Stress resilience and aging in Alzheimers disease and dementia caregivers

项目摘要 Alexandra Crosswell博士的研究的总体目标是确定慢性压力干扰 健康的认知和生物功能的老年人，并针对这些途径与定制 心理干预。这个K01奖将支持她成为一个独立资助的科学家， 通过支持她在流行病学方法方面的培训， 神经心理学评估、衰老生物标志物和干预开发。她也将成为 与老年人阿尔茨海默氏症和相关痴呆症护理人员合作的专家， 对公共卫生和公共政策的极大兴趣。近1600万家庭和朋友提供无偿护理， 老年痴呆症和相关痴呆症患者。与年龄匹配的非照顾者相比， 照料者的身心健康状况恶化，包括慢性病发病率增加。什么让 对健康有害的饮食在很大程度上是未知的。需要确定照顾者风险和复原力因素 以制定有针对性的干预措施。克罗斯威尔博士的研究计划将调查评估是否 的评估与健康结果有关， 心理干预可以提高压力恢复力。在目标1和目标2中，她将审查 两个既定的压力评估（角色囚禁和利益发现）和预测慢性 疾病发展和进展，即认知控制、炎症负荷和细胞老化。这 将在两个纵向队列中进行测试，包括照顾者，骨质疏松性骨折的照顾者研究 和脑健康登记处在两个独立样本中重复结果是本研究的主要优势。 提议的研究。在第三项研究中（Aim3），克罗斯威尔博士将对阿尔茨海默氏症进行简短的在线干预 疾病和相关痴呆症的照顾者健康下降的风险最大。克罗斯威尔博士将测试四个 表达性写作可以增加对写作的积极压力评估，日常积极情感， 认知控制能力通过表达性写作，参与者通过以下方式处理压力或创伤性经历： 认知地重新构建它们以适应现有的图式，或者改变图式以适应经验。 三项初步研究表明，表达性书写对痴呆症照顾者的心理益处， 尽管没有人把写作的重点放在可能产生更大影响的积极方面， 因为它鼓励重新规划，包括更大的利益发现，一个既定的压力缓冲。K01 研究科学家职业发展奖将提供必要的培训和指导， 博士克罗斯韦尔的职业生涯作为一个独立的调查员进行高影响力的研究，在交叉点， 压力，健康和衰老，使用实验和流行病学的方法。她的工作最终 支持NIA的使命，即了解衰老的本质，以延长健康、活跃的生命。

PROJECT SUMMARY The overall goal of Dr. Alexandra Crosswell’s research is to identify pathways by which chronic stress disrupts healthy cognitive and biological functioning in older adults, and to target these pathways with tailored psychological interventions. This K01 award will support her in becoming an independently funded scientist at the intersection of stress, health, and aging research by supporting her training in epidemiological methods, neuropsychological assessment, biomarkers of aging, and intervention development. She will also become an expert in working with older adult Alzheimer’s and related dementia caregivers, a high stress population of great interest for public health and public policy. Nearly 16 million family and friends provide unpaid care to those with Alzheimer’s disease and related dementias. Compared to age-matched non-caregivers, dementia caregivers have worse mental and physical health, including increased rates of chronic disease. What makes caregiving detrimental to health is largely unknown. Caregiver risk and resilience factors need to be identified in order to develop targeted interventions. Dr. Crosswell’s program of research will examine whether appraisals of the caregiving experience are associated with health outcomes, and whether targeting these appraisals with psychological intervention can increase stress resilience. In Aims 1 and 2 she will examine associations between two established stress appraisals (role captivity and benefit finding) and outcomes that predict chronic disease development and progression, namely, cognitive control, inflammatory burden, and cellular aging. This will be tested in two longitudinal cohorts that include caregivers, the Caregiver-Study of Osteoporotic Fractures and the Brain Health Registry. Replication of results in two independent samples is a major strength of the proposed research. In a third study (Aim 3), Dr. Crosswell will pilot a brief online intervention for Alzheimer’s disease and related dementia caregivers at greatest risk of health decline. Dr. Crosswell will test whether four sessions of expressive writing can increase positive stress appraisals of caregiving, daily positive affect, and cognitive control abilities. Through expressive writing participants process stressful or traumatic experiences by cognitively reframing them to fit in to existing schemas or altering schemas to allow the experience to fit in. Three initial studies have shown the psychological benefits of expressive writing for dementia caregivers, though none have focused the writing on the positive aspects of caregiving which may result in stronger effects as it encourages reframing that includes greater benefit finding, an established stress buffer. This K01 Research Scientist Career Development Award will provide the necessary training and mentorship to launch Dr. Crosswell’s career as an independent investigator conducting high impact research at the intersection of stress, health, and aging, using both experimental and epidemiological approaches. Her work ultimately supports NIA’s mission of understanding the nature of aging to extend the healthy, active years of life.