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.
Caring for a family member with Alzheimer?s disease or related dementia is often tremendously stressful, and can result in the deterioration of the caregiver?s own cognitive and physical health. The goal of this project is to test whether the caregiver?s appraisal of the caregiving experience (as a positive or negative part of their life) predicts health trajectories, and whether an online expressive writing intervention can increase positive appraisals of caregiving. The ultimate goal is to improve the emotional, cognitive, and physical health of the growing number of older adult caregivers in the US.
