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Social Connection and Suicide Risk in ADRD Caregivers

ADRD 护理人员的社会联系和自杀风险

基本信息

批准号：
10723500
负责人：
Kimberly Allison Van Orden
金额：
$ 41.49万
依托单位：
UNIVERSITY OF ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10723500
关键词：
Acceleration Activities of Daily Living Adult Age Aging Alzheimer&apos s disease related dementia Anxiety Behavior Caregivers Caring Cellular Phone Cessation of life Child Chronic Conflict (Psychology)Data Day Care Dementia Dementia caregivers Disease Progression Ecological momentary assessment Elderly Etiology Family Family Caregiver Family member Feeling Feeling suicidal Fostering Friends Intervention Intervention Studies Interview Knowledge Life Link Loneliness Mental Depression Mental Health Monitor Observational Study Perception Personal Satisfaction Persons Pilot Projects Recording of previous events Reporting Research Research Design Risk Factors Role Severities Spouses Suicide Variant Work aging population care giving burden care recipients caregiving caregiving outcomes dementia care depressive symptoms experience follow-up functional decline functional status indexing middle age response satisfaction social stressor suicidal behavior suicidal risk theories

项目摘要

Social Connection & Suicide Risk in ADRD Caregivers Providing care for a family member or friend with Alzheimer’s Disease and Related Dementias (ADRD, ‘caregivers’) is a common experience for adults in mid- and later-life and can foster experiences that are beneficial to mental health (e.g., purpose, mastery), but can also lead to anxiety, depression, and suicide ideation. Our scientific premise is that social disconnection—the quality and quantity of social ties with others— contributes to the most severe mental health problems during caregiving, including suicide ideation and behavior. Social disconnection is a common experience among caregivers and is one of the strongest risk factors for suicide ideation, attempts, and deaths. The Interpersonal Theory of Suicide proposes that stressors such as caregiving increase suicide risk by impacting two forms of social disconnection—feeling lonely (also termed low belonging) and like one is a burden on others (perceived burden). In line with NIA priorities of promoting well-being in caregivers and understanding mechanisms, our objective is to examine loneliness (and low belonging) and perceived burden on others as mechanisms that increase suicide risk in ADRD caregivers. This study builds on our team’s work on social connection in ADRD caregivers via the Rochester Roybal Center for Social Ties & Aging Research. Our pilot studies routinely assess suicide risk given the robust link between social disconnection and suicide risk. We found that at least 10% of caregivers screened for our pilot studies report suicide ideation in the past month. We propose an observational study of n=200 ADRD caregivers who report caregiving stress, loneliness, and recent suicide ideation in which subjects complete baseline interviews (to characterize caregiving and obtain histories of suicide ideation and behavior), 10 days of smartphone-based ecological momentary assessment (daily caregiving stressors and benefits, social connection, and suicide ideation), and 6-month follow-up (changes in care receiver functional status). Our first aim is to examine whether daily caregiving experiences are associated with daily variations in loneliness and perceived burden. We hypothesize that caregiving mastery and sense of purpose in life will be associated with lower loneliness and greater perceived burden, while caregiving strain, losses, and relationship conflict will be associated with greater loneliness and perceived burden. Our second aim examines whether loneliness and perceived burden predict daily variation in suicide ideation. We hypothesize that caregiving stressors will predict suicide ideation via increases in loneliness and perceived burden. Our third aim is to examine whether suicide ideation in caregivers is associated with worse caregiving outcomes in the short-term (next day caregiving stress, fewer positive interactions) and longer-term (functional decline at 6-month follow-up). Understanding mechanisms whereby caregiving may increase suicide risk could identify social connection as an intervention target and also increase knowledge about the role of daily stressors in the link between social disconnection and suicide in mid- and later life.

ADRD 护理人员的社会联系和自杀风险为患有阿尔茨海默病和相关痴呆症 (ADRD、 “照顾者”）是中年和晚年成年人的常见经历，可以培养有益于心理健康（例如目标、掌握），但也可能导致焦虑、抑郁和自杀构思。我们的科学前提是社会脱节——与他人的社会联系的质量和数量—— 导致护理期间最严重的心理健康问题，包括自杀意念和行为。社交脱节是护理人员的常见经历，也是最大的风险之一自杀意念、自杀企图和死亡的因素。自杀的人际理论认为，压力源例如，照顾会通过影响两种形式的社会脱节——感到孤独（也被称为低归属感），就像一个人对他人来说是一种负担（感知的负担）。符合 NIA 的优先事项促进照顾者的福祉和理解机制，我们的目标是检查孤独感（和低归属感）和对他人的感知负担是增加 ADRD 护理人员自杀风险的机制。这项研究建立在我们团队通过罗切斯特 Roybal 开展的 ADRD 护理人员社交联系工作的基础上社会关系与老龄化研究中心。鉴于两者之间存在强有力的联系，我们的试点研究定期评估自杀风险社会脱节和自杀风险之间的关系。我们发现至少 10% 的护理人员接受了我们试点项目的筛查研究报告了过去一个月的自杀意念。我们提出一项 n=200 ADRD 的观察性研究报告照顾压力、孤独和最近自杀意念的照顾者，其中受试者完成基线访谈（描述护理的特征并获取自杀意念和行为的历史），10 天基于智能手机的生态瞬时评估（日常护理压力源和益处、社会联系和自杀意念），以及 6 个月的随访（被看护者功能状态的变化）。我们的第一个目的是检查日常护理经历是否与孤独感和孤独感的日常变化有关。感知到的负担。我们假设护理的掌握和生活的目的感将与孤独感降低，感知负担增加，而照顾压力、损失和关系冲突将会与更大的孤独感和感知的负担有关。我们的第二个目标是检验孤独是否与感知的负担预测自杀意念的每日变化。我们假设护理压力源会通过孤独感和感知负担的增加来预测自杀意念。我们的第三个目标是检验是否护理人员的自杀意念与短期（第二天）护理结果较差有关护理压力、积极互动减少）和长期（6 个月随访时功能下降）。了解护理可能增加自杀风险的机制可以将社会联系识别为干预目标，并增加对日常压力源在社会与社会之间联系中的作用的了解中年和晚年的断绝关系和自杀。