Social Connection and Suicide Risk in ADRD Caregivers

ADRD照顾者的社会联系与自杀风险 为患有阿尔茨海默病和相关痴呆症(ADRD， 照顾者)是成年人在中后期的一种常见经历，可以促进 有益于心理健康(例如，目标、掌握)，但也可能导致焦虑、抑郁和自杀 想象力。我们的科学前提是，社会脱节--与他人的社会联系的质量和数量-- 导致照看过程中最严重的精神健康问题，包括自杀念头和 行为。社交脱节是照顾者的常见经历，也是最大的风险之一 自杀意念、企图和死亡的因素。自杀的人际关系理论认为，压力源 例如，照料会影响两种形式社交脱节，从而增加自杀风险--感到孤独(也 低归属感)，喜欢一个人是别人的负担(感知到的负担)。符合NIA的优先事项 在照顾者和理解机制中促进幸福感，我们的目标是检查孤独(和 低归属感)和对他人的负担被认为是增加ADRD照顾者自杀风险的机制。 这项研究建立在我们团队通过Rochester Roybal在ADRD照顾者中的社会联系方面的工作基础上 社会关系与老龄化研究中心。我们的初步研究通常会评估自杀风险，因为两者之间存在很强的联系 社会脱节和自杀风险之间的关系。我们发现，至少有10%的护理员为我们的飞行员进行了筛选 研究报告称，在过去的一个月里有自杀意念。我们建议对n=200的ADRD进行观测研究 报告照料压力、孤独感和最近自杀意念的照顾者 基线面谈(描述照料特征并获得自杀意念和行为史)，10天 基于智能手机的生态即时评估(日常护理压力源和好处、社交 和6个月的随访(护理接受者功能状态的改变)。我们的第一次 目的是检查日常照料经历是否与孤独和孤独的日常变化有关 感觉到的负担。我们假设，对照料的掌握和对生活的使命感将与 较低的孤独感和更大的感知负担，而照顾压力、损失和关系冲突将会 与更大的孤独感和感觉到的负担有关。我们的第二个目标是考察孤独和 负担感可以预测自杀意念的日常变化。我们假设照顾他人的压力源会 通过增加孤独和感觉到的负担来预测自杀意念。我们的第三个目标是检查 照顾者的自杀意念与短期内(次日)较差的照看结果有关 照顾压力，更少的积极互动)和长期(6个月随访时功能下降)。 了解照料可能增加自杀风险的机制可以将社会联系确定为 一个干预目标，也增加了关于日常应激源在社会联系中的作用的知识 中年和晚年的割裂和自杀。

Social Connection & Suicide Risk in ADRD Caregivers Providing care for a family member or friend with Alzheimer’s Disease and Related Dementias (ADRD, ‘caregivers’) is a common experience for adults in mid- and later-life and can foster experiences that are beneficial to mental health (e.g., purpose, mastery), but can also lead to anxiety, depression, and suicide ideation. Our scientific premise is that social disconnection—the quality and quantity of social ties with others— contributes to the most severe mental health problems during caregiving, including suicide ideation and behavior. Social disconnection is a common experience among caregivers and is one of the strongest risk factors for suicide ideation, attempts, and deaths. The Interpersonal Theory of Suicide proposes that stressors such as caregiving increase suicide risk by impacting two forms of social disconnection—feeling lonely (also termed low belonging) and like one is a burden on others (perceived burden). In line with NIA priorities of promoting well-being in caregivers and understanding mechanisms, our objective is to examine loneliness (and low belonging) and perceived burden on others as mechanisms that increase suicide risk in ADRD caregivers. This study builds on our team’s work on social connection in ADRD caregivers via the Rochester Roybal Center for Social Ties & Aging Research. Our pilot studies routinely assess suicide risk given the robust link between social disconnection and suicide risk. We found that at least 10% of caregivers screened for our pilot studies report suicide ideation in the past month. We propose an observational study of n=200 ADRD caregivers who report caregiving stress, loneliness, and recent suicide ideation in which subjects complete baseline interviews (to characterize caregiving and obtain histories of suicide ideation and behavior), 10 days of smartphone-based ecological momentary assessment (daily caregiving stressors and benefits, social connection, and suicide ideation), and 6-month follow-up (changes in care receiver functional status). Our first aim is to examine whether daily caregiving experiences are associated with daily variations in loneliness and perceived burden. We hypothesize that caregiving mastery and sense of purpose in life will be associated with lower loneliness and greater perceived burden, while caregiving strain, losses, and relationship conflict will be associated with greater loneliness and perceived burden. Our second aim examines whether loneliness and perceived burden predict daily variation in suicide ideation. We hypothesize that caregiving stressors will predict suicide ideation via increases in loneliness and perceived burden. Our third aim is to examine whether suicide ideation in caregivers is associated with worse caregiving outcomes in the short-term (next day caregiving stress, fewer positive interactions) and longer-term (functional decline at 6-month follow-up). Understanding mechanisms whereby caregiving may increase suicide risk could identify social connection as an intervention target and also increase knowledge about the role of daily stressors in the link between social disconnection and suicide in mid- and later life.