Social Connection and Suicide Risk in ADRD Caregivers

ADRD 护理人员的社会联系和自杀风险

• 批准号: 10723500
• 负责人: Kimberly Allison Van Orden
• 金额: $ 41.49万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10723500
• 关键词: Acceleration; Activities of Daily Living; Adult; Age; Aging; Alzheimer' s disease related dementia; Anxiety; Behavior; Caregivers; Caring; Cellular Phone; Cessation of life; Child; Chronic; Conflict (Psychology); Data; Day Care; Dementia; Dementia caregivers; Disease Progression; Ecological momentary assessment; Elderly; Etiology; Family; Family Caregiver; Family member; Feeling; Feeling suicidal; Fostering; Friends; Intervention; Intervention Studies; Interview; Knowledge; Life; Link; Loneliness; Mental Depression; Mental Health; Monitor; Observational Study; Perception; Personal Satisfaction; Persons; Pilot Projects; Recording of previous events; Reporting; Research; Research Design; Risk Factors; Role; Severities; Spouses; Suicide; Variant; Work; aging population; care giving burden; care recipients; caregiving; caregiving outcomes; dementia care; depressive symptoms; experience; follow-up; functional decline; functional status; indexing; middle age; response; satisfaction; social; stressor; suicidal behavior; suicidal risk; theories; Acceleration; Activities of Daily Living; Adult; Age; Aging; Alzheimer' s disease related dementia; Anxiety; Behavior; Caregivers; Caring; Cellular Phone; Cessation of life; Child; Chronic; Conflict (Psychology); Data; Day Care; Dementia; Dementia caregivers; Disease Progression; Ecological momentary assessment; Elderly; Etiology; Family; Family Caregiver; Family member; Feeling; Feeling suicidal; Fostering; Friends; Intervention; Intervention Studies; Interview; Knowledge; Life; Link; Loneliness; Mental Depression; Mental Health; Monitor; Observational Study; Perception; Personal Satisfaction; Persons; Pilot Projects; Recording of previous events; Reporting; Research; Research Design; Risk Factors; Role; Severities; Spouses; Suicide; Variant; Work; aging population; care giving burden; care recipients; caregiving; caregiving outcomes; dementia care; depressive symptoms; experience; follow-up; functional decline; functional status; indexing; middle age; response; satisfaction; social; stressor; suicidal behavior; suicidal risk; theories

Social Connection & Suicide Risk in ADRD Caregivers Providing care for a family member or friend with Alzheimer’s Disease and Related Dementias (ADRD, ‘caregivers’) is a common experience for adults in mid- and later-life and can foster experiences that are beneficial to mental health (e.g., purpose, mastery), but can also lead to anxiety, depression, and suicide ideation. Our scientific premise is that social disconnection—the quality and quantity of social ties with others— contributes to the most severe mental health problems during caregiving, including suicide ideation and behavior. Social disconnection is a common experience among caregivers and is one of the strongest risk factors for suicide ideation, attempts, and deaths. The Interpersonal Theory of Suicide proposes that stressors such as caregiving increase suicide risk by impacting two forms of social disconnection—feeling lonely (also termed low belonging) and like one is a burden on others (perceived burden). In line with NIA priorities of promoting well-being in caregivers and understanding mechanisms, our objective is to examine loneliness (and low belonging) and perceived burden on others as mechanisms that increase suicide risk in ADRD caregivers. This study builds on our team’s work on social connection in ADRD caregivers via the Rochester Roybal Center for Social Ties & Aging Research. Our pilot studies routinely assess suicide risk given the robust link between social disconnection and suicide risk. We found that at least 10% of caregivers screened for our pilot studies report suicide ideation in the past month. We propose an observational study of n=200 ADRD caregivers who report caregiving stress, loneliness, and recent suicide ideation in which subjects complete baseline interviews (to characterize caregiving and obtain histories of suicide ideation and behavior), 10 days of smartphone-based ecological momentary assessment (daily caregiving stressors and benefits, social connection, and suicide ideation), and 6-month follow-up (changes in care receiver functional status). Our first aim is to examine whether daily caregiving experiences are associated with daily variations in loneliness and perceived burden. We hypothesize that caregiving mastery and sense of purpose in life will be associated with lower loneliness and greater perceived burden, while caregiving strain, losses, and relationship conflict will be associated with greater loneliness and perceived burden. Our second aim examines whether loneliness and perceived burden predict daily variation in suicide ideation. We hypothesize that caregiving stressors will predict suicide ideation via increases in loneliness and perceived burden. Our third aim is to examine whether suicide ideation in caregivers is associated with worse caregiving outcomes in the short-term (next day caregiving stress, fewer positive interactions) and longer-term (functional decline at 6-month follow-up). Understanding mechanisms whereby caregiving may increase suicide risk could identify social connection as an intervention target and also increase knowledge about the role of daily stressors in the link between social disconnection and suicide in mid- and later life.

ADRD护理人员的社会联系和自杀风险 提供给家庭成员或阿尔茨海默氏病和相关痴呆症的朋友的护理（ADRD， “看护者”）是成年人中期和后期生活的常见经历，可以培养经验 对心理健康有益（例如，目的，精通），但也可能导致焦虑，抑郁和自杀 构想。我们的科学前提是社会脱节 - 与他人的社会联系的质量和数量 - 在护理过程中最严重的心理健康问题做出了贡献，包括自杀的想法和 行为。社会脱节是看护者的普遍经历，是强烈的风险之一 自杀想法，尝试和死亡的因素。自杀提案的人际理论是压力源 例如护理人员通过影响两种形式的社会脱节来增加自杀风险 - 孤独（也是如此） 被称为低属于属于的），就像一个人对其他人的燃烧（感知燃烧）。与NIA优先级 促进护理人员的幸福感和理解机制，我们的目标是检查孤独感（和 属于低的属性），并认为烧伤其他人是增加ADRD护理人员自杀风险的机制。 这项研究是基于我们团队通过罗切斯特Roybal在ADRD护理人员中的社交联系的工作 社会纽带和老龄化研究中心。我们的试点研究通常会根据稳健的链接评估自杀风险 在社会脱节和自杀风险之间。我们发现至少有10％的护理人员被筛选为我们的飞行员 研究报告了过去一个月的自杀想法。我们提出了一项n = 200 ADRD的观察性研究 报告护理压力，孤独和最近的自杀想法的护理人员，受试者完成了这些想法 基线访谈（要表征护理并获得自杀的想法和行为历史），10天 基于智能手机的生态瞬时评估（日常护理压力源和福利，社会 连接和自杀想法）和6个月的随访（护理接收器功能状态的变化）。我们的第一个 目的是检查日常护理经历是否与孤独的每日变化有关 感知负担。我们假设护理的精通和生活意识将与 降低孤独感和更大的感知烧伤，而照料压力，损失和关系冲突将是 与更大的孤独和感知负担有关。我们的第二个目标考试是孤独和 感知的烧伤预测自杀想法的每日变化。我们假设护理压力源将 通过增加孤独和感知负担来预测自杀的想法。我们的第三个目标是检查是否 护理人员的自杀构想与短期的护理结果较差有关（第二天 护理压力，较少的积极相互作用）和长期（6个月随访的功能下降）。 理解护理可能增加自杀风险的机制可以确定社会联系 干预目标，并增加有关日常压力源在社会联系中的作用的知识 中期和晚年的断开和自杀。