Daily Experiences Among Couples Living With Early-Stage Dementia: Implications for Daily Sleep and Long-Term Well-Being and Cognitive Function

患有早期痴呆症的夫妇的日常经历：对日常睡眠、长期健康和认知功能的影响

• 批准号: 10658256
• 负责人: Courtney A. Polenick
• 金额: $ 77.57万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-15 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10658256
• 关键词: Acceleration; Affect; Aging; Alzheimer' s disease related dementia; Area; Caregivers; Caring; Cellular Phone; Chronic Disease; Cognition; Communities; Couples; Data; Data Collection; Dementia; Ecological momentary assessment; Elderly; Family; Health; Hour; Impaired cognition; Individual; Intervention; Interview; Knowledge; Life; Link; Literature; Mental Depression; Modeling; Observational Study; Outcome; Patient Self-Report; Personal Satisfaction; Persons; Play; Process; Reporting; Research; Rewards; Risk; Role; Self Efficacy; Shapes; Sleep; Sleep Disorders; Social support; Spouses; Stress; Surveys; Symptoms; Telephone; Testing; Time; United States; Variant; Well in self; Work; Wrist; actigraphy; adverse outcome; aged; cognitive function; cognitive testing; dementia care; depressive symptoms; effective intervention; experience; falls; gender difference; high risk; improved; improvement on sleep; individual variation; innovation; longitudinal design; member; mortality; novel; perceived stress; preservation; promote resilience; psychological distress; psychosocial resources; recruit; risk mitigation; sex; sleep quality; structured data

PROJECT SUMMARY Persons living with dementia (PLWD) frequently experience sleep problems (e.g., trouble falling and staying asleep), which may reduce psychological well-being and exacerbate cognitive decline. PLWD are often supported by their spouses or cohabiting partners who are themselves at increased risk of sleep problems, psychological distress, and cognitive impairment. Spouses shape one another’s health and well-being in the context of aging and chronic illness. However, ADRD care research has primarily focused on caregivers’ own sleep, well-being, and cognitive function, limiting knowledge of how each care dyad member’s experiences may influence sleep, well-being, and cognitive function within the care dyad. This project will advance the literature on ADRD care by testing a novel conceptual model within an innovative dyadic intensive longitudinal design to assess how daily perceived stress and positive experiences are associated with daily sleep as well as long-term impacts on well-being and cognitive function among couples living with early-stage ADRD. The proposed project will recruit 150 married or cohabiting couples aged 60 and older (300 individuals) in which one partner lives with early-stage ADRD. At baseline, both partners will be asked to complete hour-long phone interviews and in-person cognitive assessments followed by 7 consecutive days of brief ecological momentary assessment (EMA) smartphone surveys (5 times a day) and objective sleep tracking using wrist actigraphy. The hour-long phone interviews and cognitive assessments will be repeated at 1 and 2 years after baseline with midpoint check-in calls and brief semi-structured data collection at 6 months in between study waves. We will explore three specific areas of inquiry: First, we will determine whether own and partner reports of daily perceived stress and positive experiences predict daily sleep (e.g., self-reported sleep quality, objective sleep efficiency) within ADRD care dyads. Second, we will evaluate whether own and partner daily perceived stress, daily positive experiences, and daily sleep predict well-being (e.g., depressive symptoms) and cognitive function (e.g., global cognition) over 2 years within ADRD care dyads. Third, we will examine whether own and partner daily sleep reactivity (i.e., daily perceived stress-sleep links and daily positive experiences-sleep links) predicts well-being and cognitive function over 2 years within ADRD care dyads. In all three aims, we will examine variations by PLWD and spouse reports of psychosocial resources (personal mastery, self-efficacy, purpose in life, and social support) that may mitigate risk of adverse outcomes. Findings will identify potentially modifiable mechanisms at the daily level that explain both daily and long-term health outcomes within ADRD care dyads. Understanding dynamic processes and factors that promote resilience within ADRD care dyads will inform timely dyadic interventions to improve the health and functioning of PLWD and their spouses.

项目摘要 患有痴呆症（PLWD）的人经常遇到睡眠问题（例如，麻烦跌倒和 保持睡眠状态），这可能会减少心理健康并加剧认知能力下降。 PLWD通常是 在他们的配偶或同居伴侣的支持下，他们本身就是增加睡眠问题的风险， 心理困扰和认知障碍。配偶在彼此的健康和福祉中形成 衰老和慢性病的背景。但是，ADRD护理研究主要集中于看护人自己的 睡眠，福祉和认知功能，限制了每个护理二元成员如何经历的知识 可能会影响护理二元组中的睡眠，福祉和认知功能。这个项目将推进 通过在创新的二元密集型纵向中测试新颖的概念模型，通过测试ADRD护理的文献 设计以评估每日感知的压力和积极经历与日常睡眠的关系 随着对早期ADRD生活的夫妇的长期影响和认知功能的长期影响。 拟议的项目将招募150名已婚或同居的60岁及以上（300个人）的夫妇 一个合作伙伴在早期的addrd生活。在基线时，将要求两个合作伙伴完成长达一个小时 电话访谈和面对面的认知评估，然后连续7天短暂生态学 瞬时评估（EMA）智能手机调查（每天5次）和手腕的客观睡眠跟踪 摄影。长达一个小时的电话访谈和认知评估将在1和2年后重复 基线带有中点入住通话，在研究之间6个月时在6个月时进行简短的半结构数据收集 波浪。我们将探讨三个特定的询问领域：首先，我们将确定自己和合作伙伴报告是否和合作伙伴报告 每天感知到的压力和积极的经历可以预测每日睡眠（例如，自我报告的睡眠质量，客观 睡眠效率）在Adrd Care Dyad中。其次，我们将评估自己和合作伙伴是否每天感知到 压力，每日积极的经历和日常睡眠可以预测幸福感（例如抑​​郁症状）和认知 功能（例如，全球认知）在Adrd Care Dyads中超过2年。第三，我们将研究是否拥有 伴侣每日睡眠反应性（即每天感知到的压力 - 睡眠链接和每日积极的体验 - 睡眠链接） 在Adrd Care Dyads中预测2年的福祉和认知功能。在这三个目标中，我们将 检查PLWD和配偶的变体关于社会心理资源的报告（个人精通，自我效果， 生活的目的和社会支持）可能会减轻不良后果的风险。调查结果可能会确定 每天的可修改机制，这些机制在ADRD中解释了每日和长期健康结果 护理二元。了解动态过程和因素二元组中促进弹性的因素 将告知及时的二元干预措施，以改善PLWD及其配偶的健康和运作。