R01AG075043

Long-Term Impact of the COVID-19 Pandemic on Self-Management of Chronic Conditions: The C3 Study - Abstract

We will extend an active NIA cohort study of diverse, middle-aged and older adults with one or more chronic conditions to assess COVID-19's long-term and disparate impact on health and healthcare experiences. COVID-19 has become an unprecedented public health threat in modern times, especially for older adults with a chronic illness. As of January 2021, 94% of COVID deaths have been among adults over 55; 92% of those who have died had one or more underlying health conditions.

Beyond consequences to personal health associated with acquiring COVID-19, the impact of the pandemic may likely extend to non-COVID-19 outcomes as a patient's ability to self-manage chronic conditions during and after a pandemic may be compromised for several reasons.

In March 2020, our team rapidly launched the COVID-19 & Chronic Conditions (C3) study as cases of COVID-19 emerged in the U.S. to assess how adults with one or more chronic conditions were responding to the pandemic. Five active studies with uniform data collection on a range of patient-reported outcomes prior to COVID-19 and with electronic health records access were leveraged to establish the C3 cohort; 673 adults in Chicago were interviewed during the first week of the outbreak. The cohort was immediately expanded using two of the 'parent studies' that also had sites in New York City (N=200; N=873). C3 participants are diverse by socioeconomic status, race, ethnicity, gender, health literacy, and comorbidity.

An NIA COVID-19 supplement was awarded in August 2020 to expand the cohort via the parent studies (N=1200) and continue data collection up to 2022; 5 of 7 planned survey waves have been completed (83-94% retention). C3 findings reveal many adults exhibit sustained, high stress due to COVID-19 that impacts lifestyle, treatment adherence, and healthcare use. Disparities by sex, race, ethnicity, and SES also are present. Health professionals and researchers are now voicing concern for possible long-term consequences of COVID-19 on personal health and healthcare.

In response, we propose to continue to follow the C3 cohort to capture data 5 years post-onset of the U.S. outbreak. All participants will have a 'pre-COVID' baseline and 7+ follow-up assessments to assess trajectories in healthcare use, patient-reported, and chronic disease outcomes. Our primary aims are to:

1) Evaluate changes in lifestyle, health behaviors, healthcare use, health status, and chronic disease outcomes from a pre-pandemic baseline through 5 years after onset of COVID-19.
2) Determine the extent to which stress, anxiety, and depression contribute to poor health status and chronic disease outcomes through 5 years after the pandemic's onset.

Our secondary aim is to:

3) Identify factors that mediate or moderate associations between stress, anxiety, and depression during/after the pandemic with health status and chronic disease outcomes.

While our exploratory aim is to:

4) Explore whether health disparities by age, sex, race, ethnicity, or socioeconomic status emerge or worsen during/after the pandemic and the contributing role of stress, anxiety, and depression.

Northwestern University

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM; TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT; TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT; AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS; TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT; AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Chicago, Illinois 606114550 United States

Single Zip Code

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the total obligations have increased 365% from $682,908 to $3,172,685.