Cognitive Health and Modifiable Factors of Daily Sleep and Activities Among Dementia Family Caregivers

项目总结 大约1600万美国人为阿尔茨海默病及相关疾病患者担任家庭照顾者 痴呆症和这种护理可能会造成身体和精神上的损失。未被研究的是这种非正式护理如何影响照顾者 认知健康和相关的日常睡眠和活动，所有这些都是可改变的健康行为。从事 在痴呆症护理中，对个人有意义的、认知刺激的活动可以有益于认知和睡眠健康 双子星。尽管活动参与对认知功能和睡眠质量很重要，但现有的 在全球一级，活动和成果往往是自我报告的，不同步。活动的同期评估， 睡眠、认知健康和幸福感将通过以下方式极大地推动这一领域的研究：1 对日常睡眠和日常活动的评估，2)确定照顾者的社会背景如何 帮助痴呆症患者的活动参与缓和认知健康之间的联系 和幸福感，以及日常睡眠和活动，以及3)确定慢性压力生物标记物，头发皮质醇 在自然主义的环境中，注意力调节着活动和睡眠认知的联系。建议的被辅导者 职业发展奖结合了严格的研究、指导和教学计划，以促进候选人的 成长为一名专注于为设计提供信息的独立调查员的总体职业目标 对包括痴呆症在内的有复杂护理需求的老年护理夫妇的干预措施，以改善双方的健康状况 是存在的。培训目标将帮助应聘者获得：1)扎实的临床护理和教育知识 与神经认知评估、功能和理解临床方面有关的护理二人组之间的需求 痴呆症，2)评估、分析和解释日常睡眠和活动措施的专门技能以及 慢性压力的生物学测量，与痴呆症护理情况有关，特别是与照顾者认知健康有关 和幸福感，以及3)在应用密集重复措施设计方面的专业知识，这将产生新的见解 二元背景下不良照顾者结局的近端风险和保护性因素。培训的目标是寻求 进一步发展候选人作为晚年痴呆症家庭领域跨学科研究人员的专长 护理，并与研究目标密切相关：1)使用动作记录仪量化照顾者的日常睡眠特征 并确定它们与照顾者认知功能和幸福感的关系；2)量化照顾者的日常活动 加速度计的特征，并确定它们与照顾者认知功能和幸福感的关系； 3)描述护理者对PLwD活动参与度的帮助如何缓和，以及头发皮质醇如何 注意力在睡眠➔认知和活动➔认知之间的联系中起中介作用。一个整合的、生物、心理和社会的 确定促进复原力和减少有害风险因素的保护性因素的办法将使 在高度脆弱的老龄化人口的二元背景下，制定未来有针对性的照顾者干预措施。

PROJECT SUMMARY Approximately 16 million Americans serve as family caregivers for a person with Alzheimer's disease and related dementias and this care can take a physical and emotional toll. Understudied is how this informal care can affect caregiver cognitive health and associated daily sleep and activities, all of which are modifiable health behaviors. Engaging in personally meaningful, and cognitively stimulating activities can benefit cognitive and sleep health among dementia care dyads. Despite the importance of activity engagement for cognitive functioning and sleep quality, existing assessment of activities and outcomes is often self-reported asynchronously at global levels. Contemporaneous assessment of activities, sleep, and cognitive health and well-being would significantly advance research in this area by 1) conducting objective assessments on daily sleep and activities within a dyadic context, 2) determining how the social context of caregivers' assistance for the individuals with dementia's activity engagement moderates the associations between cognitive health and well-being, and daily sleep and activities, and 3) determining how a chronic stress biomarker, hair cortisol concentration, mediates the activities- and sleep-cognition associations in naturalistic settings. The proposed mentored career development award combines a rigorous program of research, mentorship, and didactics to facilitate the candidate's growth toward an overall career goal of becoming an independent investigator focused on informing the design of interventions for aging caregiving dyads with complex care needs including dementia to improve both partners' well- being. The training aims will assist the candidate in acquiring: 1) grounded knowledge of clinical care and educational needs among care dyads relating to neurocognitive assessment, functioning, and understanding the clinical aspects of dementia, 2) specialized skills in the assessment, analysis, and interpretation of daily sleep and activity measures and the biological measure of chronic stress that link to the dementia care situation and specifically to caregiver cognitive health and well-being, and 3) expertise in the application of intensive repeated measures designs that will generate novel insights on proximal risk and protective factors for poor caregiver outcomes within the dyadic context. The training aims seek to further develop the candidate's expertise as an interdisciplinary researcher in the area of later-life dementia family caregiving and align closely with the research aims to: 1) quantify caregiver daily sleep characteristics with actigraphy and determine their associations with caregiver cognitive functioning and well-being; 2) quantify caregiver daily activity characteristics with accelerometry and determine their associations with caregiver cognitive functioning and well-being; and 3) To characterize how caregiver assistance for PLwD's activity engagement moderates, and how hair cortisol concentration mediates associations of sleep➔cognition and activities➔cognition. An integrated, biopsychosocial approach to identifying protective factors that promote resilience and reduce harmful risk factors will inform the development of future targeted caregiver interventions in the dyadic context for a highly vulnerable aging population.