Style and Substance: Characterizing Dementia Caregiving Styles and Associated Biopsychosocial and Health Services Utilization Outcomes

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As the number of individuals with Alzheimer's disease and other forms of age-related dementia is increasing, millions of adults in the United States are taking on the role of caregiver for these individuals. Extending beyond existing work within the Stress Process Model, this work aims to identify caregivers at highest risk for negative psychological and physiological outcomes and increased health services utilization, by considering the understudied area of dementia caregiving styles. Dementia caregiving style may be defined by cognitive beliefs, readiness to change, and behavioral strategies toward dementia management. This mentored career development award aims to combine a program of focused research, mentorship, and didactics to enable the candidate's growth toward a long-term goal of becoming an independent researcher focused on the delineation of factors associated with the mental health and health outcomes of dementia caregivers, and developing and disseminating interventions targeted toward unique caregiving styles. Aims of the proposed training plan are to: 1) gain exposure to care challenges for persons with dementia and their families through observation of clinical encounters; 2) increase methodological knowledge of biomarker collection, assays, and statistical methodology, and latent class analysis; and 3) acquire skills to develop, implement, and evaluate future behavioral interventions utilizing the caregiving styles advanced during the proposal. The training objectives seek to develop the candidate's potential as a geriatric mental health services researcher and align closely with the research aims to: 1) characterize caregiving-style typologies through the mixed-methods assessment of dementia caregivers on cognitive beliefs, readiness to change, and behavioral strategies toward dementia management. Semi-structured qualitative interviews and latent-class analysis will be used to determine how these measures cluster within distinct caregiving styles. 2) Define high-risk groups of caregivers by the association of biomarkers of the stress process, psychological well-being, and health services utilization with caregiving styles. 3) Finally, an exploratory aim will consider the mutability of caregiving styles over 6 months. The expected results would significantly increase understanding of high-risk groups of caregivers which would benefit from interventions tailored toward these distinct caregiving styles, thereby improving outcomes for both people with age-related dementia and their caregivers.