Mechanisms of psychological stress and resilience in aging

Dr. Alexandra Wuttke-Linnemann

Background

Stress is ubiquitous in daily life and particularly chronic stress posits a threat to health. In line with a diathesis-stress model, stress can be one antecedent in the manifestation of physical and mental disorders. In this regard, caregivers of patients with dementia are of particular interest as they often experience chronic stress and are thus vulnerable to the development of stress-related diseases themselves. Likewise, stress has detrimental effects in patients with dementia, leading to faster cognitive decline and faster disease progression. However, there are interindividual differences in the caregivers and patientsdue to their individual resilience properties. Resilience refers to individual differences in coping when facing adversity and might explain why some caregivers and patients present better health than others while adapting to disease-related changes. Studying the mechanisms underlying psychobiological stress and resilience is necessary to tailor interventions for caregivers and patients that reduce stress and strengthen resilience. In this regard, it is particularly promising to consider interdependencies between patients and caregivers by adopting a dyadic approach in addition to considering patients and caregivers separately.

Research focus

  • Biopsychological stress response and dyadic co-regulation in daily life in caregivers and patients with dementia
  • Interventions in patients with dementia and their informal caregivers to reduce stress and increase resilience

Secondary Research Focus:

  • Biopsychological mechanisms underlying late-life Depression
  • Music listening in daily life as means of stress reduction in patients with dementia

Methods

The methods used share these three distinct characteristics

  • By means of ambulatory assessment, studies are set in daily life. That means, patients and caregivers are investigated while being embedded in their daily routine instead of examinations in a lab environment.
  • Constructs are measured by means of biopsychological assessment tools. Subjective self-reports of patients and caregivers are complemented by objective stress markers (e.g. cortisol as marker for the hypothalamic–pituitary–adrenal axis; alpha-amylase and heart rate variability as marker for the autonomic nervous system).
  • Patients and their respective caregiver are treated as one unit of analysis, which allows studying dyadic interdependencies.

Projects

  •  DYADEM: biopsychological evaluation of a home-based dyadic interventions for caregivers and patients with dementia
  • TK-DEM: Biopsychological stress and resilience in caregivers and patients with dementia during day clinic treatment
  • EMA-DEM: Biopsychological mechanisms of stress and resilience in caregivers and patients in daily life
  • BAVA-AD: Biofeedback-Assisted Behavioral Activation as Component of Multimodal Treatment for Late-Life Depression

Cooperation partners

  • PD Dr. Kristina Endres, University Medical Center Mainz
  • Prof. Dr. N. Müller, Marion-von-Tessin Memory Zentrum, Munich
  • Prof. Dr. Urs Nater, Dr. Nadine Skoluda, University of Vienna
  • Dr. Ralf Suhr, Zentrum für Qualität in der Pflege, Berlin