CORRELATES OF MENTAL HEALTH IN ALZHEIMER SPOUSES

阿尔茨海默型痴呆（DAT）的特征在于： 进行性认知/行为障碍。 随着DAT的发展， 病人越来越不能照顾自己 依赖于他/她的照顾者（通常是配偶）。 增加 患者的认知/行为/情感下降可能导致 配偶的心理/身体健康状况下降。 伙伴关系仍有很多事情要 了解这些动态。 绝大多数DAT研究 关注的是病人或护理者，而不是两者。 我们认识到DAT患者的潜在影响， 配偶的身心健康。 在这项多学科纵向研究中，我们将比较 心理社会，免疫和心血管疾病，在70 轻度DAT患者的配偶在70岁时的痛苦-性别-和 健康状况匹配的对照组配偶。 控制将发生 两次相隔15个月 我们相信我们可以获得所需的 在建议的时间内使用我们的DAT名册和 社区抽样程序在我们目前的研究实践。 使用苦恼的理论模型来指导我们的研究， 将测试分层假设：（1）最初和 后续DAT配偶将比控制配偶更苦恼 （2）在后续DAT配偶将更多 比基线时更痛苦，而随着时间的推移 对照组配偶的部分原因是DAT患者的 认知/功能下降;然而，这些关系将是 由3个配偶因素（生活压力，脆弱性， （4）生物和心理社会的痛苦将更多 在随访时与初始评估时相关;并且在两个 对于脆弱的配偶来说， (e.g.,敌意/愤怒等）而对于有资源的配偶来说 (e.g.,社会支持和应对）。 一般线性模型将 用于统计检验假设。 这项研究将 DAT中压力综合心理社会和生物学后遗症 配偶，从而阐明ADAMHA的优先事项。

Dementia of the Alzheimer's Type (DAT) is characterized 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). Increased cognitive/behavioral/affective decline in the patient may result in decreased mental/physical health in the spouse. 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. We recognize the potential effect of DAT patients on the mental/physical health of their spouses. In this multidisciplinary longitudinal study, we will compare psychosocial, immunological, and cardiovascular distress, in 70 spouses of mild DAT patients to the distress in 70 age- sex- and health status-matched spouses of controls. The controls will occur twice, 15 months apart. We believe we can obtain the required samples in the proposed time by using both our DAT Roster and the community sampling procedures practiced in our current studies. Using a theoretical model of distress to guide our research, 4 hierarchical hypotheses will be tested: (1) initially and at follow-up DAT spouses will be more distressed than control spouses on all measures; (2) at follow-up DAT spouses will be more distressed than at baseline, whereas mean differences over time in control spouses partially explained by increases in DAT patient's cognitive/functional decline; however, these relationships will be modified by 3 spouse factors (life stressors, vulnerability, and resources); (4) biological and psychosocial distress will be more correlated at follow-up than at initial assessment; and at both times these relationships will be greater for vulnerable spouses (e.g., hostile/angry, etc.) and less for spouses with resources (e.g., social support and coping). The General Linear Model will be used to statistically test the hypotheses. This research will integrate psychosocial and biological sequelae of stress in DAT spouses and therefore shed light on ADAMHA priorities.