It is estimated that 88% of all older adults have at least one chronic condition, 69% have more than one chronic condition, and 33% experience functional disability. Thus, married older adults are not only likely to cope with chronic conditios and disability of their own but also their spouse's. Understanding how support dynamics in marriage influence each partner's health will provide great insight into helping couples stay healthier and functionally independent into late life.
The aim of the proposed Mentored Research Scientist Development Award (MRSDA) is to train the candidate in epidemiology of aging and advanced dyadic data analysis techniques to build on her expertise in experimental research and to understand how mutual care in late-life marriage influence health, particularly cardiovascular health and depression, and longevity. The proposed research focuses on older couples in which both partners suffer from chronic conditions and disability, and drawing from communal relationships theory, mutual care is defined as both partners receiving high levels of balanced instrumental and emotional support from one another. Through this MRSDA, the candidate will (1) learn from expert mentors and consultants about the epidemiology of aging and advanced statistical techniques to analyze dyadic, longitudinal data, (2) conduct secondary analysis on a large epidemiologic dyadic data set to examine how mutual care in older adult marriages influences long-term health and longevity and an experiment to examine a proposed mechanism, cardiovascular stress recovery, (3) complete coursework in epidemiology of aging, advanced epidemiologic statistics, and research ethics, and (4) attend workshops on dyadic data analysis. Yale University is a phenomenal environment to pursue this training as it has extensive resources in epidemiology of aging, statistics for analyzing epidemiologic data, experimental relationships research, and cardiovascular psychophysiology. The candidate has a state-of-the- art observational and psychophysiology lab that she will utilize for this project. Th Yale School of Public Health and the Claude D. Pepper Older American's Independence Center at Yale have excellent junior faculty mentoring programs. The candidate's primary mentor, Dr. Becca Levy at Yale School of Public Health has extensive expertise in bridging experimental and epidemiological methods to study psychosocial factors and health in older adults, including dyads. Dr. Richard Schulz will serve as a co-mentor, as he is the primary investigator for the Cardiovascular Health Effects Study which will be used for Study 1 of the proposed research and is an expert in conducting large, longitudinal studies. Dr. Trace Kershaw, an expert in dyadic data analysis at Yale School of Public Health, will also be a co-mentor. The proposed training will occur in the context of (1) a longitudinal study of married couples in which both members of the couple have chronic conditions and disability (Study 1;The Caregiver Health Effects Study;n=819 couples;an ancillary study to the Cardiovascular Health Study) examining the influence of mutual support on health trajectories (e.g. clinical and subclinical indicators of cardiovascular disease, clinical depression, and self-reported health) and longevity, and (2) an experimental study (Study 2;n=100 couples) examining cardiovascular stress recovery, a proposed mechanism for the link between mutual care and cardiovascular health proposed in Study 1. In the experimental study each partner will discuss a health-related stressor, and mutual support will be manipulated and compared to a control and one-sided support conditions to examine the effects on cardiovascular stress recovery. Consistent with the priorities outlined by the National Institute on Aging, the proposed MRSDA has the potential to address mechanisms for links between interpersonal relationships and health in the context of aging (RFA: PA-11-128). Further, the combination of training and research will serve as a spring board for the candidate's independent research career to elucidate how interpersonal relationships influence health among older adults.
It is estimated that 88% of all older adults have at least one chronic condition, 69% have more than one chronic condition, and 33% are functionally disabled. Married older adults are not only likely to cope with chronic conditions and disability of their own but also their spouse's. Understanding how support dynamics in marriage influence each partner's health will provide great insight into helping older adults stay healthy and maintain functional independence into late life.
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