Steven H. Zarit
Family caregiving for the elderly; health and functioning of the oldest old; development of prevention and treatment programs for mental health problems in later life; cross-national comparisons of old age care systems.
Current Research Projects
Daily Stress and Health (DaSH). Investigators: Steven H. Zarit, Principal Investigator. David Almeida, Elia Femia, Laura Klein, Peter Molenaar, Michael Rovine.
Caring for a person with dementia (PWD) has been found to be associated with a variety of negative changes in health and well-being. Much of this research, however, has been correlational, with data gathered at one or two points in time, which can blur the sequence of events and thus the underlying mechanism by which stressors may affect health. New design approaches that use intensive repeated measurement of individuals offer the potential for clarifying the sequence of events from stressors to health markers and well-being and to establish more precisely the short-term health effects of concrete daily experiences The DaSH study is collecting daily diary data over a 9-day period on daily stressors, daily mood and health symptoms and daily measures of three critical biomarkers to demonstrate the links between stress and health, as well as possible mediators of that relationship. In contrast to prior daily diary studies, where the range of exposure to stressors is limited, we take advantage of a naturally-occurring experiment by comparing the stress responses of caregivers using Adult Day Services (ADS) for their relative on days they use ADS and days they do not. Prior work by our group found that caregivers experienced a 66 percent reduction in exposure to care-related stressors on days they used ADS compared to non-ADS days. Comparable to the classic A-B-A research design, this approach enables us to to examine immediate as well as delayed effects of stressors under high and low stress conditions.
We are currently recruiting a sample of 180 family caregivers of a PWD who is currently using ADS. Participants are assessed over a period of 9 consecutive days, including when their relative uses ADS (low stress days) and when their relative does not (high stress days). Daily measures include care-related and non-care stressors, subjective distress and health symptoms. Biomarkers are obtained from saliva samples provided at scheduled times during each day. Assays will be obtained for 3 key biomarkers with implications for health: cortisol, alpha-amylase and dehydroepiandrosterone-sulfate (DHEA-S). The results of the study will clarify the relation among daily stressors, well-being and biomarkers of health, and suggest the pathways by which caregiving stressors might affect health. The findings should also yield practical information on how caregiver services could reduce health risks. This research is funded by the National Institute on Aging (1 RO1 AG031758)
Adaptive Interventions for At-Risk Caregivers. Investigators: Steven H. Zarit, Principal Investigator. Elia Femia, Co-PI. Carol Whitlatch, (Margaret Blenkner Research Institute at Benjamin Rose), Co-PI.
This study explores the development of a new strategy, adaptive intervention, for family caregivers. Adaptive interventions use a structured assessment to identify the specific risk factors for each caregiver and apply only those interventions specific to the risk factors found. The project was be conducted in two phases. In the first phase, we developed and evaluated a theory-driven assessment tool that will identify risk factors and their cut-offs for assigning people to specific interventions. The second phase was be a small trial in which the assessment developed in Phase 1 was used to assign people to treatment modules. We expect that by giving family caregivers intervention modules specific to their risk profile will improve outcomes. The study has been completed but data analysis is continuing. This research was funded by the National Institute of Mental Health (1 R34 MH073559).
Independence and Disabilitiy in the Oldest Old. Investigators: Steve Zarit, Denis Gerstorf and Nilam Ram, Penn State University; Elizabeth Fauth (PI), Utah State University; Bo Malmberg, Gerdt Sundström, Gerontology Institute, Jönköping University, Jönköping, Sweden.
This research is part of an international collaboration with faculty at the Gerontology Institute of Jönköping University. Studies explore the transition from independence to dependence in population-based and longitudinal samples of people in their 80s and early 90s. A theory based model of the disability process is used to guide the analysis of changes over time. We are also examining the responses of family and formal services to increased levels of disabilities. The goal of these projects are to identify factors that may delay the onset of disability in very late life, learn more about the care received by the very old, and look at social policies which may promote independence and quality of life in the face of dependence.
Independence and Disability in a Developing Country. Investigators: Steve Zarit, Penn State University; Ha Nguyen, Wake Forest University; Nguyen Ngoc and Hoang Ngoc Chuong, National Technical College of Medicine No. 2, Da Nang, Vietnam, and Alan Zonderman, National Institute on Aging.
This project is a collaborative effort of researchers in the United States, Sweden and Vietnam. Our goal is to identify functional competency and rates of dependency in a representative sample of people aged 55 and older living in Da Nang, Vietnam, and its surrounding rural districts. The study provides systematic information about the need for assistance of older adults in Vietnam and how well traditional family supports are able to manage in caring for an expanding number of elders. We also explored the medical, social, environmental and psychological processes that contribute to disability. Another outcome is providing information on the needs of elders in the Da Nang area that can be used for development of services and other initiatives. This research was funded through a contract from the National Institute on Aging Intramural Branch. Data collection is complete and analysis of the data is continuing.
Family Exchanges Study. Investigators: Karen Fingerman, Principal Investigator (Purdue University); Steve Zarit, Michael Rovine, David Eggebeen (Penn State University).
There are few legal or social sanctions in the U.S. requiring adults to provide assistance for their parents or grown offspring, but middle-aged adults frequently exchange assistance with generations above and below them. A burgeoning literature shows that most adults also experience frustration and tensions with parents and grown offspring. This study examines: Aim 1) patterns of exchanges with parents vs. offspring (what is exchanged and who does the exchanging), Aim 2) beliefs about these exchanges, and Aim 3) feelings about these exchanges and relationships. We also consider parents’ and offspring’s reports of the exchanges. The study fills a large gap in the literature by examining psychological processes (e.g., beliefs, feelings) associated with exchanges and considering multiple family members’ perspectives on these exchanges. Participants include 633 adults aged 40 to 60 who have at least one living parent and one child over the age of 18. We interviewed the target person, his/her spouse, his/her parents, and up to three children. We are examining multiple family members’ (middle-aged adult, offspring, parent) reports of exchanges, as well as agreements and disagreements in family members’ views of supports and feelings. Unique contributions of the study include examination of: different family members’ reports of support within the same family (Aim 1); beliefs about motivations underlying exchanges with parents and offspring (Aim 2); and positive and negative feelings about everyday exchanges and relationships (Aim 3). Findings from this study will have implications for understanding how provision and receipt of support are associated with variability in health at midlife. Findings also will be of use to policy makers concerning expectations and feelings adults hold regarding familial versus public obligations. This research is funded by the National Institute on Aging (R01 AG027769).