Couples Managing Early-Stage Dementia: Mutual Influences on Daily Stress, Self-Care, and Well-Being

项目摘要 阿尔茨海默病和相关痴呆症（ADRD）是目前日益增加的公共卫生问题， 影响了超过500万美国成年人和大约300万他们的配偶照顾者。该项目延伸 研究照顾者的压力和健康结果，考虑日常压力，自我照顾， 管理ADRD早期阶段的夫妇中的幸福感，这是一个潜在的关键时间窗口， 每一个护理伙伴的幸福。人们越来越认识到早期干预和自我护理的价值 在ADRD患者及其照顾者中实施的战略，反映了提高对 护理二人组内的早期相互影响，为维持其最佳健康的干预措施提供信息， 功能拟议中的指导职业发展奖结合了严格的研究计划， 导师制和教学法，以促进候选人的成长，朝着成为一个整体的职业目标， 一名独立调查员专注于为有复杂护理的老年夫妇提供干预措施的设计信息 包括ADRD在内的需求，以改善双方的福祉。培训目标将帮助候选人 获得：1）ADRD患者及其临床护理和教育需求的基础知识 配偶将为将研究结果转化为有针对性的干预措施提供基础; 2） 在评估，分析和解释压力的生物测量的专业技能，是潜在的 将ADRD护理情况与健康和福祉联系起来的机制;以及3）熟练使用强化 重复测量设计，将产生新的信息，近端风险和保护因素，为穷人 护理二人组内的结果。培训旨在进一步发展候选人的专业知识， 跨学科的研究人员在晚年的配偶关系，并与密切配合， 研究的目的是：1）检查自己和伴侣的日常压力，自我护理和良好的报告之间的联系， 2）确定自己和伴侣报告的日常压力源之间的联系， 护理二人组内压力的生物测量;以及3）确定哪些个人和夫妇或多或少 通过评估心理社会资源（自我效能，二元应对和婚姻质量） 在二元结构中，日常压力、自我照顾和幸福感之间的关联是适度的。这些发现将产生 日常相互影响对夫妻管理中积极和消极结果的关键知识 早期ADRD，提供有针对性的干预措施，以促进护理伙伴的福祉。

PROJECT SUMMARY Alzheimer's disease and related dementias (ADRD) are an increasing public health concern, currently affecting over 5 million US adults and approximately 3 million of their spousal caregivers. This project extends research on caregiver stress and health outcomes to consider the relations among daily stress, self-care, and well-being within couples managing the early stages of ADRD, a potentially critical time window to preserve each care partner's well-being. There is growing recognition for the value of early intervention and self-care strategies among persons with ADRD and their caregivers, reflecting the urgency for greater awareness of early mutual influences within care dyads that inform interventions to maintain their optimal health and functioning. The proposed mentored career development award combines a rigorous program of research, mentorship, and didactics to facilitate the candidate's growth toward an overall career goal of becoming an independent investigator focused on informing the design of interventions for aging couples with complex care needs including ADRD to improve both partners' well-being. The training aims will assist the candidate in acquiring: 1) grounded knowledge of clinical care and educational needs for persons with ADRD and their spouses that will provide a foundation for translating research findings into targeted interventions; 2) specialized skills in the assessment, analysis, and interpretation of biomeasures of stress that are potential mechanisms linking the ADRD care situation to health and well-being; and 3) proficiency in the use of intensive repeated measures designs that will generate novel information on proximal risk and protective factors for poor outcomes within care dyads. The training aims seek to further develop the candidate's expertise as an interdisciplinary researcher in the area of later-life spousal caregiving relationships and align closely with the research aims to: 1) examine the links among own and partner reports of daily stressors, self-care, and well- being within care dyads; 2) determine the links among own and partner reports of daily stressors and biomeasures of stress within care dyads; and 3) identify which individuals and couples are more or less resilient to stress by evaluating how psychosocial resources (self-efficacy, dyadic coping, and marital quality) within dyads moderate the associations among daily stress, self-care, and well-being. The findings will yield key knowledge of everyday mutual influences on positive and negative outcomes among couples managing early-stage ADRD, informing targeted interventions to promote the well-being of both care partners.