Mindfulness Meditation and Insomnia in Alzheimer Disease Caregivers: Inflammatory and Biological Aging Mechanisms

阿尔茨海默病护理人员的正念冥想和失眠：炎症和生物衰老机制

• 批准号: 9926024
• 负责人: Michael R Irwin
• 金额: $ 7.1万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9926024
• 关键词: Academy; Adoption; Aging; Alzheimer' s Disease; American; Awareness; Beds; Behavior; Biological Aging; Caregiver Burden; Caregivers; Cell Aging; Chronic Insomnia; Clinic; Clinical Trials; Cognitive Therapy; Consumption; Cost Analysis; Drowsiness; Economics; Educational Curriculum; Elderly; Equipment and Supplies; Equipment and supply inventories; Family; Health; Healthcare; Human Resources; Impairment; Individual; Inflammatory; Internships; Intervention; Lead; Measures; Medicine; Methods; Outcome; Participant; Patients; Population; Primary Health Care; Psychiatry; Public Health; Randomized; Randomized Clinical Trials; Research; Resources; Risk Factors; Scanning; Science; Sleep; Sleep disturbances; Sleeplessness; Societies; Spouse Caregiver; Stimulus; Sum; Time; Training; Work; base; caregiving; clinical care; clinical practice; collaborative care; control trial; cost; cost-effectiveness evaluation; disorder risk; follow-up; genomic biomarker; improved; inflammatory marker; mindfulness; mindfulness intervention; mindfulness meditation; modifiable risk; mortality risk; sleep quality; standard of care; treatment arm; treatment choice

Project Summary/Abstract Over 5 million Americans provide informal Alzheimer's Disease (AD) caregiving, which negatively impacts caregivers' health and is associated with a 63% greater risk of mortality as compared to non-caregiving controls. Insomnia occurs in over 60% of AD caregivers and has independent negative influences on caregiver health and mechanisms of disease risk. Although insomnia is a modifiable risk factor, no prior study has targeted insomnia in AD caregivers. The ongoing randomized control trial, CARES, is evaluating the non-inferiority of Mindful Awareness Practices for Insomnia (MAP-I ) vs. Cognitive Behavioral Therapy for Insomnia (CBT-I) on outcomes of insomnia, cellular and genomic markers of inflammation, and cellular aging in older adult AD spousal caregivers with insomnia (N=150) over one-year follow-up. This supplement project will measure and estimate the costs associated with implementing the MAP-I and CBT-I interventions in the CARES trial. A micro-costing method will be used to itemize and abstract costs of all components included in each of the two interventions to estimate total and per-participant costs per intervention. For each step in each intervention arm, all inputs – including personnel, patient time, supplies and equipment – will be inventoried and measured. Unit costs will be applied to the quantities of each such resource consumed, and results will be summed to obtain total costs per component and overall for each of the MAP-I and CBT-I interventions. Per-participant costs will be estimated by dividing total costs by number of participants. The analysis will end with sensitivity analyses to evaluate the robustness of estimates to changes in key cost components.

项目摘要/摘要 超过500万美国人提供非正式的阿尔茨海默氏病（AD）护理，对此产生负面影响 护理人员的健康状况与非关注相比，死亡率高63％ 控件。失眠症发生在60％以上的广告护理人员中，对护理人员产生了独立的负面影响 疾病风险的健康和机制。尽管失眠是一种可修改的危险因素，但先前的研究没有 广告护理人员的有针对性失眠。 正在进行的随机控制试验CARES正在评估正念意识实践的不效率 对于失眠（CBT-I）的失眠（MAP-I）与认知行为疗法（CBT-I）有关失眠，细胞结局 炎症的基因组标记和失眠的老年人AD配偶护理人员的细胞衰老 （n = 150）在一年的随访中。该补充项目将衡量和估计与 在CARES试验中实施MAP-I和CBT-I干预措施。 微观构件的方法将用于逐项和抽象成本 每次干预措施估计总和参与者成本的两种干预措施。对于每个干预的每个步骤 ARM，所有投入（包括人，患者时间，用品和设备）将进行清单和测量。 单位成本将应用于每个此类资源的数量，结果将是夏季 对于MAP-I和CBT-I干预措施，获得每个组件的总成本和总成本。人均 成本将通过将总成本除以参与者的数量来估算。分析将以灵敏度结束 分析以评估估计值对关键成本组成部分变化的鲁棒性。