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

非裔美国人(AA)患阿尔茨海默病和相关痴呆症的可能性要高出2到3倍 (ADRD)与欧洲裔美国人(EAs)相比，给AA家庭带来了很大的负担。AA ADRD照顾者 倾向于报告比EA ADRD照顾者更好的心理健康但更差的身体健康。看护预示着 高血压和冠心病(CHD)的风险增加，这在AA中比 EAS。对日常经验的研究提供了关于照看的机制的关键信息 经历与健康有关，但人们对种族在日常生活中的积极和消极差异知之甚少 ADRD照顾者的经历或他们与日常福祉和心血管健康的联系。作为回应 根据PAR-18-027关于阿尔茨海默病非正式和正式护理的研究，本研究寻求 了解日常体验、幸福感和心血管健康之间的动态联系 在AA和EA ADRD照顾者中。我们将收集详细的自我报告和心血管数据 组成部分：1)基线访谈，2)每日研究，包括5天，每天6次，生态 自我报告的暴露和反应性(心理和行为)的瞬时评估(EMAS) 阴性和阳性事件，以及评估心血管反应性的两个动态监测设备 (心率、心率变异性和血压)。痴呆症患者(PLWD)也将穿着 用于评估心率和心率变异性的监测器。样本将包括150个EA和150个AA 底特律大都市区的照顾者(70%为女性；30%为男性)(通过地区机构和 社区组织)与PLWD共同居住并为其提供无偿护理的人。这项研究 解决三个目标：1)比较日常积极和消极护理相关和非护理体验 在AA和EA照顾者中，2)检查日常经历之间的联系(积极和消极的护理- 相关和非护理经历)、每日自我报告幸福感和每日心血管健康 在AA和EA照顾者和PLWD中，以及3)确定AA和AE照顾者中更多或 对日常护理相关和非护理压力的适应能力较差。辨别日常生活中的种族差异 塑造心理和身体健康将成为有针对性的干预措施，以维持照顾者的福祉和 增强他们提供优质护理的能力。

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.