Puga receives five-year, $3.1M R01

Photo of Frank Puga

By Erica Techo

University of Alabama at Birmingham School of Nursing Assistant Professor Frank Puga, PhD, has been awarded a five-year, $3.14 million grant from the National Institutes of Health National Institute on Aging to build on his program of research focused on the mental health of older adults living with chronic illness and their families by examining the mental health experiences of Hispanic and Latino/a caregivers of individuals with Alzheimer’s disease and related dementias.

“Hispanic and Latino/a adults develop dementia at a younger age, may experience more symptom burden than other ethnic/racial groups and have higher rates of comorbidities,” Puga said. “Given these observed disparities, Hispanic and Latino/a dementia caregivers are uniquely susceptible to increased caregiving stress that can negatively impact their mental health.”

The link between caregiving-related stress and health outcomes is well-documented, Puga said, but this grant supports research to better understand the dynamic factors that impact the experiences of Hispanic and Latino/a caregivers.

“This study is especially needed as this group of dementia caregivers is underserved and underrepresented in aging research,” Puga said. “As a Hispanic investigator, it is important to me that we increase representation of Hispanic and Latino/a individuals in research, as members of the workforce and as participants.”

In order to track caregiver experiences and day-to-day mental health, study participants will complete a series of daily diary surveys. Responses to these daily surveys can help identify patterns of depression and anxiety-related symptoms over time, while examining individual-level and cultural factors associated with the identified patterns.

By focusing on often overlooked variables, including cultural values, acculturation and experiences of racism and discrimination, this study can better support diverse populations that are also oftentimes disproportionately affected by stress and poor health outcomes.

“Imagine being a Spanish-speaking caregiver trying to navigate the health system for your loved one living with dementia or trying to seek support services. It can be a very stressful situation since services may be predominantly in English, may not be culturally sensitive, or you may just not feel comfortable because of how you are treated or talked to,” Puga said.

There are also strengths that can be derived from cultural factors, such as the focus on family leading to more social support. By better understanding the unique experiences of Hispanic and Latino/a caregivers, Puga aims to identify culturally sensitive interventions to improve caregiver mental health and resilience.

This topic is also personal for Puga, whose maternal grandparents were diagnosed with dementia and moved in with his parents while he was in college.

“Finding services and support for my grandparents was not always easy, and I saw firsthand how stressful caregiving can be for a family,” Puga said. “I often think back to that time and how support services for Hispanic caregivers like my parents are needed to help manage the stress of caregiving. This project is dedicated to the memory of my grandparents and to the compassion and endurance of my parents and my family.”

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