Stress resilience and aging in Alzheimers disease and dementia caregivers

项目总结 亚历山德拉·克罗斯韦尔博士研究的总体目标是确定慢性压力破坏的途径 老年人的健康认知和生物功能，并针对这些途径量身定制 心理干预。这项K01奖将支持她成为一名独立资助的科学家 通过支持她在流行病学方法方面的培训，进行压力、健康和衰老研究的交叉， 神经心理评估，衰老的生物标记物，以及干预发展。她也将成为一名 与老年阿尔茨海默氏症和相关痴呆症照顾者合作的专家，高压力人群 对公共卫生和公共政策非常感兴趣。近1600万名家人和朋友为 那些患有阿尔茨海默病和相关痴呆症的人。与年龄匹配的非照顾者相比，痴呆症 照顾者的心理和身体健康状况更差，包括慢性病患病率增加。是什么让 照料对健康有害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 以便制定有针对性的干预措施。克罗斯韦尔博士的研究计划将检查评估 护理经验与健康结果相关，以及是否将这些评估作为目标 心理干预可以提高压力韧性。在目标1和目标2中，她将研究 在两个既定的压力评估(角色囚禁和利益发现)和预测慢性病的结果之间 疾病的发展和进展，即认知控制、炎症负担和细胞老化。这 将在两个纵向队列中进行测试，其中包括护理者，护理者-骨质疏松性骨折研究 和大脑健康登记处。在两个独立样本中重复结果是该方法的一个主要优势 拟开展的研究。在第三项研究(AIM 3)中，克罗斯韦尔博士将尝试对阿尔茨海默氏症进行一项简短的在线干预 健康下降风险最大的疾病和相关痴呆症照顾者。克罗斯韦尔博士将测试四个 表现性写作课程可以增加对照顾的积极压力评估，日常积极情感，以及 认知控制能力。通过表达写作，参与者通过以下方式处理压力或创伤性体验 认知性地重组它们以适应现有的模式，或者改变模式以使体验适应。 三项初步研究表明，表达写作对痴呆症照顾者的心理益处， 虽然没有人把写作的重点放在护理的积极方面，这可能会产生更强的影响 因为它鼓励重组，包括更大的利益发现，建立的压力缓冲。这个K01 研究科学家职业发展奖将提供必要的培训和指导，以启动 克罗斯韦尔博士的职业生涯是一名独立调查员，在 压力、健康和衰老，使用实验和流行病学方法。她的作品最终 支持NIA的使命，即了解衰老的本质，以延长健康、活跃的寿命。

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.