ABSTRACT
Background While the global COVID-19 pandemic has hindered many human research operations, it has allowed for the investigation of novel scientific questions. Particularly, the effects of the pandemic and its resulting social isolation on elderly individuals and their association with Alzheimer?s disease biomarkers remains a broad and open question. Here, we sought to investigate whether knowledge of COVID-19, pandemic-related distress, and changes in sleep quality were associated with in vivo tau deposition in an AD-enriched cohort. Methods COVID-19 telephone assessments were conducted in N=292 individuals (29 young/174 CN/52 MCI/19 AD/18 other) of the TRIAD cohort in April-July 2020. Assessment consisted of clinical and neuropsychiatric, instruments, including scales assessing the individual?s experience of the pandemic. Structural MRI and [18F]MK6240 tau-PET were acquired before the pandemic. [18F]MK6240 standardized uptake value ratio (SUVR) were calculated 90-110 minutes post-injection using cerebellar grey matter as the reference region. Voxel-based regression analyses were conducted to examine the associations between baseline [18F]MK6240 SUVR and knowledge of COVID-19, distress related to COVID-19, and change in sleep quality since the pandemic. Results Higher tau-PET SUVR was associated with less knowledge of COVID-19 in N=210 individuals in the cuneus, cingulate and superior temporal regions. Tau-PET was similarly associated with lower levels of COVID-19-related distress in the isthmus and rostral anterior cingulate (N=201 individuals). Furthermore, tau-PET tracer uptake was significantly associated with increases in sleep quality as assessed by rate of change in Pittsburgh Sleep Quality Index before and during the pandemic (N=176 individuals). All results survived correction for multiple comparisons using random field theory with a cluster threshold of p < 0.001. Conclusion Our results suggest that those with increased tau deposition may have a weaker understanding of symptoms and prevention of COVID-19 and lower levels of distress related to the pandemic than individuals with less brain tau. Individuals with higher tau may also experience improved sleep quality during the pandemic. While these observations appear to be favourable effects of tau, the first may suggest that public health information about COVID-19 is less accessible to the aging population. The interactions and mediation of these effects remain to be properly elucidated.
ABSTRACT
Background Following the rapid spread of the COVID-19 virus throughout Quebec, the TRIAD cohort, a longitudinal observational study, evaluated the effects of COVID-19 on it?s aging and vulnerable population and their caregivers. This study aims at investigating the behavioural and psychological effects of COVID-19 and social isolation on the aging population. The TRIAD Assessment of Social Isolation and Cognition (TASIC) was developed to assess these effects on participants of observational trials. Method Pre-pandemic data including, demographical information, Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Montreal Cognitive Assessment (MoCA) and a Social Support Questionnaire, were collected during in-person visits and take-home questionnaires. Following the onset of COVID-19, TASIC was created to include additional COVID-19 specific scales developed by Dr. Rosa-Neto and Dr. King that include Knowledge of COVID-19 scale, the Montreal Assessment of Stress related to COVID-19 (MASC), as well as the Impact of Events Scale (IESR), the Peritraumatic Distress Inventory (PDI), the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) for COVID-19. Assessments were conducted via telephone interviews with TRIAD participants (n=292) and their informants (n=243) by eight trained research assistants from April through June 2020. All participants enrolled in previous TRIAD studies, deemed eligible through detailed screening criteria were contacted. Result As a result of this study, and previous work done by the cohort, a culmination of information is available, with 90% of TRIAD participants having completed the COVID-19 study also having plasma collected. 80% of participants from the COVID-19 study have PET imaging using [18F]AZD4694 and [18F]MK6240 and MRI sequencing. Conclusion The COVID-19 study conducted by TRIAD provides a unique opportunity to understand the effects of a global pandemic on our aging population as well as caregiver burden. This data, in conjunction with other measures available in the cohort, can make important strides in finding ways to help, and better understand those most impacted by the crisis.
ABSTRACT
Background The occurrence of the COVID-19 pandemic has had a significant impact on cohort studies, particularly those whose subjects are at higher risk of developing complications from the virus. As such, assessment methods must be adapted to minimize COVID-19 exposure risk. The TRIAD (Translational Biomarkers of Aging and Dementia) cohort assessed N=292 individuals during initial COVID-19 lockdown measures by telephone interview to rate cognition, neuropsychiatric symptoms, and impact of the pandemic. To increase speed and efficiency of data collection, we aim to follow these individuals by means of online survey. Here, we present a validation of our online assessment tools by comparing data obtained through both methods (phone interview and online survey) in the same subjects. Methods 10 subjects (4 elderly CN/3 MCI/3 AD) and their informants participated in this study. Subjects were varied for assessment language (English/French) and first assessment method (phone/online). 18 instruments were administered (listed in Table 1). Instrument scores were first compared by computing individual differences (phone-online), then by pooling all scores by assessment type and calculating an effect size. Pearson correlation coefficient between phone and online scores was also computed. Results Mean interval between assessments was 8.8±4.8 days. Mean length of online assessment (63.7±20.7mins) was comparable to mean phone interview length (72.6±32.4mins). Instrument scores from phone interviews had a total mean of 102.60, while scores from online surveys had a total mean of 103.93, with a pooled SD of 716.09. Effect size was -0.00186. Correlation of phone and online scores yielded a Pearson?s R of 0.85 (p<0.05). Pearson?s R was also computed by applying bootstrapping using 1000 resamples without replacement with a sample size of 50. The Pearson R coefficient after bootstrapping was 0.91 (95% CI: [0.7699-0.998]). Conclusion Our results suggest that instrument scores from phone and online assessments are comparable, and not significantly different from each other. The observed variance in scores between phone and online assessments may be due in part to the normal test-retest variability associated with re-administering instruments. This validation of online assessment tools in an aging population is of significant importance to human studies in the context of COVID-19.