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.

项目概要 痴呆症患者 (PLWD) 经常遇到睡眠问题（例如，跌倒困难和 （保持睡眠）可能会降低心理健康并加剧 PLWD 的认知能力下降。 得到其配偶或同居伴侣的支持，而他们自己也面临更高的睡眠问题风险， 心理困扰和认知障碍影响着彼此的健康和福祉。 然而，ADRD 护理研究主要关注护理人员自身的情况。 睡眠、幸福感和认知功能，限制了对每个护理二人成员的经历的了解 可能会影响护理二元组中的睡眠、幸福感和认知功能。 通过在创新的二元密集纵向测试中测试新颖的概念模型来研究 ADRD 护理文献 旨在评估日常感知压力和积极体验与日常睡眠的关系 对患有早期 ADRD 的夫妇的健康和认知功能产生长期影响。 拟议项目将招募 150 名 60 岁及以上的已婚或同居夫妇（300 人） 哪一方患有早期 ADRD 在基线时，双方都将被要求完成长达一小时的任务。 电话访谈和现场认知评估，然后是连续 7 天的简短生态 瞬时评估 (EMA) 智能手机调查（每天 5 次）和使用手腕进行客观睡眠跟踪 长达一小时的电话访谈和认知评估将在 1 年后和 2 年后重复进行。 基线，包括中点登记电话和研究之间 6 个月的简短半结构化数据收集 我们将探讨三个具体的询问领域：首先，我们将确定自己和合作伙伴是否进行报告。 每日感知的压力和积极经历可预测每日睡眠（例如，自我报告的睡眠质量、客观的睡眠质量） ADRD 护理二元组中的睡眠效率） 其次，我们将评估自己和伴侣的日常感知。 压力、每日积极经历和每日睡眠可预测幸福感（例如抑​​郁症状）和认知能力 第三，我们将检查是否拥有和使用 ADRD 护理二人组中的功能（例如整体认知）。 伴侣每日睡眠反应性（即每日感知的压力-睡眠联系和每日积极体验-睡眠联系） 预测 ADRD 护理二元组内 2 年内的福祉和认知功能 在所有三个目标中，我们将。 检查 PLWD 和配偶报告的心理社会资源（个人掌控力、自我效能、 生活目标和社会支持）可以减轻不良结果的风险。 日常层面的可修改机制，可以解释 ADRD 中的日常和长期健康结果 了解促进 ADRD 护理二元内复原力的动态过程和因素。 将告知及时的二元干预措施，以改善 PLWD 及其配偶的健康和功能。