Writing to Heal: Developing an Internet-Based Cognitive-Behavioral Writing Intervention for Alzheimer’s Disease Spousal Caregivers

项目总结/摘要 照顾患有阿尔茨海默病和相关痴呆症（ADRD）的配偶是非常紧张的， 通常是长期的，从3.3年到11.7年不等。对于许多照顾者来说，这段时间是一个“生活”时期， “丧亲之痛”，或者是在ADRD进展之前为他们曾经认识的亲人悲伤的时间。加剧 炎症及其相关的疾病行为可能会对照顾者的健康和护理质量产生负面影响， 生活低心率变异性（HRV）反映了迷走神经张力差，或情绪和行为能力下降。 从压力中恢复过来，并参与到一个人的社会环境中，这可能会产生负面影响。 他们给予照顾的能力。然而，目前还不清楚是否干预措施旨在改善照顾者的悲伤， 炎症和HRV在ADRD配偶照顾者中是可行或有效的。由NIH阶段指导 行为干预发展模型，候选人在第0阶段的过去研究通知阶段1 &这里提出的第二阶段研究，在翻译观察性研究结果方面提供有价值的培训 干预措施的开发和初步疗效的测试。这些研究将奠定基础， 未来NIH资助的随机对照试验（R 01申请在第5年提交），以测试 有针对性的写作干预可以减轻照顾者的悲伤、改善心率变异性、减少炎症和 疾病行为，改善生活质量和提高ADRD配偶照顾者的自我效能。 为配合拟议项目而专门设计的培训活动将通过 结合正式课程，指导阅读，研讨会，实践培训，补助金 写作和研究活动。培训将主要在莱斯大学的生物科学研究中心进行 协作（BRC），一个创新的空间，科学家和教育工作者从莱斯大学及其 德克萨斯州医学中心（TMC）的邻居可以聚集在一起进行合作研究，以改善 人类健康通过科学。这一拟议的导师职业发展奖的五年计划是 旨在启动候选人的独立研究生涯， 生物行为机制，为干预措施的制定提供信息，减少疾病负担，并促进 老年人的生活质量。

Project Summary/Abstract Caregiving for a spouse with Alzheimer’s Disease and Related Dementia (ADRD) is extremely stressful and often prolonged, ranging from 3.3 and 11.7 years. For many caregivers, this period serves as a “living bereavement,” or a time of grieving the loved one they once knew before the ADRD progression. Heightened inflammation and its associated sickness behaviors may negatively influence caregiver’s health and quality of life. Low heart rate variability (HRV) reflects poor vagal tone, or a diminished capacity to emotionally and physiologically recover from stress and engage in one’s social environment, which could negatively impact their ability to give care. However, it is unknown whether interventions aimed at improving caregiver grief, inflammation, and HRV among ADRD spousal caregivers are feasible or effective. Guided by the NIH Stage Model for Behavioral Intervention Development, the candidate’s past research in Stage 0 informs the Stage 1 & Stage 2 research proposed here, providing valuable training in translating observational research findings into intervention development, and testing for preliminary efficacy. These studies will lay the groundwork for a future NIH-funded randomized control trial (R01 application submitted in Year 5) to test the efficacy of the targeted writing intervention in decreasing caregiving grief, improving HRV, reducing inflammation and sickness behaviors, and improving quality of life and caregiving self-efficacy among ADRD spousal caregivers. Training activities specifically designed to coincide with the proposed project will be accomplished through a combination of formal coursework, mentorship with directed readings, workshops, hands-on training, grant writing, and research activities. The training will take place primarily at Rice University’s Bioscience Research Collaborative (BRC), an innovative space where scientists and educators from Rice University and its neighbors in the Texas Medical Center (TMC) can come together to conduct collaborative research to improve human health through science. This five-year plan for the proposed Mentor Career Development Award is aimed at launching the candidate’s independent research career in identifying and targeting biobehavioral mechanisms that inform intervention development, reduce disease burden, and promote quality of life among the aging.