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

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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.