Sunday, May 18, 2025
5/18/2025
Daily Experiences and Well-being among Caregivers for Older Adults Experiencing Lewy Body Dementia. - Summary There is a dire need for research addressing caregivers of persons with Lewy Body Dementias (LBD), the second most common cause of dementia. LBD encompasses Dementia with Lewy Bodies and Parkinson’s Disease with Dementia and accounts for 4 to 15% of dementia cases. Core symptoms of LBD present a distinct profile of caregiving demands driving high stress: fluctuations in cognition, hallucinations, delusions, and behavioral sleep disturbances (including acting out dreams). These are compounded by cognitive symptoms of AD and motor symptoms of Parkinson’s Disease, shared by LBD. Caregivers living with a spouse or romantic partner who has LBD (N = 150 caregivers) will complete a baseline interview and Ecological Momentary Assessment surveys (EMA; 5 minute surveys) every 3 hours for 4 days. The surveys involve reports of care recipient symptoms, caregiving tasks and stress, self-efficacy, support and well-being. Caregivers will wear a Fitbit to measure cardiovascular functions (heart rate) and sleep as indicators of stress reactivity. The care recipient will wear a FitBit to assess agitation via physiological indicators (e.g., heart rate). Aim 1: Identify associations between care recipient symptoms, caregiver tasks and stress throughout the day. The Caregiver Stress and Coping Model addresses caregivers’ stress reactivity (associations between appraisal of stress and well-being). To intervene effectively for LBD caregivers, we must ascertain which combinations of symptoms and caregiving tasks have the greatest immediate and cumulative impact on caregiver stress throughout the day. Example hypothesis: Caregivers will report greater stress when dealing with LBD symptoms than other caregiving demands. Aim 2: Examine how caregiver stress is associated with mood and cardiovascular stress responses throughout the day. The Stress Pile Up Model suggests that demands and stress may accumulate throughout the day generating worse outcomes at the end of the day. Caregivers will sleep more poorly when they report more cumulative caregiving demands, particularly symptoms unique to LBD. Aim 3: Investigate two possible resilience factors (efficacy and social support) to buffer LBD care-related stressors on well-being. Based on Self Efficacy Theory, during periods of the day when caregivers experience greater efficacy, they will appraise caregiving as less stressful and experience better mood and cardiovascular functioning. LBD caregivers report greater difficulty obtaining social support than caregivers for other dementias. Social support theories suggest that when caregivers have respite or social support during the day, they will be less reactive to caregiving stress. LBD is a highly challenging form of dementia with shared symptoms of other dementias, and unique core symptoms (e.g., hallucinations, cognitive fluctuations) that may exacerbate caregiver stress. Studies of caregiver stress, interventions, and services have largely used samples with AD and other dementias. To enhance the well-being of caregivers for older adults with LBD, we must gather the information necessary to design LBD-tailored interventions with an understanding of the daily contexts in which symptoms, caregiving, and stress occur.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).