CORRELATES OF MENTAL HEALTH IN ALZHEIMER SPOUSES

阿尔茨海默氏型痴呆(DAT)的特征是 进行性认知/行为障碍。随着DAT的进行， 患者照顾自己的能力变得越来越差 依赖他/她的照顾者(通常是配偶)。增加了 可能导致患者认知/行为/情感功能下降 配偶的精神/身体健康状况下降。需要做的事情很多 了解这些动态。绝大多数DAT研究 集中在病人或照顾者身上，而不是同时关注两者。 我们认识到DAT患者对 配偶的心理/身体健康。 在这项多学科的纵向研究中，我们将比较 心理社会、免疫学和心血管方面的困扰 轻度DAT患者的配偶对70岁-性别-和 健康状况--对照组的配对配偶。控制将会发生 两次，相隔15个月。我们相信我们能获得所需的 使用我们的DAT花名册和 在我们目前的研究中采用了社区抽样程序。 使用痛苦的理论模型来指导我们的研究，4 将检验分层假设：(1)最初和在 随访的DAT配偶会比对照配偶更痛苦 在所有指标上；(2)在后续的DAT中，配偶将会更多 比基线时更痛苦，而随着时间的推移 部分由DAT患者的增加解释的控制配偶 认知/功能衰退；然而，这些关系将是 受3个配偶因素影响(生活压力源、脆弱性和 资源)；(4)生物和心理社会痛苦将会更多 在后续行动中比在最初评估时更相关； 对于易受伤害的配偶来说，这些关系的次数会更多 (例如，充满敌意/愤怒等。)而对于有资源的配偶来说则更少 (例如，社会支持和应对)。一般线性模型将 用来对假设进行统计检验。这项研究将 综合应激的心理、社会和生物后遗症 并因此阐明了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.