STRESS IN ALZHEIMERS PATIENT-SPOUSE INTERACTIONS

阿尔茨海默型痴呆（DAT）的特征是进行性 认知/行为障碍。 随着DAT的进展， 能够照顾自己，更加依赖他/她的照顾者 （通常是配偶）。 随着时间的推移，患者变得更加局限于 家庭环境和照顾者/配偶的心理社会环境。 因此，患者的功能可以越来越多地反映功能 他/她的配偶。 同时，通过反馈回路， 患者的认知/行为下降可能导致增加 配偶的心理障碍。 这种恶性循环可能导致 患者由于神经元变性而衰退得远远超过该值。 不幸的是，我们需要对这些动态进行更多的了解： 大多数DAT研究都集中在患者或护理人员身上， 但不是两个都有。 在这项研究中，将检查纵向关系，以评估 配偶变量对轻度DAT患者的重要性（目的1）和轻度DAT 配偶的患者变量（目标2）：1）进行初始和/或随访 心理社会配偶变量解释了随访中的差异 患者的认知/行为功能超出预期 患者的初始认知/行为功能？ 2)是否初始 和/或患者的后续认知/行为功能 超出预期的随访心理社会配偶变量的差异 从最初的心理社会配偶变量？ 两波随动设计 将使用：患者/配偶将首先在入组时进行评估， 老人及家庭服务诊所。 后续评估将 在各自的初始评估后18个月进行。 标准 患者入选标准为：DSM III诊断为原发性退行性变 痴呆（无混合性痴呆），轻度（早期）AD，与自己的 配偶是谁照顾，并住在一个小时的车程内， 西雅图。 鉴于这4项标准，将在以下时间点获得初始/随访数据： 90对。 分层回归将用于满足目标。 输入的变量将反映压力/痛苦的理论模型， 涉及压力源、资源、脆弱性和痛苦。 本研究 将阐明ADAMHA的两个优先事项： 压力，应对和DAT的管理，以及心理社会因素 在DAT患者中塑造和维持积极行为的环境。

Dementia of the Alzheimer's Type (DAT) is characterizd by progressive cognitive/behavioral impairment. As DAT progresses the patient is less able to care for him/herself, becoming more dependent on his/her caregiver (usually spouse). Over time the patient becomes more restricted to the home environment and the psychosocial environment of the caregiver/spouse. As such, the patient's functioning may increasingly reflect the functioning of his/her spouse. Simultaneously, via feedback loops, increased cognitive/behavioral decline in the patient may result in increased psychosocial impairment in the spouse. This vicious cycle may lead to patient decline well beyond that due to neuronal degeneration. Unfortunately, much needs to be learned about these dynamics: The vast majority of DAT research has concentrated on the patient or the caregiver, but not on both. In this study longitudinal relationships will be examined to assess the importance of spouse variables on mild DAT patients (Aim 1) and mild DAT patient variables on spouses (Aim 2): 1) Do initial and/or follow-up psychosocial spouse variables account for variance in follow-up cognitive/behavioral functioning of patients beyond that expected from initial cognitive/behavioral functioning of patients? 2) Does initial and/or follow-up cognitive/behavioral functioning of patients account for variance in follow-up psychosocial spouse variables beyond that expected from initial psychosocial spouse variables? A two wave follow-up design will be used: patients/spouses will be first assessed at entry into the Geriatric and Family Services Clinic. Follow-up assessments will be performed 18 months after the respective initial assessments. Criteria for patient inclusion will be: DSM III diagnosis of Primary Degenerative Dementia (no mixed dementias), mild (early) stage of AD, living with one's spouse who is the caregiver, and living within one hour's drive of Seattle. Given these 4 criteria initial/follow-up data will be obtained on 90 dyads. Hierarchical regression will be used to meet the aims. Variables entered will reflect a theoretical model of stress/distress which involves stressors, resources, vulnerability and distress. This research will shed light on two ADAMHA priorities: The interaction of family stress, coping and the management of DAT, and factors in the psychosocial environment that shape and maintain positive behavior in DAT patients.