Adverse Childhood Experiences and Individual Differences among Dementia Spousal Caregivers: A Biobehavioral Approach to Stress Across the Lifespan

项目摘要/摘要 照顾患有阿尔茨海默病(AD)的配偶是一个人所能经历的最有压力的经历之一 相遇。慢性心理压力会促进全身性促炎状态，这可能会产生负面影响 影响老年和老龄化的疾病。“Inflammaging”是一个新兴的术语，用来描述慢性、 衰老中的全身性炎症是发病率和死亡率的重要指标。因此，慢性压力 与阿尔茨海默病相关的护理通过失调免疫系统和增加 慢性炎症。然而，并不是所有的照顾者都会经历同样程度的风险。不良童年 经历是发生在童年的潜在创伤性事件，会加剧成年后的压力诱导 免疫失调(即，促炎细胞因子的产生增加)贯穿整个生命周期。不利的 童年经历扰乱了个体对压力的生理反应，增加了患上 在以后的生活中经历慢性压力时的不良健康后果(例如，作为AD配偶照顾者)。这个 老年儿童不良童年经历与慢性应激关系的机制 人们对成年期的理解还不够充分。不利的童年经历会导致抑制性控制的缺陷，这 当在成年后面临慢性压力时，可能会导致负面结果。抑制性控制指的是 控制不想要的想法或行为的能力，包括个人调节自己情绪的能力 在压力时期的反应。鉴于抑制性控制对调节压力的影响，抑制性 控制是检查那些在成年后经历慢性压力的人的一个重要机制。 本应用程序的目标是(1)描述AD配偶照顾者之间的关系 不良童年经历史和配偶照顾者身体健康的生物标记物(即 炎症)和AD配偶照顾者幸福感，以及(2)评估将不良童年联系起来的模型 身体健康(即炎症升高)和AD配偶照顾者的经历和抑制性控制 幸福。该方法是招募110名AD配偶照顾者作为父母NIH R01研究的一部分。 参与者将完成对儿童不良经历、抑制控制、健康、 照顾者负担、悲伤症状和生活质量。参与者将完成“情绪面孔GO/NOGO” 评估抑制性控制和完成抽血以评估压力相关的实验室行为任务 生物标志物(即炎症)。拟议中的研究将提高对个人风险因素的科学认识。 用于AD配偶照顾者的疾病和过早衰老。进一步了解潜在的 整个生命周期的压力机制可能有助于预测年龄相关疾病和早产 衰老。该项目将提供机械性的发现，使研究人员和临床医生能够识别高危AD 更好地照顾配偶，并为量身定做的干预开辟新的途径。

Project Summary/Abstract Caregiving for a spouse with Alzheimer's disease (AD) is one of the most stressful experiences a person can encounter. Chronic psychological stress promotes a systemic pro-inflammatory state, which can negatively impact diseases of older adulthood and aging. “Inflammaging” is an emerging term characterizing the chronic, systemic inflammation in aging that is an important indicator of morbidity and mortality. Thus, chronic stress associated with AD caregiving negatively impacts health by dysregulating the immune system and increasing chronic inflammation. However, not all caregivers experience the same amount of risk. Adverse childhood experiences are potentially traumatic events that occur in childhood and exacerbate stress-induced adult immune dysregulation (i.e., elevated proinflammatory cytokine production) throughout the lifespan. Adverse childhood experiences dysregulate an individual's physiological response to stress, increasing the risk for adverse health outcomes when experiencing chronic stress later in life (i.e., as an AD spousal caregiver). The mechanisms underlying the relationship between adverse childhood experiences and chronic stress in older adulthood are not fully understood. Adverse childhood experiences cause deficits in inhibitory control, which may lead to negative outcomes when facing a chronic stressor in older adulthood. Inhibitory control refers to the capacity to control unwanted thoughts or actions, including an individual's ability to regulate their emotional responses during times of stress. Given the impact that inhibitory control has on regulating stress, inhibitory control is an important mechanism to examine among those experiencing chronic stress in older adulthood. The objectives of this application are to (1) characterize the relationships between AD spousal caregivers' history of adverse childhood experiences and biomarkers of spousal caregiver physical health (i.e., elevated inflammation) and AD spousal caregiver wellbeing and (2) evaluate models linking adverse childhood experiences and inhibitory control with physical health (i.e., elevated inflammation) and AD spousal caregiver well-being. The approach is to recruit 110 AD spousal caregivers as part of the parent NIH R01 study. Participants will complete self-report assessments of adverse childhood experiences, inhibitory control, health, caregiver burden, grief symptoms, and quality of life. Participants will complete an “Emotional Face Go/Nogo” laboratory behavioral task to assess inhibitory control and complete a blood draw to evaluate stress-related biomarkers (i.e., inflammation). The proposed study will advance scientific knowledge of individual risk factors for disease and premature aging among AD spousal caregivers. Further understanding of the underlying mechanisms of stress across the lifespan can be helpful in forecasting age-related disease and premature aging. The project will provide mechanistic findings, allow researchers and clinicians to identify at-risk AD spousal caregivers better, and open new avenues for tailored interventions.