Determining the Longer-term Impact of COVID-19 Stressors, Alcohol Use and Neurobiobehavioral Decline in Older Adults Through Prospective Study

Project Summary/Abstract Although the COVID-19 pandemic is leaving no one untouched, the health of older adults and Black, Indigenous and other people of color (BIOPC) has been disproportionately impacted. Further, the emergent variants and data demonstrating that at least some variants can be contracted and transmitted by those vaccinated are accompanied by continued messaging emphasizing mask-wearing and social distancing, exacerbating concerns of social re-engagement. An extant literature demonstrates that social distancing is linked to a host of biopsychosocial consequences including psychological distress, loneliness, sleep disruption, pain severity, and of particular relevance here, escalation in alcohol use and cognitive decline. Critically, these outcomes have noted interactions and are particularly disadvantageous in the context of concurrent aging processes. Thus, there are compelling arguments for study of biopsychosocial outcomes of the COVID-19 pandemic among older adults. Additionally, given the disproportionate impact on BIOPC and studies (albethey limited) illustrating race- related differences in vulnerability to isolation related stressors, it is imperative that purposeful study of the role of race/ethnicity be conducted. Finally, although there is a large literature detailing female sex as a risk factor for increased vulnerability for psychological distress and related outcomes, the manner and degree to which such risk would be evidenced in light of the prolonged COVID-19 pandemic and as a function of age and race/ethnicity is not known. Currently emerging data address some of these issues as they were experienced in early phases of the pandemic. However, characterizing the long-term consequences of this prolonged pandemic requires conceptually-driven longitudinal study, expeditiously initiated. If delayed, information fundamental to scientific progress and public health programming will be missed. Thus, guided by RFA AA-21-002 and existing data, we propose a prospective, multi-method/multi-modal longitudinal study directed to clarifying the interactive effects of COVID-19 stressors (i.e., sleep quality, psychological distress, loneliness/negative affect and chronic pain), alcohol use and neurobiobehavioral decline/stability in 160 older (age 65-75) male and female current drinkers (n=80 each) of both majority and minority race/ ethnicity (60/40 distribution) while controlling for essential covariates such as emotional and physical proximity to COVID-19. Through longitudinal assessment across 3 years, we will define the pandemic's evolving impact and clarify significant modulators of outcomes. Together, these data will inform both scientific questions regarding the long-term impact of COVID-19 stressors, patterns of alcohol use, and neurobiobehavioral change and public health planning and prevention efforts.