The project proposed in this diversity supplement will focus on understanding the mental health outcomes of family caregivers of individuals with Alzheimer?s disease or related dementias (ADRD). Family caregivers are at an increased risk of developing mental health problems. Despite the high prevalence of anxiety and depression among family caregivers, little is known about caregivers? daily symptom experience, including what individual- level vulnerabilities (i.e., coping skills, childhood trauma) increase the likelihood of experiencing symptoms on a given day. Further, it is unclear how common caregiver behaviors, such as engaging in elder abuse and neglect (EAN), or common daily stressors (i.e., behavioral symptoms of dementia; BSD) exacerbate ADRD family caregiver mental health symptomology either directly or through interaction with the individual vulnerabilities. A better understanding of the contextual triggers for mental health symptoms is needed for more tailored and ecologically valid interventions for ADRD family caregivers. We will address this gap by examining how daily environmental stressors, caregiver behaviors, and individual-level factors impact the daily odds of experiencing mental health symptoms. Using the prospective, observational, multi-timescale design of the parent R01, in this proposal we will describe variations in the daily mental health symptom experience in a population of ADRD caregivers. We will determine when a caregiver is vulnerable to anxiety and depressive symptoms, examine factors that contribute to variations in the daily caregiver mental health symptom experience, and expand upon psychological theories of caregiver mental health. The overall objective of the parent grant is to investigate when, how, for whom, and what contextually dependent factors increase or decrease the daily use of EAN. The proposed work in this mentored-research experience will contribute to the parent grant by investigating factors that impact the daily mental health symptom experience. The only change made to the approach of the parent grant is the addition of a measure on daily mental health symptomology, in order to test new, additional hypotheses on variations in ADRD family caregiver mental health. Future work stemming from this diversity supplement proposal will examine a possible cyclical relationship between mental health symptom experiences and caregiver behaviors (i.e., EAN). Work done in this supplement will contribute to the development of targeted interventions to improve caregiver mental health and improve care quality for ADRD individuals. Through completing the objectives outlined in the training plan, the mentored-research experience provided by this diversity supplement will provide a foundation for the independent research career of Dr. Frank Puga in the area of mental health of abusive and at-risk ADRD family caregivers.
Family caregivers of individuals with Alzheimer?s disease or related dementias (ADRD) are at an increased risk for depression and anxiety. Caregiver mental health can directly impact quality of care and the mortality of individuals for whom they care for. Due the potential negative effects of mental health symptoms on caregiver quality of life and ADRD patient outcomes, a pressing need exists to examine how the interaction between, daily stressors associated with caregiving, caregiver behaviors and individual-level vulnerabilities increase the likelihood of experiencing mental health symptoms on a given day.
