Daily Experiences among Black and White Dementia Caregivers: Implications for Well-being and Cardiovascular Health

非裔美国人（AAs）患阿尔茨海默病和相关痴呆的可能性是常人的2到3倍

African Americans (AAs) are 2 to 3 more times more likely have Alzheimer’s disease and related dementia (ADRD) compared to European Americans (EAs), placing high burden on AA families. AA ADRD caregivers tend to report better mental health but worse physical health than EA ADRD caregivers. Caregiving predicts increased risk of hypertension and coronary heart disease (CHD), which are more common among AAs than EAs. Studies of daily experiences provide crucial information regarding the mechanisms by which caregiving experience is linked with health, yet little is known about race differences in daily positive and negative experiences among ADRD caregivers or their links with daily well-being and cardiovascular health. In response to PAR-18- 027 Research on Informal and Formal Caregiving for Alzheimer's Disease, the present study seeks to understand the dynamic associations between daily experiences, well-being, and cardiovascular health among AA and EA ADRD caregivers. We will collect detailed self-report and cardiovascular data with two components: 1) a baseline interview, and 2) a daily study which incorporates a 5-day, 6-times a day, ecological momentary assessments (EMAs) of self-reported exposure and reactivity (psychological and behavioral) to negative and positive events, as well two ambulatory monitoring devices to assess cardiovascular reactivity (heart rate, heart rate variability, and blood pressure). The persons living with dementia (PLWDs) will also wear a monitor to assess heart rate, and heart rate variability. The sample will include 150 EA and 150 AA caregivers (70% women; 30% men) in the Detroit metropolitan area (recruited via area agencies and community organizations) who co-reside with and provide unpaid caregiving for a PLWD. The study addresses three aims: 1) Compare daily positive and negative care-related and noncare experiences among AA and EA caregivers, 2) Examine links among daily experiences (positive and negative care- related and noncare experiences), daily self-reported well-being, and daily cardiovascular health among AA and EA caregivers and the PLWD, and 3) Identify AA and AE caregivers who are more or less resilient to daily care-related and non-care stress. Identifying racial disparities in daily experiences that shape mental and physical health will inform targeted interventions to maintain caregivers’ well-being and enhance their ability to provide quality care.