Identifying Distinctions and Commonalities between Elder Mistreatment and Late-life IPV: A Study of ADRD Caregiving Dyads

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Abstract This application seeks funding through the Research Supplements to Promote Diversity in Health-Related Research mechanism (PA-21-071) and is associated with parent award R01 AG060096. This supplement will provide Elizabeth Avent, a PhD student in the University of Southern California's Gerontology program, with the systematic training, professional development, and mentorship needed to establish a pathway to independence as a scientist in the field of aging. Ms. Avent's proposed work will explore the patterns of abuse over the life course and build a data-driven conceptualization of late-life intimate partner violence. The parent study aims to identify risk and protective factors for elder mistreatment (EM) among older adults with Alzheimer's Disease and related dementias (ADRD) and their caregivers by: 1) tracking a longitudinal cohort of 200 over 18 months, to assess predictors of EM at baseline and over the follow-up period; 2) with 50 purposively selected caregivers, conduct qualitative interviews, assess the breadth of their social and instrumental support networks, and track for 1 month using health-tracking technology; and 3) compare electronic health records of ADRD patients with reported EM to ADRD patients who are not suspected of experiencing EM. The research under this proposed supplement will contribute to the parent study's Aim 1 by investigating the causes and consequences of EM that are unique to spousal and intimate partner dyads, and will also contribute to the parent study's Aim 2 by exploring the ways that the relationship history of spousal and intimate partner dyads is related to EM. Crucially, this supplement will endeavor to distinguish novel EM perpetrated by a spouse or intimate partner from late-life intimate partner violence (IPV) in ADRD caregiving dyads. Using a convergent mixed-methods design, this project will address three specific aims: Aim 1. Describe the population of intimate partner/spousal caregiving dyads, compared to other types of caregiving dyads. Research Question: To what degree do spousal and intimate partner dyads who experience EM differ from those who have experienced a pattern of IPV across the life course? Aim 2. Explore the relationship and life histories of intimate partner/spousal caregiving dyads in which abuse is present to discern patterns of abuse over the life course and determine whether there are distinct differences between EM and IPV in late life. Research Question: What distinctions emerge between spousal and intimate partner dyads who have experienced IPV across the lifespan versus those who are experiencing novel EM? Aim 3. Investigate how the onset and progression of ADRD may influence the direction of abuse or exacerbate abuse in intimate partner/spousal caregiving dyads. Research Question: Does the onset and progression of ADRD impact the dynamics and/or direction of abuse in spousal and intimate partner dyads with a history of IPV?