Alzheimer's Disease Research Center Determinants of health seeking behaviors during COVID-19 in persons with MCI/ADRD and their caregivers

The recent pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or coronavirus disease(COVID-19), has disrupted much in the world. New York City and Columbia University Irving Medical Centerhave been the hospital at the COVID national and international epicenter. The psychosocial and functionalimplications of COVID-19 on our local population are myriad. The population affected by mild cognitiveimpairment and dementia (including Alzheimer's Disease (AD) and Alzheimer Disease-related dementias(ADRD)) faces high case fatality rates and major disruptions in care following necessary social distancing policesfor high risk persons. These changes have imposed new and unexpected personal and professional caregiverstrains. Specifically, the following have occurred in the population for whom our center provides care:a) the loss of potential direct contact with professional caregivers due to their own social distancingrequirements, new person caregiving responsibilities, personal illnessesb) limited excursions in the local environment out of concerns, for contracting COVID-19, andc) closure of myriad social day activities, both formal and informal.As a result, during periods of social isolation, persons with dementia are largely bound to their homes,confused by the chaos, and perceive and express the stress their family members experience. Moreover, manyof these same family caregivers must balance remote work responsibilities and family caregiving, often withinthe same home. Unfortunately, some of these circumstances are untenable and have led to illness,hospitalization, and death of some of our patients and research participants, as well as their family members.This proposal will explore the experiences, knowledge, attitudes, healthcare-seeking behaviors, andpsychosocial support related to the NYC COVID-19 epidemic, particularly among adults with normal cognitionbeing followed in the ADRC as well as care partners for those persons with pathological cognitive aging, as wellas socioeconomic determinants. It is hypothesized that many adults will have experienced adverse outcomes,been impacted in their personal and professional caregiver expectations, and variably demonstrate COVID-19specific health seeking behaviors, as well as had care impacted, particularly those of advancing age or caringfor others with advancing age, in ethnic minorities, and disadvantaged socioeconomic groups.Better understanding health-seeking behaviors and determinants during and after the local COVID-19epidemic has potential implications both locally and potentially globally wherever community spread is growing.An effective survey instrument, with modules purposefully designed to be capture multigenerational effects maybe relevant to some time to come, until the current pandemic has passed, as well as future pandemics or otheremergencies which restrict social engagement and population movement.