Daily Experiences Among Couples Living With Early-Stage Dementia: Implications for Daily Sleep and Long-Term Well-Being and Cognitive Function

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PROJECT SUMMARY Persons living with dementia (PLWD) frequently experience sleep problems (e.g., trouble falling and staying asleep), which may reduce psychological well-being and exacerbate cognitive decline. PLWD are often supported by their spouses or cohabiting partners who are themselves at increased risk of sleep problems, psychological distress, and cognitive impairment. Spouses shape one another’s health and well-being in the context of aging and chronic illness. However, ADRD care research has primarily focused on caregivers’ own sleep, well-being, and cognitive function, limiting knowledge of how each care dyad member’s experiences may influence sleep, well-being, and cognitive function within the care dyad. This project will advance the literature on ADRD care by testing a novel conceptual model within an innovative dyadic intensive longitudinal design to assess how daily perceived stress and positive experiences are associated with daily sleep as well as long-term impacts on well-being and cognitive function among couples living with early-stage ADRD. The proposed project will recruit 150 married or cohabiting couples aged 60 and older (300 individuals) in which one partner lives with early-stage ADRD. At baseline, both partners will be asked to complete hour-long phone interviews and in-person cognitive assessments followed by 7 consecutive days of brief ecological momentary assessment (EMA) smartphone surveys (5 times a day) and objective sleep tracking using wrist actigraphy. The hour-long phone interviews and cognitive assessments will be repeated at 1 and 2 years after baseline with midpoint check-in calls and brief semi-structured data collection at 6 months in between study waves. We will explore three specific areas of inquiry: First, we will determine whether own and partner reports of daily perceived stress and positive experiences predict daily sleep (e.g., self-reported sleep quality, objective sleep efficiency) within ADRD care dyads. Second, we will evaluate whether own and partner daily perceived stress, daily positive experiences, and daily sleep predict well-being (e.g., depressive symptoms) and cognitive function (e.g., global cognition) over 2 years within ADRD care dyads. Third, we will examine whether own and partner daily sleep reactivity (i.e., daily perceived stress-sleep links and daily positive experiences-sleep links) predicts well-being and cognitive function over 2 years within ADRD care dyads. In all three aims, we will examine variations by PLWD and spouse reports of psychosocial resources (personal mastery, self-efficacy, purpose in life, and social support) that may mitigate risk of adverse outcomes. Findings will identify potentially modifiable mechanisms at the daily level that explain both daily and long-term health outcomes within ADRD care dyads. Understanding dynamic processes and factors that promote resilience within ADRD care dyads will inform timely dyadic interventions to improve the health and functioning of PLWD and their spouses.