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Attachment Behaviors in Parent Child Dyads Coping with Early Stage Alzheimer’s Disease & Related Dementias


Collaborators: Joan Monin (PI), Kira Birditt, Brooke Feeney, Richard Marottoli

Funding Agency: National Institute on Aging

Grant: R01 (AG058565-01A1)

Project Period: 02/15/2019 – 11/30/2023

Description: As the prevalence of Alzheimer’s disease (AD) and related dementias increases with the aging population, more adult children are becoming caregivers for their parents. While caregiving can be rewarding and meaningful, adult children face many challenges that can erode their psychological and physical health.  There are unique interpersonal aspects of adult child-older parent caregiving relationships that need to be better understood.  For instance, role reversals can impact how care is provided and how parents respond to care, and adult children often have other conflicting care responsibilities. Children and parents with early AD will especially benefit from interventions that address both of their needs; yet, there is little theoretically driven information from relationship science to design effective interventions tailored to this context.

Attachment theory provides an ideal foundation for investigating parent-child caregiving processes and health.  Attachment theory stipulates that the need for security is one of the most fundamental needs for individuals of all ages, and it provides a basis for understanding the complex dynamics involved in support-seeking and caregiving in times of stress. Although self-reported attachment styles have been shown to predict older adults’ well-being, little research has focused on observed attachment behaviors as they occur in older adults’ relationships.

Support-seeking and caregiving behaviors are important targets for dyadic interventions because behaviors have direct implications for both parents’ and children’s well-being. To address this gap in knowledge, a Stage 0, dyadic, cross-sectional, observational study will examine support seeking and caregiving behaviors in a sample of 200 adults aged 65 and older with early stage AD or related dementia and one adult child caregiver.  First, both dyad members, also called partners, will complete interviews at home assessing current and retrospective attachment styles, demographics, social network factors, dementia factors, relationship satisfaction, and psychological and physical health. Next, the dyad will engage in videotaped discussions in the laboratory about each partner’s concerns about their experience with the parent’s dementia.  Dyadic analyses will evaluate actor, partner, and mutual effects of attachment behaviors on each partner’s health.

Aim 1 will examine whether specific support seeking and caregiving behaviors relate to child and parent attachment security and relationship quality. Aim 2 will examine whether attachment security and relationship satisfaction relate to psychological and physical health. Exploratory Aim 3 considers the influences of demographics, social network characteristics, and dementia factors in these processes.

This work will provide theoretically driven information on specific behaviors that can be targeted in interventions for families coping with AD and related dementias to enhance attachment security, relationship quality, and health.  Findings will also lead to a Stage 1 application to create an attachment based dyadic intervention tailored for adult children and older parents with early AD or related dementias to protect both partners’ psychological and physical health over time.