查和神经心理学测试 （2020 年 6 月至 2021 年 6 月）从 10 月开始，在另外三个一年的时间间隔内，共有 196 名参与者 2022 年至 2025 年 9 月。在目标 1 中，我们将测试社会隔离与 在目标 2 中，我们将测试一年、两年和三年后的流行病和认知功能是否变老。 建筑环境资源较少的退伍军人将表现出社会孤立感恶化， 随着时间的推移，孤独、抑郁、焦虑和认知将受到考验，首先是两个目标。 我们将确定患有或未患有 AD 认知障碍的个人可以在多大程度上 通过以下方法成功改变了他们对社会孤立和 AD 相关误解的看法 其次，我们将测试修正程序是否随时间的变化而变化。 我们已经得到了延迟 1 年和 2 年的初步横截面数据。 招募了最终的老年人样本（N = 196），有和没有AD支持之间的关系 社会隔离和认知障碍（目标 1）、建筑环境和社会隔离（目标 2）、 认知障碍和误解纠正（目标 3）。 持续发展数年（可能数十年），我们必须了解这种关系 患有和不患有阿尔茨海默病的退伍军人的社会孤立与未来认知障碍之间的关系 疾病。