Employment Status, Psychosocial Functioning, and Chronic Inflammation Among Dementia Spousal Caregivers

痴呆症配偶照顾者的就业状况、心理社会功能和慢性炎症

• 批准号: 10538206
• 负责人: Jensine Paoletti
• 金额: $ 6.72万
• 依托单位: RICE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10538206
• 关键词: Alzheimer' s Disease; Alzheimer' s disease related dementia; Americas; Atherosclerosis; Bereavement; Cancer Fatigue; Cardiovascular Diseases; Caregiver Burden; Caregivers; Caring; Chronic; Chronic stress; Conflict (Psychology); Data; Dementia; Dementia caregivers; Emotions; Employee; Employment; Employment Status; Equilibrium; Exhibits; Family; Family Caregiver; Fatigue; Feeling; Foundations; Funding; Future; Health; Health Psychology; Hour; Inflammation; Inflammatory; Inflammatory Response; Intervention; Investigation; Lead; Leisures; Life; Linear Regressions; Longitudinal Studies; Malignant Neoplasms; Mediating; Mediation; Mediator of activation protein; Mental Depression; Mental Health; Methods; Modeling; National Research Service Awards; Non-Insulin-Dependent Diabetes Mellitus; Occupational Health; Occupations; Osteoporosis; Outcome; Patient Self-Report; Patients; Poverty; Premature aging syndrome; Production; Psychoneuroimmunology; Psychosocial Factor; Research; Research Design; Research Personnel; Rest; Risk; Risk Factors; Role; Sampling; Social Environment; Spouse Caregiver; Spouses; Stress; Testing; Time; Widow; Work; Workplace; base; cardiovascular risk factor; care giving burden; caregiving; cytokine; dementia caregiving; effective intervention; emotion regulation; experience; family caregiving; frailty; mortality; novel; perceived stress; physical conditioning; prognostic; psychosocial; retiree; stressor; theories

Project Summary/Abstract Caregiving for a spouse with Alzheimer's disease and related dementias (ADRD) is an extreme, chronic stressor. There are 16 million informal (i.e., unpaid) ADRD caregivers in America; ADRD caregivers have chronically elevated inflammation relative to their non-caregiver counterparts1–3. Chronic inflammation is a risk factor for cardiovascular disease, atherosclerosis, type II diabetes, some cancers, fatigue, depression, premature aging, mortality, and Alzheimer's disease. ADRD caregivers often need to balance their caregiving duties with their employment responsibilities, as about half of all ADRD caregivers work over 20 hours per week4,5. To understand the impact of employment on ADRD caregivers’ psychosocial functioning and chronic inflammation, researchers must utilize theories and methods from occupational health psychology and psychoneuroimmunology. Compared to retired caregivers, employed caregivers experience two chronic stressors: employment and caregiving. Therefore, employed spousal caregivers may experience higher perceived stress than retired counterparts due to an additive effect of work stress plus caregiving stress. Working necessitates various demands and takes up a significant portion of time – time that could be used to care for their spouse or for their own rest and leisure. The time associated with employment, plus caregiving, may also result in employed caregivers evaluating their caregiving as more burdensome. This study aims to test the hypothesis that employment plus caregiving is related to poorer psychosocial functioning (i.e., perceived stress and subjective caregiver burden) and higher proinflammatory cytokine markers. Although inflammation has been implicated in studies of caregivers, very few studies have examined the inflammatory responses of caregivers’ workplace experiences6. Specific Aims: (1) To examine the role of employment status for ADRD spousal caregivers’ chronic inflammation. (2) To examine the role of employment status for ADRD spousal caregivers’ psychosocial functioning (i.e., perceived stress and caregiver burden). (3) To explore psychosocial functioning as mediators between employment status and chronic inflammation. Concurrent with an R01 project funded by NIA, this project will examine employment, psychosocial functioning, and chronic inflammation in a longitudinal study of 180 ADRD spousal caregivers (90 employed, 90 retired). Investigation of the relationship between employment and inflammation would further understanding of the role of employment as a risk factor for caregivers’ health. Results will yield important information for tailoring health interventions for ADRD caregivers. This proposed project will also introduce the applicant to psychoneuroimmunology and enable her research pipeline which will integrate occupational health psychology and psychoneuroimmunology.

项目摘要/摘要 照顾患有阿尔茨海默病和相关痴呆(ADRD)的配偶是一种极端、慢性的 压力源。在美国，有1600万非正式的(即无偿的)ADRD照顾者；ADRD照顾者有 相对于非照顾者的慢性炎症升高1-3。慢性炎症是一种风险 心血管疾病、动脉粥样硬化、II型糖尿病、某些癌症、疲劳、抑郁、 过早衰老、死亡率和阿尔茨海默氏症。ADRD照顾者通常需要平衡他们的照顾 职责与就业责任，因为大约一半的ADRD照顾者每天工作20小时以上 第4、5周了解就业对ADRD照顾者心理社会功能的影响 慢性炎症，研究人员必须运用职业健康心理学的理论和方法 和心理神经免疫学。与退休照顾者相比，在职照顾者经历了两种慢性病 压力源：就业和照料。因此，有工作的配偶照顾者可能会经历更高的 由于工作压力和照料压力的相加作用，感觉到的压力比退休的同龄人要大。 工作需要各种不同的要求，并占用了相当大一部分时间--本来可以用来 照顾配偶或照顾自己的休息和休闲。与就业相关的时间，加上照顾， 可能还会导致受雇的照顾者认为他们的照看工作更繁重。这项研究旨在 测试就业和照料与较差的心理社会功能相关的假设(即， 感受到的压力和主观的照顾者负担)和更高的促炎细胞因子标志物。虽然 炎症与照顾者的研究有牵连，很少有研究检查炎症 照顾者工作经历的反应6。具体目标：(1)研究就业的作用 ADRD配偶照顾者慢性炎症的状况。(2)研究就业状况在以下方面的作用 ADRD配偶照顾者的心理社会功能(即感知的压力和照顾者负担)。(3)至 探讨心理社会功能在就业状况和慢性炎症之间的中介作用。 与NIA资助的R01项目同时，该项目将检查就业、心理社会功能、 在一项对180名ADRD配偶照顾者(90名在职人员，90名退休人员)进行的纵向研究中，发现了慢性炎症。 调查就业和炎症之间的关系将进一步了解 关于就业对照顾者健康的风险因素的作用。结果将产生重要的 为ADRD照顾者量身定做健康干预措施的信息。这个拟议的项目还将 向申请者介绍心理神经免疫学，并使她的研究流水线 职业健康心理学和心理神经免疫学。