Writing to Heal: Developing an Internet-Based Cognitive-Behavioral Writing Intervention for Alzheimer’s Disease Spousal Caregivers

Project Summary/Abstract Caregiving for a spouse with Alzheimer’s Disease and Related Dementia (ADRD) is extremely stressful and often prolonged, ranging from 3.3 and 11.7 years. For many caregivers, this period serves as a “living bereavement,” or a time of grieving the loved one they once knew before the ADRD progression. Heightened inflammation and its associated sickness behaviors may negatively influence caregiver’s health and quality of life. Low heart rate variability (HRV) reflects poor vagal tone, or a diminished capacity to emotionally and physiologically recover from stress and engage in one’s social environment, which could negatively impact their ability to give care. However, it is unknown whether interventions aimed at improving caregiver grief, inflammation, and HRV among ADRD spousal caregivers are feasible or effective. Guided by the NIH Stage Model for Behavioral Intervention Development, the candidate’s past research in Stage 0 informs the Stage 1 & Stage 2 research proposed here, providing valuable training in translating observational research findings into intervention development, and testing for preliminary efficacy. These studies will lay the groundwork for a future NIH-funded randomized control trial (R01 application submitted in Year 5) to test the efficacy of the targeted writing intervention in decreasing caregiving grief, improving HRV, reducing inflammation and sickness behaviors, and improving quality of life and caregiving self-efficacy among ADRD spousal caregivers. Training activities specifically designed to coincide with the proposed project will be accomplished through a combination of formal coursework, mentorship with directed readings, workshops, hands-on training, grant writing, and research activities. The training will take place primarily at Rice University’s Bioscience Research Collaborative (BRC), an innovative space where scientists and educators from Rice University and its neighbors in the Texas Medical Center (TMC) can come together to conduct collaborative research to improve human health through science. This five-year plan for the proposed Mentor Career Development Award is aimed at launching the candidate’s independent research career in identifying and targeting biobehavioral mechanisms that inform intervention development, reduce disease burden, and promote quality of life among the aging.