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以及 那些患有阿尔茨海默氏症或相关痴呆的人。SARS-CoV-2是一种高度传染性的病毒，可导致 严重的呼吸系统问题，甚至死亡。老年人和所有年龄段的潜在合并症患者 被认为是新冠肺炎严重疾病的高危人群。在这场大流行期间，痴呆症配偶 照顾者的任务是保护他们的配偶不会生病，甚至死于COVID- 19岁，同时履行他们典型的照看责任。绝大多数痴呆症患者 配偶照顾者及其患有痴呆症的配偶年龄超过65岁，将 新冠肺炎并发症和死亡率的高危人群。社交距离准则构成了 目前的预防建议有很大比例；因此，孤独和其他负面情绪将 可能会比平时更频繁、更激烈。拟议的竞争性修订建立在主要目标的基础上 通过使用依恋理论作为总体理论框架来实现父母资助(R01AG062690) 根据冠状病毒疾病2019年了解痴呆症配偶照顾者的风险和弹性(新冠肺炎 疾病)。拟议的研究直接涉及PA-18-935而不是-AG-20-022的几个目标。 利用将参与父母研究的痴呆症配偶照顾者，我们建议收集 每月一周的额外数据，为期三个月。我们将使用生态瞬间收集这些数据 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 和智能手表技术。我们的目标是了解情绪是如何在自然环境中实时评估的 环境，影响AD配偶照顾者自适应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如何起源于 人们的亲密关系史(即依恋取向)决定了风险和韧性。作为一个探索者 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 可以将被动收集的信息(即位置、心率、心率变异性、活动、睡眠)与 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 预测三个关键新冠肺炎具体结果的动力学：社交疏远坚持、社交疏远 自我效能感和照顾者自我效能感。通过了解风险和弹性的模式，干预科学家 将能够更好地识别高危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风险 这也许是对AD中社交距离的最全面、最详细、最实时、最真实的调查 到目前为止的配偶照顾者。

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.