Spousal Dementia Caregivers: Risk for Accelerated Aging

配偶痴呆症照顾者：加速衰老的风险

• 批准号: 10261514
• 负责人: JANICE KIECOLT-GLASER
• 金额: $ 118.48万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10261514
• 关键词: Address; Age; Aging; Bacterial Translocation; Behavior; Behavioral; Biological Aging; Biological Markers; CD8-Positive T-Lymphocytes; CDKN2A gene; Caregiver Burden; Caregivers; Caring; Chronic; Chronic stress; Chronology; Clinic; Cytomegalovirus; Data; Dementia; Dementia caregivers; Dimensions; Disease; Distress; Endotoxins; Epigenetic Process; Family Practice; Gender; Health; Health Benefit; Home; Immune system; Immunologics; Impairment; Individual; Inflammaging; Inflammation; Intake; Intestinal permeability; Lead; Leaky Gut; Length; Longevity; Memory; Memory Disorders; Mental Depression; Meta-Analysis; Methodology; Molecular; Moods; Morbidity - disease rate; Nature; Ohio; Outcome; Pathway interactions; Persons; Process; Research; Risk; Risk Behaviors; Sampling; Source; Spouse Caregiver; Spouses; Stress; Support Groups; Telomere Shortening; Testing; Time; Visit; Woman; base; care recipients; caregiving; clinically significant; dementia caregiving; depressive symptoms; design; follow-up; frailty; frontier; healthspan; immune function; innovation; insight; men; mortality; novel; prospective; recruit; secondary analysis; seropositive; social relationships; sociodemographics; stressor; telomere

Project Summary/Abstract Many studies have shown that providing care for a spouse with dementia can be quite stressful, leading to a heightened risk for depression, multiple negative health outcomes, frailty, and early mortality. Stress- and depression-related immune system alterations are seen as a key pathway to poorer health in caregivers. However, the health impacts of caregiver stress have been questioned in recent years, based on newer evidence that caregiving may benefit health and extend lifespan. Furthermore, even though caregivers have typically had poorer immune function than noncaregiving controls, the clinical significance of these differences has been questioned. These discrepant findings reflect both methodological and conceptual issues that this project will address. Three molecular aging biomarkers (telomere length, p16INK4a expression, and epigenetic age) have each been associated with multiple diseases and disorders. Their combined use will provide an innovative way to quantify the long-term health risks of caregiving, allowing us to ask novel questions: Does caregiving accelerate aging? Can caregiving-related distress propel molecular aging and shorten health span (the length of time that a person is healthy—not just alive)? We will also assess three stress-sensitive pathways relevant to molecular aging: inflammation, intestinal permeability, and cytomegalovirus serostatus and reactivation. Drawing on behavioral, immunological, and molecular aging research, this transdisciplinary study will assess concurrent and prospective relationships related to key caregiving risk-related dimensions (gender, social relationships, caregiving intensity/burden, and benefit finding), and these aging biomarkers. Spousal dementia caregivers and sociodemographically-comparable married noncaregivers will be evaluated at study intake and then again one and two years later. This design will provide longitudinal data to assess changes in caregiving, depression, key risk behaviors, aging biomarkers, and the stress-sensitive pathways related to molecular aging. We have three specific aims: 1) To characterize the concurrent and prospective differences between caregivers and noncaregivers on the molecular aging biomarkers, inflammation, and mood. 2) To assess the relationships among the molecular aging biomarkers. 3) This exploratory aim addresses the relative contributions of key risk-related dimensions to depression, accelerated increases in aging biomarkers, and inflammation. This proposal describes a distinctly novel methodology that will provide a way to test innovative and original hypotheses about the ways that spousal dementia caregiving impacts lifespan and health span. The interactions between behavior and molecular aging represent an important new frontier for understanding how caregiving (and other chronic stressors) can accelerate or slow aging. This cutting edge research will help illuminate the mechanisms through which caregiving and depression influence health and longevity.

项目概要/摘要 许多研究表明，为患有痴呆症的配偶提供护理可能会带来很大的压力，导致 抑郁症、多种负面健康结果、虚弱和早期死亡的胃肠道风险。 与抑郁症相关的免疫系统改变被视为导致健康状况恶化的关键途径 然而，近年来，护理人员压力对健康的影响受到质疑。 新证据表明护理可能有益于健康并延长寿命。 护理人员的免疫功能通常比非护理对照组较差，临床意义 这些差异的存在受到了质疑。 该项目将解决的概念问题。 三种分子衰老生物标志物（端粒长度、p16INK4a 表达和表观遗传年龄）各自具有 它们与多种疾病和病症有关，联合使用将提供一种创新的方法。 量化护理的长期健康风险，使我们能够提出新的问题：护理是否会影响健康？ 护理相关的痛苦会加速衰老并缩短健康寿命吗？ 一个人健康的时间长度——不仅仅是活着）？我们还将评估三种压力敏感途径。 与分子衰老相关：炎症、肠道通透性和巨细胞病毒血清状态 这种跨学科的研究借鉴了行为学、免疫学和分子衰老研究。 研究将评估与关键护理风险相关维度相关的同时和前瞻性关系 （性别、社会关系、护理强度/负担和利益发现）以及这些衰老生物标志物。 配偶痴呆症照顾者和社会人口统计学上相当的已婚非照顾者将 在研究开始时进行评估，并在一年和两年后再次进行评估，该设计将提供纵向数据。 评估护理、抑郁、关键风险行为、衰老生物标志物和压力敏感的变化 我们有三个具体目标：1）表征同时发生和发生的情况。 护理人员和非护理人员在分子衰老生物标志物方面的前瞻性差异， 炎症和情绪 2) 评估分子衰老生物标志物之间的关系。 探索性目标涉及关键风险相关维度对抑郁症的相对贡献， 衰老生物标志物和炎症加速增加。 该提案描述了一种独特新颖的方法，该方法将提供一种测试创新和 关于配偶痴呆症护理影响寿命和健康寿命的方式的原始假设。 行为与分子衰老之间的相互作用代表了理解的重要新领域 这项前沿研究将如何加速或减缓衰老。 有助于阐明护理和抑郁影响健康和寿命的机制。