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

项目总结 痴呆症患者(PLWD)经常遇到睡眠问题(例如，摔倒困难和 保持睡眠)，这可能会降低心理幸福感，加剧认知能力下降。PLWD通常是 由他们的配偶或同居伴侣支持，这些伴侣本身就有更高的睡眠问题风险， 心理困扰和认知障碍。配偶在婚姻中塑造彼此的健康和幸福 老龄化和慢性病的背景。然而，ADRD的护理研究主要集中在照顾者自己 睡眠、幸福感和认知功能，限制了对每个二元成员如何护理体验的了解 可能会影响睡眠、幸福感和护理二元体的认知功能。这一项目将推进 关于ADRD护理的文献，通过在创新的二元集约化纵向内测试新的概念模型来实现 旨在评估日常感受到的压力和积极体验如何与日常睡眠相关联 对患有早期ADRD的夫妇的幸福感和认知功能的长期影响。 拟议的项目将招募150对60岁及以上的已婚或同居夫妇(300人) 哪一位伴侣与早期ADRD一起生活。在基线阶段，双方将被要求完成长达一小时的 电话采访和面对面的认知评估，然后连续7天进行简短的生态 即时评估(EMA)智能手机调查(每天5次)和使用腕部的客观睡眠跟踪 动作记录仪。长达一小时的电话采访和认知评估将在一年和两年后重复进行 在两次研究之间的6个月内，采用中点登记电话和简短的半结构化数据收集的基线 海浪。我们将探索三个具体的调查领域：第一，我们将确定自己和合作伙伴的报告 每天感受到的压力和积极的经历预测每天的睡眠(例如，自我报告的睡眠质量，客观的 睡眠效率)内的ADRD护理二人组。其次，我们将评估所有者和合作伙伴是否每天都 压力、日常积极经历和日常睡眠预示着幸福感(例如，抑郁症状)和认知能力 在ADRD护理二人组内超过2年的功能(例如，全球认知)。第三，我们将检查自己和 伴侣每天的睡眠反应(例如，每天感受到的压力-睡眠联系和每天积极的经历-睡眠联系) 预测ADRD护理二人组两年内的幸福感和认知功能。在这三个目标中，我们将 检查PLWD和配偶对心理社会资源(个人掌握、自我效能、 生活目标和社会支持)，这可能会减少不良后果的风险。调查结果将潜在地确定 每日一级的可修改机制，解释ADRD内的每日和长期健康结果 关爱二人组。了解促进ADRD护理二人组复原力的动态过程和因素 将提供及时的二元干预措施，以改善可持续发展妇女及其配偶的健康和功能。

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.