Influence of Interpersonal Connectedness in Spousal Care Dyads on Early Progression of AD - PROJECT SUMMARY Research on factors influencing the early progression of Alzheimer’s disease (AD) has primarily focused on persons with dementia (PWD), such as their genetics. Most PWDs live within their communities, and many maintain close connections with their spousal caregivers (CGs). Relationship science research has shown that close connectedness to family, particularly spouses, benefits health; however, the influence of interpersonal connectedness between PWDs and spousal CGs on early AD progression has been overlooked. Family is part of the community, and the influence of PWD-CG connectedness on AD progression may be moderated by the dyad’s connectedness to their communities (e.g., receiving social support), which can differ between rural and urban areas. Our central hypothesis is that stronger PWD-CG connectedness is associated with slower AD progression. In a 2-year longitudinal study, we will recruit 71 urban and 71 rural co-living spousal care dyads where care recipients are in the early stages of late-onset AD. Laboratory measures of PWD- CG connectedness (e.g., observations of synchrony in positive emotions during face-to-face interactions) and AD progression (e.g., increased clinical symptoms and reduced brain volumes) will be collected at baseline and at a 2-year follow-up. Real-world wearable measures (i.e., the dyad’s in- home physical proximity and movement synchrony during daily social interactions for a 2-week period) and questionnaire measures of PWD-CG connectedness will be collected every 6 months throughout the study. Analyses will adjust for known risk factors for AD progression (e.g., APOE-ε4) and other confounding factors (e.g., medications, personality). Using a multi-method design, at the end of the 2-year follow-up period, we will also conduct qualitative interviews with the dyads to integrate their explanations of the quantitative findings into the study's outcome interpretation. Analyses will be conducted to determine how PWD-CG connectedness influences early AD progression (Aim 1), how communities (urban and rural) influence PWD-CG connectedness and its impact on early AD progression (Aim 2), and the value of measuring PWD-CG connectedness using wearables (Aim 3). Findings will significantly advance the understanding of social and psychosocial factors in disease mechanisms and protective factors for AD. The findings will help identify early predictors, digital markers, and novel interventions targeting PWD-CG connectedness and, more broadly, family and community connectedness, to mitigate early AD progression.
