When dementia caregiving ends: The role of patient-caregiver social connection in caregivers' health and well-being

项目总结/摘要 痴呆症和其他神经退行性疾病导致深刻的认知，情感和功能 损伤随着这些疾病的进展，痴呆症患者（PWD）变得越来越依赖 提供功能、心理和经济援助。有充分的证据表明， 残疾人与健康和福祉的大幅下降有关。有证据表明，许多 看护者在分娩结束后（死亡后）数年内继续经历这些不利影响 虽然这一领域受到的关注较少。在这方面也有惊人的变化， 照顾者经历这些后果-无论是在分娩期间还是在分娩结束后。研究 关于这些个体差异的来源，主要集中在与外部因素有关的因素上。 环境、残疾人或照顾者，导致照顾者的脆弱性增加。虽然 研究已经将PWD-照顾者关系质量与照顾者幸福感的下降联系起来，但鲜为人知 关于有助于照顾者结果的特定人际机制。例如正 PWD-照顾者社会联系的情感品质可以缓冲以下负面影响： 低质量的社会联系可能会增加照顾者的孤独感。在 建议的研究，我将通过观察措施来衡量残疾人照顾者的社会联系， 从基本的情感科学，包括在实验室为基础的互动情绪行为的二元编码 残疾人和照顾者之间的关系（研究1; N = 186）和文本分析的情感语言照顾者使用 当描述最近的时间，他们觉得连接到PWD（研究2; N = 533）。然后我将决定 残疾人-照顾者社会联系对照顾者健康和福祉的影响（目标1），同时（在 当前护理者）和纵向（在前护理者中，在护理结束后）。另外，我将 比较现任和前任护理人员之间这些关联的相对强度，我将 研究可能的机制（例如，孤独），通过这种方式，残疾人照顾者的社会联系与 照顾者的健康和福祉。然后，我将评估PWD-照顾者社会联系的预测价值 对照顾者的健康和福祉，超越了通过机器识别的一组最佳预测因素 学习（目标2）。拟议的论文研究将准备我进行未来的研究调查 可能影响照顾者健康轨迹的社会情绪机制。F31将提供 为实现以下研究目标提供必要的支持：（1）进一步发展基础情感科学的专业知识 方法（例如，二元行为编码，文本分析）;（2）达到高级统计能力 纵向和机器学习分析技术;（3）提高对 神经退行性疾病，包括神经心理学和鉴别诊断。

PROJECT SUMMARY/ABSTRACT Dementia and other neurodegenerative diseases lead to profound cognitive, emotional, and functional impairments. As these diseases progress, the person with dementia (PWD) becomes increasingly dependent on a caregiver for functional, psychological, and economic assistance. It is well-documented that caring for a PWD is associated with considerable declines in health and well-being. Evidence suggests that many caregivers continue to experience these adverse effects for years after caregiving has ended (after the death of the PWD), though this area has received less attention. There is also striking variability in the extent to which caregivers experience these consequences – both during caregiving and after it has ended. Research on the sources of these individual differences has largely focused on factors related to the external environment, the PWD, or the caregiver that contribute to increased vulnerability in caregivers. Although research has linked PWD-caregiver relationship quality with declines in caregiver well-being, little is known about the specific interpersonal mechanisms that contribute to caregiver outcomes. For example, the positive emotional qualities of the PWD-caregiver social connection may buffer against the negative effects of caregiving stress, whereas lower quality social connection may drive increases in caregivers’ loneliness. In the proposed research, I will measure PWD-caregiver social connection through observational measures derived from basic affective science, including dyadic coding of emotional behavior in a laboratory-based interaction between PWDs and caregivers (Study 1; N = 186) and text analysis of emotional language caregivers used when describing a recent time they felt connected to the PWD (Study 2; N = 533). I will then determine the impact of PWD-caregiver social connection on caregivers’ health and well-being (Aim 1), both concurrently (in current caregivers) and longitudinally (in former caregivers, after caregiving has ended). Additionally, I will compare the relative strength of these associations between current and former caregivers, and I will investigate possible mechanisms (e.g., loneliness) through which PWD-caregiver social connection is linked to caregivers’ health and well-being. I will then evaluate the predictive value of PWD-caregiver social connection on caregivers’ health and well-being, above and beyond an optimal set of predictors identified through machine learning (Aim 2). The proposed dissertation research will prepare me to conduct future studies investigating the socioemotional mechanisms that may influence caregivers’ health trajectories. This F31 will provide the necessary support to accomplish the following research goals: (1) to further expertise in basic affective science methodologies (e.g., dyadic behavioral coding, text analysis); (2) to achieve advanced proficiency in statistical techniques for longitudinal and machine learning analyses; and (3) to enhance knowledge of neurodegenerative disease, including neuropsychology and differential diagnosis.