Individual differences in dementia spousal caregiver burden: A biobehavioral approach revision

摘要 SARS-Cov-2病毒的爆发加剧了痴呆症配偶照顾者的脆弱性， 老年痴呆症或相关痴呆症患者。SARS-Cov-2是一种高度传染性的病毒， 严重的呼吸系统问题甚至死亡老年人和有潜在合并症的所有年龄段的人群 被认为是COVID-19严重疾病的"高风险"。在这场大流行期间， 照顾者的任务是保护他们的配偶免受新冠病毒感染，甚至死亡的负担， 19，同时履行其典型的责任。绝大多数痴呆症 配偶照顾者及其患有痴呆症的配偶年龄超过65岁， COVID-19疾病并发症和死亡风险最高的人群。社交距离准则构成了一个 目前的预防建议的比例很大;因此，孤独和其他负面情绪将 可能比平时更频繁更强烈。拟议的竞争性修订以主要目标为基础， 父母补助金（R01AG062690）通过使用依恋理论作为一个总体理论框架， 了解2019冠状病毒病（COVID-19）背景下痴呆症配偶照顾者的风险和恢复能力 疾病）。拟定研究直接解决了PA-18 - 935、NOT-AG-20 - 022中的几个目标。 利用将参加父母研究的痴呆症配偶照顾者，我们建议收集 每个月一周，连续三个月。我们将收集这些数据使用生态瞬时 评估方法，同时通过智能手机被动评估位置、活动、自主活动和睡眠 智能手表技术。我们的目标是了解情绪，在自然的实时评估， 环境，影响AD配偶照顾者适应性地应对相关挑战的程度 新冠肺炎。我们还将致力于确定相对稳定的个体差异模式是如何起源于 人们的亲密关系历史（即，依恋取向）告知风险和弹性。作为探索性 高风险/高回报目标，我们将评估动态风险预测模型和机器学习方法 可以合并被动收集的信息（即，位置、心率、心率变异性、活动、睡眠）， 我们从我们的主要目标中学习的信息，以产生对现实世界的详细和复杂的理解 预测三个关键的COVID-19特定结果的动态：社交距离遵守，社交距离 自我效能和照顾者自我效能。通过了解风险和复原力的模式，干预科学家 将能够更好地识别有风险的AD配偶照顾者。拟议的研究将推动我们的 了解AD配偶照顾者如何减少自己和他们照顾的人的疾病暴露 因为这可能是对广告中社交距离的最全面、最详细、最实时、最真实的调查。 配偶看护人

Abstract The outbreak of SARS-Cov-2 virus has exasperated the vulnerability of dementia spousal caregivers, as well as those with Alzheimer’s disease or related dementias. SARS-Cov-2 is a highly contagious virus that can cause severe respiratory problems and even death. Older adults and people of all ages with underlying comorbidities are considered to be at “high-risk” for severe illness from COVID-19. During this pandemic, dementia spousal caregivers are tasked with the burden of keeping their spouse safe from getting sick and even dying from COVID- 19, while simultaneously performing their typical caregiving responsibilities. The vast majority of dementia spousal caregivers and their spouses with dementia are over sixty-five years of age, the age bracket that puts people at most risk for COVID-19 disease complications and mortality. Social distancing guidelines make up a large proportion of the current prevention recommendations; thus, loneliness and other negative emotions will likely be frequent and more intense than usual. The proposed competitive revision builds upon the primary aims of the parent grant (R01AG062690) by using attachment theory as an overarching theoretical framework to understand dementia spousal caregiver risk and resilience in light of coronavirus disease 2019 (COVID-19 disease). The proposed research directly addresses several objectives from the PA-18-935, NOT-AG-20-022. Capitalizing on the dementia spousal caregivers who will take part in the parent study, we propose to collect additional data for one week each month for three months. We will collect this data using ecological momentary assessment methods, while passively assessing location, activity, autonomic activity, and sleep via smartphone and smartwatch technology. We aim to understand how emotions, assessed in real-time in the natural environment, affect the extent to which AD spousal caregivers adaptively navigate the challenges associated COVID-19. We will also aim to determine how relatively stable individual difference patterns that originate from people’s close relationship histories (i.e., attachment orientations) inform risk and resilience. As an exploratory high risk/high reward aim, we will evaluate if dynamic risk prediction models and machine learning approaches can incorporate passively collected information (i.e., location, heart rate, heart rate variability, activity, sleep) with information that we learn from our primary aims, to yield a detailed and sophisticated understanding of real-world dynamics that predict three critical COVID-19 specific outcomes: social distancing adherence, social distancing self-efficacy, and caregiver self-efficacy. By understanding patterns of risk and resilience, intervention scientists will be better able to identify at-risk AD spousal caregivers. The proposed research would advance our understanding of how AD spousal caregivers can reduce illness exposure for themselves and those they care for in perhaps the most comprehensive, detailed, real-time, real-world investigation of social distancing in AD spousal caregivers to date.