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Spousal Dementia Caregivers: Risk for Accelerated Aging

配偶痴呆症照顾者：加速衰老的风险

基本信息

批准号：
10642931
负责人：
Lisa Michelle Christian
金额：
$ 109.69万
依托单位：
OHIO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-15 至 2025-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10642931
关键词：
Acceleration Address Age Aging Bacterial Translocation Behavior Behavioral Biological Aging Biological Markers CD8-Positive T-Lymphocytes CDKN2A gene Caregiver Burden Caregivers Caring Chronic Chronic stress Chronology Clinic Cytomegalovirus Data Dementia Dementia caregivers Dimensions Disease Distress Eligibility Determination Endotoxins Epigenetic Process Family Practice Gender Health Health Benefit Home Immune system Immunologics Impairment Individual Inflammaging Inflammation Intake Intestinal permeability Leaky Gut Length Longevity Memory Memory Disorders Mental Depression Meta-Analysis Methodology Molecular Moods Morbidity - disease rate Nature Ohio Outcome Pathway interactions Persons Process Research Risk Risk Behaviors Sampling Source Spouse Caregiver Spouses Stress Support Groups Telomere Shortening Testing Time Visit Woman care recipients caregiver stress caregiving clinically significant dementia caregiving depressive symptoms design follow-up frailty frontier healthspan immune function innovation insight men mortality novel prospective recruit secondary analysis seropositive social relationships sociodemographics stressor telomere

项目摘要

Project Summary/Abstract Many studies have shown that providing care for a spouse with dementia can be quite stressful, leading to a heightened risk for depression, multiple negative health outcomes, frailty, and early mortality. Stress- and depression-related immune system alterations are seen as a key pathway to poorer health in caregivers. However, the health impacts of caregiver stress have been questioned in recent years, based on newer evidence that caregiving may benefit health and extend lifespan. Furthermore, even though caregivers have typically had poorer immune function than noncaregiving controls, the clinical significance of these differences has been questioned. These discrepant findings reflect both methodological and conceptual issues that this project will address. Three molecular aging biomarkers (telomere length, p16INK4a expression, and epigenetic age) have each been associated with multiple diseases and disorders. Their combined use will provide an innovative way to quantify the long-term health risks of caregiving, allowing us to ask novel questions: Does caregiving accelerate aging? Can caregiving-related distress propel molecular aging and shorten health span (the length of time that a person is healthy—not just alive)? We will also assess three stress-sensitive pathways relevant to molecular aging: inflammation, intestinal permeability, and cytomegalovirus serostatus and reactivation. Drawing on behavioral, immunological, and molecular aging research, this transdisciplinary study will assess concurrent and prospective relationships related to key caregiving risk-related dimensions (gender, social relationships, caregiving intensity/burden, and benefit finding), and these aging biomarkers. Spousal dementia caregivers and sociodemographically-comparable married noncaregivers will be evaluated at study intake and then again one and two years later. This design will provide longitudinal data to assess changes in caregiving, depression, key risk behaviors, aging biomarkers, and the stress-sensitive pathways related to molecular aging. We have three specific aims: 1) To characterize the concurrent and prospective differences between caregivers and noncaregivers on the molecular aging biomarkers, inflammation, and mood. 2) To assess the relationships among the molecular aging biomarkers. 3) This exploratory aim addresses the relative contributions of key risk-related dimensions to depression, accelerated increases in aging biomarkers, and inflammation. This proposal describes a distinctly novel methodology that will provide a way to test innovative and original hypotheses about the ways that spousal dementia caregiving impacts lifespan and health span. The interactions between behavior and molecular aging represent an important new frontier for understanding how caregiving (and other chronic stressors) can accelerate or slow aging. This cutting edge research will help illuminate the mechanisms through which caregiving and depression influence health and longevity.

项目总结/摘要许多研究表明，为患有痴呆症的配偶提供护理可能会带来相当大的压力，抑郁症、多种负面健康结果、虚弱和过早死亡的风险增加。压力- 与抑郁症相关的免疫系统改变被视为导致健康状况恶化的关键途径，照顾者然而，近年来，照顾者压力对健康的影响受到质疑，新的证据表明，长寿可能有益健康，延长寿命。此外，尽管照顾者的免疫功能通常比非照顾者的对照组差，这些差异受到了质疑。这些不一致的结果反映了方法和这个项目要解决的概念问题。三种分子衰老生物标志物（端粒长度，p16 INK 4a表达和表观遗传年龄）分别具有与多种疾病和紊乱有关。它们的结合使用将提供一种创新的方式，量化吸烟的长期健康风险，让我们提出新的问题：吸烟是否加速衰老？与衰老相关的痛苦会促进分子衰老并缩短健康寿命吗？一个人健康的时间长度-不仅仅是活着）？我们还将评估三种压力敏感途径与分子衰老相关：炎症、肠通透性和巨细胞病毒血清状态，重新激活借鉴行为，免疫学和分子衰老研究，这一跨学科本研究将评估与关键风险相关维度相关的并发和前瞻性关系（性别、社会关系、生育强度/负担和益处发现）和这些衰老生物标志物。配偶痴呆照顾者和社会人口统计学上可比的已婚非照顾者将在研究开始时进行评估，然后在一两年后再次进行评估。本设计将提供纵向数据评估衰老、抑郁、关键风险行为、衰老生物标志物和压力敏感性的变化，与分子老化有关的途径。我们有三个具体的目标：1）表征并发和照顾者和非照顾者之间在分子衰老生物标志物上的前瞻性差异，炎症和情绪2)评估分子衰老生物标志物之间的关系。3)这探索性的目的是解决关键风险相关维度对抑郁症的相对贡献，老化生物标志物和炎症的加速增加。该提案描述了一种独特的新颖方法，将提供一种方法来测试创新和关于配偶痴呆症影响寿命和健康跨度的方式的原始假设。的行为和分子老化之间的相互作用代表了一个重要的新领域，压力（和其他慢性压力源）如何加速或减缓衰老。这项前沿研究将有助于阐明抑郁症和抑郁症影响健康和寿命的机制。