Older Adults Living with Alzheimer's Disease and their Caregivers: Testing an Evidence-Based Intervention for Underserved Populations

患有阿尔茨海默病的老年人及其照顾者：测试针对服务不足人群的循证干预措施

• 批准号: 9443934
• 负责人: KAREN Ilene FREDRIKSEN-GOLDSEN
• 金额: $ 74.21万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9443934
• 关键词: Address; Adherence; Affect; Aftercare; Aging; Alzheimer' s Disease; Attenuated; Behavioral; Caregiver Burden; Caregivers; Caring; Censuses; Characteristics; Collaborations; Communities; Dementia; Dementia caregivers; Deterioration; Elderly; Evidence based intervention; Face; Faculty; Family Caregiver; Formal caregiving; Friends; Funding; Funding Opportunities; Gender; Generations; Health; Health Sciences; Healthy People 2020; Impaired cognition; Institute of Medicine (U.S.); Institutionalization; Interdisciplinary Study; Intervention; Intervention Studies; Long-Term Care; Long-Term Effects; Longitudinal Studies; Medical; Mental Depression; Minority; Oregon; Participant; Peer Review; Persons; Physical Exercise; Physical Function; Physical activity; Policies; Population; Positioning Attribute; Protocols documentation; Public Health; Publishing; Quality of life; Recruitment Activity; Research; Risk; Risk Factors; Role; School Nursing; Schools; Severities; Sexual and Gender Minorities; Sexuality; Site; Social Work; Social isolation; Social support; Spouses; Stigmatization; Testing; Time; Translating; Translations; Trauma; Underserved Population; United States National Institutes of Health; Universities; Washington; base; care recipients; caregiving; depressive symptoms; design; disability; efficacy testing; evidence base; experience; health care availability; health disparity; improved; informal care; informal caregiving; peer support; primary outcome; programs; response; secondary outcome; sex; social exclusion; social stigma; success; support network; symptomatology; therapy design; traumatic event; treatment effect

The Institute of Medicine identifies sexual/gender minority older adults as one of the most underserved populations, with significant health disparities. This at-risk group faces serious barriers to healthcare access, bias in health settings, and a lack of culturally competent care. The number of sexual/gender minority older adults living with Alzheimer's disease and related dementias (AD/RD) and their caregivers (CGs) are growing rapidly, and will exceed 4 million by 2060. The lack of efficacious research-based interventions implemented to reduce disability and depression, and improve quality of life for these older adults living with AD/RD and their CGs,is a significant public health problem. Research has documented the protective role of CGs in the health of older adults living with AD/RD as well as CGs' hardships and challenges in caregiving and the impact of caregiving on health deterioration. Caregiving of such vulnerable older adults with AD/RD is particularly of concern due to this population's lower rate of cross-generational ties and their social stigma and isolation, which may be barriers to sustaining caregiving relationships. This project builds on the success of two major NIH projects, Aging with Pride: National Health, Aging, and Sexuality/Gender Study (2R01 AG026526; K. Fredriksen-Goldsen, PI) and Reducing Disabilities in Alzheimer's Disease (RDAD); R01 AG10845; L. Teri, PI) and will test the efficacy of an enhanced RDAD intervention for stigmatized populations addressing identity management, historical trauma and diverse peer support networks. The project will address the following aims: Aim 1. Test the translation and enhancement of RDAD designed to increase physical activities of these vulnerable older adult CRs with AD/RD and their CGs . Aim 2. Evaluate the short- and long-term effect of the enhanced and standard RDAD on primary (physical activity and functioning, perceived stress for CGs, institutionalization for CRs) and secondary outcomes (HRQOL, depressive symptomatology, behavioral disturbances for CRs). Aim 3. Test the moderating roles of CR-CG characteristics, e.g., type of CR-CG relationship, sex, severity of CR AD/RD, on the treatment effect of the standard and enhanced RDAD. This team of nationally recognized experts has more than 20 years of conducting Alzheimer's and minority aging research, with the expertise and established relationships necessary to test the first evidence-based intervention for demographically diverse vulnerable older adults living with AD/RD and their CGs. The findings from this study will be fully disseminated through caregiving and aging agencies, community-based organizations, and research networks across multiple sites and settings.

医学研究所将性/性别少数的老年人确定为最重要的群体之一。 服务不足的人口，健康差距很大。这一高危群体面临着严重的 获得医疗保健的障碍、卫生机构的偏见以及缺乏文化上胜任的护理。 患有阿尔茨海默病和相关疾病的性/性别少数老年人的数量 痴呆症（AD/RD）及其护理人员（CG）正在迅速增长，到2020年将超过400万。 2060.缺乏有效的基于研究的干预措施，以减少残疾， 抑郁症，并改善这些患有AD/RD及其CG的老年人的生活质量， 一个重大的公共卫生问题。研究已经证明了CG的保护作用， AD/RD老年人的健康状况以及CG在康复过程中的困难和挑战 以及生育对健康恶化的影响。照顾这些脆弱的老年人 AD/RD尤其令人担忧，因为这一人群的跨代发病率较低， 联系以及他们的社会耻辱和孤立，这可能是持续发展的障碍， 关系。该项目建立在两个主要NIH项目的成功基础上，自豪的老龄化： 国家健康，老龄化和性/性别研究（2 R 01 AG 026526; K。弗雷德里克森-戈德森 PI）和减少阿尔茨海默病残疾（RDAD）; R 01 AG 10845; L. Teri，PI）和 将测试增强的RDAD干预措施对污名化人群的有效性， 身份管理、历史创伤和各种同伴支持网络。该项目将 实现以下目标：目标1。测试RDAD的翻译和增强， 增加这些患有AD/RD的脆弱老年CR及其CG的体力活动 . 目的 2.评价增强型和标准型RDAD对原发性肝癌的短期和长期影响 （身体活动和功能，CG的感知压力，CR的机构化）和 次要结局（HRQOL、抑郁症、CR的行为障碍）。 目标3。测试CR-CG特征的调节作用，例如，CR-CG关系的类型， 性别、CR AD/RD的严重程度、对标准和增强RDAD治疗效果的影响。这 一个由全国公认的专家组成的团队有20多年的阿尔茨海默氏症治疗经验， 少数民族老龄化研究，与专业知识和建立必要的关系，以测试 第一个以证据为基础的干预措施，针对人口统计学上多样化的脆弱老年人， AD/RD及其CG。这项研究的结果将通过宣传活动充分传播。 以及多个老龄化机构、社区组织和研究网络 网站和设置。