Alzheimer's Disease Research Center

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 Center have been the hospital at the COVID national and international epicenter. The psychosocial and functional implications of COVID-19 on our local population are myriad. The population affected by mild cognitive impairment 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 polices for high risk persons. These changes have imposed new and unexpected personal and professional caregiver strains. 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 distancing requirements, new person caregiving responsibilities, personal illnesses b) limited excursions in the local environment out of concerns, for contracting COVID-19, and c) 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, many of these same family caregivers must balance remote work responsibilities and family caregiving, often within the 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, and psychosocial support related to the NYC COVID-19 epidemic, particularly among adults with normal cognition being followed in the ADRC as well as care partners for those persons with pathological cognitive aging, as well as 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-19 specific health seeking behaviors, as well as had care impacted, particularly those of advancing age or caring for others with advancing age, in ethnic minorities, and disadvantaged socioeconomic groups. Better understanding health-seeking behaviors and determinants during and after the local COVID-19 epidemic 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 may be relevant to some time to come, until the current pandemic has passed, as well as future pandemics or other emergencies which restrict social engagement and population movement.