Predicting Risk for Adverse Outcomes in Dementia Caregivers

预测痴呆症护理人员不良后果的风险

基本信息

批准号：
10012937
负责人：
Robert Wayne Levenson
金额：
$ 70万
依托单位：
UNIVERSITY OF CALIFORNIA BERKELEY
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-15 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10012937
关键词：
Address Adverse effects Adverse event Affect Affective Aggressive behavior Agitation Alzheimer&apos s Disease Anger Anxiety Behavioral Behavioral Symptoms Biological Caregiver research Caregivers Caring Cognitive Data Dementia Dementia caregivers Diagnosis Discipline of Nursing Disease Economics Emotional Emotions Family Family member Formal caregiver Formal caregiving Frontotemporal Dementia Health Health Benefit Health Status Impairment Individual Individual Differences Intervention Laboratories Lead Life Link Loneliness Low income Measures Mental Depression Mental Health Methodology Methods Morbidity - disease rate Neurology Outcome Pathway interactions Patients Personal Satisfaction Persons Physiological Progressive Disease Psychology Public Health Quality of Care Questionnaires Research Risk Risk Factors Role Sampling Science Sleep disturbances Source Spouses Surveys Training Weight Gain Work adverse outcome base caregiver functioning caregiving dementia caregiving dementia risk effective intervention emotion regulation emotional behavior emotional factor emotional functioning emotional reaction experience informal caregiver informal caregiving innovation interdisciplinary approach interest mortality physical conditioning positive emotional state prevent psychologic psychological symptom response self esteem skills statistics

项目摘要

Alzheimer’s disease (AD) and frontotemporal dementia (FTD) lead to profound cognitive, emotional, and functional deficits. As the disease progresses, the person with dementia (PWD) becomes increasingly dependent on a caregiver (CG) for functional, psychological, and economic assistance. Caring for a PWD is a highly meaningful part of family life but can have adverse consequences for CGs including increased economic hardships, reduced health and well-being, and greater mortality. When CGs suffer these effects, their ability to provide high quality care for PWDs can become comprised, leading to an accelerating cycle of decline. Importantly, beneath these sobering group-level data are striking differences among individual caregivers in how profoundly they experience adverse effects, which raises the possibility that adverse effects of caregiving could be predicted, modified, or even prevented. The proposed research focuses on CG risk associated with emotional functioning in PWDs, CGs, and PWD-CG relationships. This focus reflects the profound impact that problematic emotional behaviors and psychological symptoms in PWDs have on CGs, the strong links between emotions and health, and our previous research linking emotional factors with adverse CG outcomes. CGs and PWDs will undergo a comprehensive, laboratory-based assessment of: (a) emotional reactivity—ability to generate emotional responses to significant challenges and opportunities; (b) emotion regulation—ability to adjust emotional responses to meet situational demands; and (c) emotion recognition—ability to detect emotions accurately in others and respond appropriately. Five studies are proposed to address four specific aims: Aim 1: To determine how emotional functioning in PWDs, CGs, and PWD-CG relationships is associated with individual differences in adverse CG outcomes (i.e., lower CG mental health, physical health, and well- being) during active caregiving (Study 1, N=180) and after caregiving has ended (Study 2, N=200). Aim 2: To use longitudinal assessments to evaluate hypothesized biological and behavioral pathways connecting risk factors with adverse CG outcomes during active caregiving (Study 3, N=84 studied for 3 years). Aim 3: To examine relationships between changes in CG health and PWD mortality (Study 4, N=400). Aim 4: To identify an optimal set of laboratory-based measures of emotional functioning for predicting adverse CG outcomes both during and after active caregiving and to determine their incremental validity compared to other established risk factors and traditional survey measures of emotional functioning (Study 5, N=350). Innovations include: (a) multidisciplinary approach (psychology, neurology, and nursing); (b) translational application of laboratory-based methods used in basic affective science methodology to CG research; (c) including CGs of individuals with both AD and FTD; (d) focusing on interpersonal functioning; (e) examining individual differences in adverse CG outcomes both during and after active caregiving; (f) examining adverse outcomes for both CGs and PWDs; and (g) longitudinal behavioral and biological assessments of CG functioning.

阿尔茨海默病 (AD) 和额颞叶痴呆 (FTD) 会导致严重的认知、情感和认知障碍随着疾病的进展，痴呆症患者（PWD）变得越来越多。依赖看护者 (CG) 提供功能、心理和经济援助。家庭生活中非常有意义的一部分，但可能会对 CG 产生不利后果，包括增加经济当 CG 遭受这些影响时，他们的能力就会受到影响。为残疾人士提供高质量的护理可能会变得困难，导致病情加速恶化。重要的是，在这些发人深省的群体层面数据之下，个体护理人员之间存在显着差异他们经历不利影响的程度有多深，这增加了照顾的不利影响的可能性可以预测、修改甚至预防。拟议的研究重点是与 CG 相关的风险。 PWD、CG 以及 PWD-CG 关系中的情绪功能反映了以下方面的深远影响。残疾人的有问题的情绪行为和心理症状对 CG 具有很强的联系情绪和健康，以及我们之前将情绪因素与不良 CG 后果联系起来的研究。残疾人将接受基于实验室的全面评估：(a) 情绪反应——能力 (b) 情绪调节——能力调整情绪反应以满足情境需求；以及 (c) 情绪识别——检测能力提出了五项研究来解决四个具体问题。目标：目标 1：确定 PWD、CG 以及 PWD-CG 关系中的情绪功能如何相关不良 CG 结果存在个体差异（即较低的 CG 心理健康、身体健康和健康状况）积极护理期间（研究 1，N=180）和护理结束后（研究 2，N=200）：目标 2：使用纵向评估来评估连接风险的已开发的生物和行为途径积极护理期间产生不良 CG 结局的因素（研究 3，N=84，研究了 3 年）。检查 CG 健康变化与 PWD 死亡率之间的关系（研究 4，N=400）：确定一套基于实验室的最佳情绪功能测量方法，用于预测不良 CG 结果在积极护理期间和之后，并确定其与其他护理相比的增量有效性建立了情绪功能的风险因素和传统调查措施（研究 5，N=350）。包括：(a) 多学科方法（心理学、神经学和护理学）；(b) 的转化应用； CG 研究的基本情感科学方法中使用的基于实验室的方法；同时患有 AD 和 FTD 的个体； (d) 关注人际功能；积极护理期间和之后不良 CG 结果的差异； (f) 检查不良结果；对于 CG 和 PWD；以及 (g) CG 功能的纵向行为和生物学评估。