Mindfulness Meditation and Insomnia in Alzheimer Disease Caregivers: Inflammatory and Biological Aging Mechanisms

项目概要/摘要 超过500万美国人提供非正式的阿尔茨海默病（AD）治疗，这对他们的健康产生了负面影响。 照顾者的健康，与非照顾者相比， 对照超过60%的AD照顾者发生过强迫症，并且强迫症对照顾者有独立的负面影响 健康和疾病风险机制。虽然失眠是一个可改变的危险因素，但没有先前的研究表明， 针对性失眠的AD照顾者。 正在进行的随机对照试验CARES正在评估正念觉知练习的非劣效性 失眠症（MAP-I）与失眠症的认知行为疗法（CBT-I）对失眠症，细胞 老年AD配偶照顾者失眠患者的炎症和细胞衰老的基因组标志物 （N=150）1年随访。该补充项目将衡量和估计与以下方面有关的费用： 在CARES试验中实施MAP-I和CBT-I干预。 将采用微观成本计算方法，逐项列出和提取每个项目中所有组成部分的成本， 两项干预措施，以估计每项干预措施的总成本和每名参与者成本。对于每次干预的每一步 在第一阶段，所有投入-包括人员、病人时间、用品和设备-都将被清点和衡量。 单位成本将适用于每种此类资源的消耗量，结果将汇总为 获得MAP-I和CBT-I每项干预措施的每个组成部分和总体总成本。每个参与者 费用将通过总费用除以与会者人数来估算。分析将以敏感性结束 进行分析，以评估估计数对关键成本组成部分变化的稳健性。

Project Summary/Abstract Over 5 million Americans provide informal Alzheimer's Disease (AD) caregiving, which negatively impacts caregivers' health and is associated with a 63% greater risk of mortality as compared to non-caregiving controls. Insomnia occurs in over 60% of AD caregivers and has independent negative influences on caregiver health and mechanisms of disease risk. Although insomnia is a modifiable risk factor, no prior study has targeted insomnia in AD caregivers. The ongoing randomized control trial, CARES, is evaluating the non-inferiority of Mindful Awareness Practices for Insomnia (MAP-I ) vs. Cognitive Behavioral Therapy for Insomnia (CBT-I) on outcomes of insomnia, cellular and genomic markers of inflammation, and cellular aging in older adult AD spousal caregivers with insomnia (N=150) over one-year follow-up. This supplement project will measure and estimate the costs associated with implementing the MAP-I and CBT-I interventions in the CARES trial. A micro-costing method will be used to itemize and abstract costs of all components included in each of the two interventions to estimate total and per-participant costs per intervention. For each step in each intervention arm, all inputs – including personnel, patient time, supplies and equipment – will be inventoried and measured. Unit costs will be applied to the quantities of each such resource consumed, and results will be summed to obtain total costs per component and overall for each of the MAP-I and CBT-I interventions. Per-participant costs will be estimated by dividing total costs by number of participants. The analysis will end with sensitivity analyses to evaluate the robustness of estimates to changes in key cost components.