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

痴呆症配偶照顾者的不良童年经历和个体差异：终生压力的生物行为方法

• 批准号: 10295122
• 负责人: Michelle A. Chen
• 金额: $ 4.5万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2022-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10295122
• 关键词: Adult; Aging; Alzheimer' s Disease; Alzheimer' s disease risk; Behavioral; Bereavement; Biological Markers; Blood; CCL2 gene; CCL4 gene; Caregiver Burden; Caregiver well-being; Caregivers; Child Abuse and Neglect; Childhood; Chronic; Chronic stress; Dementia; Disease; Elderly; Emotional; Exhibits; Face; Grief reaction; Health; Immune; Immune system; Individual; Individual Differences; Inflammaging; Inflammation; Inflammatory; Interleukin-1 beta; Interleukin-6; Intervention; Knowledge; Laboratories; Lead; Life; Link; Longevity; Mental Health; Modeling; Morbidity - disease rate; National Research Service Awards; Outcome; Parents; Participant; Pathway interactions; Patient Self-Report; Persons; Physiological; Population; Premature aging syndrome; Production; Psychological Stress; Quality of life; Recording of previous events; Reporting; Research Personnel; Risk; Risk Factors; Scientific Advances and Accomplishments; Spouse Caregiver; Spouses; Stress; Symptoms; System; TNF gene; Thinking; Time; United States National Institutes of Health; Work; adverse childhood events; age related; biobehavior; biological adaptation to stress; body system; caregiving; childhood adversity; cytokine; depressive symptoms; experience; foster care; improved; indexing; mortality; physical conditioning; psychologic; recruit; response; stressor; systemic inflammatory response; traumatic event

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.

项目概要/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 遇到。慢性心理压力会促进全身促炎症状态，从而产生负面影响 影响老年疾病和衰老。 “炎症”是一个新兴术语，描述慢性、 衰老过程中的全身炎症是发病率和死亡率的重要指标。因此，慢性压力 与 AD 相关的护理会对健康产生负面影响，因为它会导致免疫系统失调并增加 慢性炎症。然而，并非所有护理人员都会面临同样程度的风险。逆境童年 经历是童年时期发生的潜在创伤事件，会加剧成年后的压力诱发 整个生命周期中的免疫失调（即促炎细胞因子的产生升高）。不利 童年经历会导致个体对压力的生理反应失调，从而增加患上抑郁症的风险 在以后的生活中经历慢性压力（即作为 AD 配偶照顾者）时会产生不良健康后果。这 不良童年经历与老年人慢性压力之间关系的机制 成年后还没有完全理解。不良的童年经历会导致抑制控制的缺陷，从而 当老年面临慢性压力源时，可能会导致负面结果。抑制控制是指 控制不良想法或行为的能力，包括个人调节情绪的能力 压力时期的反应。鉴于抑制控制对调节压力的影响，抑制 控制是检查那些在老年时期经历慢性压力的人的重要机制。 此应用程序的目标是 (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志物（即升高 炎症）和 AD 配偶照顾者的福祉，以及（2）评估不良童年关联的模型 身体健康（即炎症加剧）和 AD 配偶照顾者的经历和抑制控制 福利。该方法是招募 110 名 AD 配偶照顾者，作为父级 NIH R01 研究的一部分。 参与者将完成对不良童年经历、抑制控制、健康、 照顾者的负担、悲伤症状和生活质量。参与者将完成“情绪面部Go/Nogo” 实验室行为任务以评估抑制控制并完成抽血以评估压力相关 生物标志物（即炎症）。拟议的研究将增进对个体风险因素的科学认识 AD 配偶照顾者中的疾病和过早衰老。进一步了解底层 整个生命周期的压力机制有助于预测与年龄相关的疾病和早产儿 老化。该项目将提供机制研究结果，使研究人员和临床医生能够识别有风险的 AD 更好地帮助配偶照顾者，并为量身定制的干预措施开辟新途径。