Close relational partners play a critical role in shaping each other's emotions during social interactions, a process known as interpersonal emotion regulation. We examined how different forms of dementia (i.e., Alzheimer's disease, behavioral variant frontotemporal dementia, primary progressive aphasia) affect interpersonal emotion regulation. We assessed how caregivers perceived their partners' prosocial regulatory efforts and tracked real-time changes in caregivers' affect during a dyadic interaction. We also investigated how these processes relate to caregivers' mental health. Informal caregivers (N = 62) reported on their own mental health symptoms (depression, anxiety) and how their care recipients, who had different forms of dementia, use prosocial interpersonal emotion regulation (i.e., efforts to make their partner feel better). Dyads then engaged in a 10-min unrehearsed discussion about a conflict in their relationship. Following this, caregivers viewed a video recording of the interaction and used a rating dial to provide continuous ratings of their own affective valence (negative-neutral-positive) during the conversation. Results revealed that among care recipients with Alzheimer's disease, primary progressive aphasia, and behavioral variant frontotemporal dementia, those with behavioral variant frontotemporal dementia showed the lowest use of prosocial interpersonal emotion regulation, and their caregivers experienced the greatest increases in negative affect during the interaction. Across diagnoses, greater increases in caregiver negativity during the interaction were associated with greater caregiver depression (but not anxiety). These findings provide new information about interpersonal emotion regulation in dementia and highlight how the emotional changes that occur during dyadic interactions are tied to caregiver depressive symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Physiological linkage, which refers to the degree that people's peripheral physiological responses change in coordinated ways, has been linked to a variety of psychiatric and developmental conditions. In contrast, physiological linkage in neurological conditions has been understudied. Behavioral variant frontotemporal dementia (bvFTD) is characterized by debilitating impairments in socioemotional functioning, including connections with others. We hypothesized that physiological linkage during interactions with loved ones would be reduced in bvFTD. During unrehearsed 10-min discussions of an area of disagreement in 86 dyads (n = 40 bvFTD; n = 35 Alzheimer's disease [AD]; n = 11 healthy controls), we computed dyadic physiological linkage using a composite of six peripheral physiological measures (i.e., heart rate, skin conductance, finger pulse amplitude, finger pulse transmission time, ear pulse transmission time, somatic activity). Specifically, we computed in-phase, anti-phase, and combined physiological linkage to examine each dyad's coordinated physiological changes that occur exclusively in the same direction (i.e., positively correlated), opposite direction (i.e., negatively correlated), or in either direction (i.e., correlated regardless of whether the correlation is positive or negative). Results indicate that bvFTD dyads had significantly lower combined (but not in-phase or anti-phase) physiological linkage compared to AD and healthy control dyads. To the extent that physiological linkage reflects social connection, these findings are consistent with the deficits in socio-emotional functioning that characterize bvFTD. We offer several possible explanations for this finding and consider implications for future research and clinical assessment of dyadic interpersonal processes in dementia and related disorders.

Connections with our loved ones play a critical role in our health, and emotions during marital interactions in mid-life can predict the development of health problems in later life. Research has documented greater interdependence among people from lower socioeconomic status (SES) backgrounds, but little is known about whether greater interdependence also emerges at a physiological level in low-SES contexts. This laboratory-based study examined physiological linkage (i.e., coordinated changes in partners’ interbeat intervals, the time between two successive heart beats) in 48 married couples (96 spouses; M = 43.38, SD = 9.25, range: 21-68 years) from highly diverse SES and racialized backgrounds across two marital interaction contexts (conflict and pleasant conversations). We analyzed both in-phase (i.e., coordinated changes in the same direction) and anti-phase (i.e., coordinated changes in opposing directions) physiological linkage. The overall number of observations was N = 192 (48 couples with four repeated measures; i.e., in-phase and anti-phase linkage in conflict and pleasant conversations). Repeated measures analyses showed that, across both conversations, spouses from lower (vs. higher) SES backgrounds showed greater in-phase and lower anti-phase physiological linkage. That is, their heart rates were more likely to change in similar ways and less likely to change in opposite ways. These findings provide first evidence linking socioeconomic status—a key macro-level factor shaping resources, rank, and societal hierarchy—with physiological linkage in married couples. Viewed through the lens of physiological linkage as an amplifier of emotions, this study prompts further research on the risks and resources for healthy aging in couples from lower-SES backgrounds.

OBJECTIVES:Caregivers for people with dementia (PWDs) often experience sleep problems due to stressors associated with their role (e.g. concern about PWDs' nighttime wandering). We investigated whether a technology system, People Power Caregiver (PPCg), that helps monitor the caregiver's home would benefit caregivers' sleep. METHODS:Primary caregivers of PWDs (Study 1: N = 70, Age M = 64.54, SD = 11.82, range = 35-84; Study 2: N = 92, Age M = 62.73, SD = 11.10, range = 32-89) were assigned to a fully activated PPCg condition or control condition (Study 1: partially active PPCg; Study 2: waitlist control). Caregivers completed the Pittsburgh Sleep Quality Index at baseline, three-months, and six-months. RESULTS:Caregivers in the control conditions reported significantly worsening sleep efficiency whereas in comparison, those in the active conditions reported improving sleep efficiency. CONCLUSIONS:Given how critical sleep is both for caregivers' health and the care they provide, these findings underscore potential benefits of in-home technologies for protecting caregivers' sleep. CLINICAL IMPLICATIONS:Technology-based interventions that help monitor the home may support caregivers' sleep. Protecting caregivers' sleep may also preserve their ability to provide high-quality care as their loved one's disease and associated functional decline progresses.

When people share emotions (e.g., laughing together), their physiological responses can become momentarily “linked” (i.e., changing in coordinated ways)—a phenomenon referred to as “physiological linkage”. Reduced physiological linkage has been observed in social interactions between people with dementia (PWD) and their family caregivers. To expand this work, in two independent samples of caregiver-PWD dyads, we examined the relationship between physiological linkage—measured in laboratory and real-world settings—and caregiver mental health and well-being. In study 1, 64 dyads had a 10-minute conversation about an area of disagreement in the laboratory with six measures of physiological responses continuously monitored. In study 2, 22 dyads wore wristwatch devices in their homes that provided a continuous measure of one physiological measure (activity) over seven days. Physiological linkage was computed as the covariation of dyads’ physiological responses during the conversation (Study 1) or waking hours (Study 2). Caregivers reported their emotional well-being (Study 1) and anxiety symptoms (Study 2) using well-established questionnaires. Findings revealed that lower physiological linkage in the laboratory was associated with lower caregiver emotional well-being (r = 0.27, p = .03). Similarly, lower physiological linkage in the home was associated with higher caregiver anxiety (r = -.48, p = .02). Findings remained statistically significant after accounting for individual-level physiological responses. We believe that caregiver-PWD dyads with lower physiological linkage may have weaker emotional connections, which can increase vulnerability in caregivers to declines in mental health and well-being.

Caregiving for a person with dementia is a highly emotional experience and can evoke numerous negative and positive affects. Not surprisingly, dementia caregivers are vulnerable to mood and anxiety disorders. In this study, 95 caregiver-person with dementia dyads had a 10-min, unrehearsed conversation about a relationship conflict in the laboratory between 2013 and 2019. After the conversation, caregivers reported the extent to which they experienced six negative and five positive affects during the conversation. Caregivers also completed self-report measures of their depression and anxiety symptoms. Analyses of caregivers' affect during the conversation revealed that greater sadness was correlated with higher depression, greater fear was correlated with higher anxiety, and greater anger and lower calm were each correlated with both higher depression and anxiety. In two multiple regressions that included the specific affect variables that were significantly correlated with caregiver depression or anxiety, respectively, we found that greater sadness and lower calm (but not anger) remained significantly associated with higher depression and lower calm (but not anger or fear) remained significantly associated with higher anxiety. Finally, when accounting for relevant caregiver demographic factors and person with dementia clinical characteristics, greater sadness and lower calm remained significantly associated with higher depression and lower calm remained significantly associated with higher anxiety. None of the associations between specific affects and depression or anxiety were moderated by caregiver sex or age. The specific affects found to be associated with psychopathology may help identify caregivers at heightened risk for mental health problems and inform selection of potential intervention targets. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

OBJECTIVES:Emotional impairments in people with dementia can be taxing for family caregivers. However, caregivers differ in their resilience to these challenges. We previously found that, compared to healthy controls and people with Alzheimer's disease, people with frontotemporal lobar degeneration (FTLD) have smaller physiological responses when anticipating upcoming emotional stimuli. This impairment may leave these people with FTLD unprepared for upcoming emotional stimuli because they cannot mount responses needed for appropriate behaviors, which may create stress and difficulties for caregivers. We examined (a) whether smaller preparatory physiological responses in people with dementia are associated with lower emotional well-being and physical functioning in caregivers; and (b) whether these associations are moderated by the dyads' relationship quality. METHODS:A total of 158 individuals with FTLD or Alzheimer's disease and their family caregivers participated. Preparatory physiological responses in people with dementia were quantified as decreases in cardiac interbeat intervals from baseline to an instruction period, during which they were told they would be watching an upcoming emotional film. Caregivers self-reported their emotional well-being, physical functioning, and relationship quality with the people with dementia. RESULTS:Smaller preparatory physiological responses in people with dementia were associated with lower emotional well-being (but not physical functioning) in caregivers. This association was moderated by relationship quality (i.e., weakened for caregivers in higher-quality relationships). DISCUSSION:Findings advance understanding of risk and resilience factors for negative caregiver outcomes. Positive interpersonal processes in high-quality relationships (e.g., positive appraisal of aberrant behaviors) may buffer caregivers from the impact of emotional impairments in people with dementia.

When people connect, their heart rates may become synchronized. Research has documented greater interdependence among people from lower socioeconomic status (SES) backgrounds, but little is known about whether greater interdependence also emerges at a physiological level in low-SES contexts. The present laboratory-based study examined physiological linkage (i.e., coordinated changes in interbeat interval on a second-by-second basis) in 48 married couples (96 spouses) from highly diverse SES and racialized backgrounds across two marital interaction contexts (i.e., a conflict and a pleasant conversation). We analyzed both in-phase (i.e., coordinated changes in same direction) and anti-phase (i.e., coordinated changes in opposing directions) linkage. The overall sample size was N = 192 observations (48 couples with four repeated measures: in-phase and anti-phase linkage in conflict and pleasant conversations). Repeated measures analyses showed that, across both conversations, spouses from lower (vs. higher) SES backgrounds showed lower anti-phase and greater in-phase physiological linkage, with the difference in anti-phase linkage being more pronounced. That is, their heart rates were less likely to change in opposite ways and more likely to change in similar ways. These findings provide the first evidence that privileged couples connect differently from less privileged couples at a physiological level, contributing to conversations on how macro-level factors become embedded and embodied in the micro.

Caregivers for people with neurodegenerative disease (PWNDs) often experience mental and physical health problems, especially when caring for PWNDs who have deficits in emotional functioning. We studied 65 PWNDs and their caregivers both during active caregiving and after caregiving had ended to determine: (a) how caregiver health changes after caregiving ends; and (b) whether PWNDs’ emotional functioning predicts these changes. PWND emotional functioning was assessed in the laboratory by measuring their generation of preparatory physiological activity (e.g., increased heart rate) to an upcoming emotional event (i.e., emotion eliciting films). Caregiver mental and physical health were measured using the Short-Form Health Survey (SF36) during active caregiving and again after caregiving had ended. Results indicated that, overall, caregivers reported increases in mental health, (t(36) = 2.58, p = .014, 95% CI [1.31, 10.93]) but decreases in physical health (t(36) = -2.35, p = .025, 95% CI [-7.26, -0.53]) across the two measurement periods. Using latent change score models, PWNDs’ preparatory physiological response impairments were associated with better caregiver mental health trajectories (β = -0.37, SE = 0.04, p = .003) such that smaller PWND preparatory responses predicted greater improvements in caregiver mental health (β = 9.92, SE = 2.84, p < .001). There was no association with changes in caregiver physical health. Smaller preparatory physiological responses in PWNDs may indicate diminished emotional responding, which is linked with lower caregiver mental health during active caregiving. Once caregiving ends, these caregivers may be most likely to “rebound” and show improvements in mental health.

Caregiving for a loved one with a neurodegenerative disease is an important part of family life. However, the associated burden of experiencing declining functionality in a parent, spouse/partner, or other family member can lead to increased loneliness in caregivers. Cognitive reappraisal is the process of reevaluating one’s thoughts about a situation to alter their emotional experience (e.g., finding the good in a bad situation). Using cognitive reappraisal may be a protective strategy to reduce loneliness in caregivers in the context of increased burden. We studied a total of 345 caregivers (age: M = 64.44, SD = 11.46) caring for a family member with a neurodegenerative disease (parent = 90; spouse/partner = 255) who were participating in our research on dementia caregivers. Caregivers’ burden, loneliness, and likelihood of using cognitive reappraisal were assessed using well-established questionnaires. We found that greater caregiver burden was associated with greater loneliness (r = 0.436, p < 0.001). This association was moderated by caregivers’ use of cognitive reappraisal (B = -0.08, p = 0.02) such that the association between burden and loneliness was less pronounced for caregivers who were more likely to use cognitive reappraisal. This moderation was maintained when controlling for potentially confounding variables (age, gender, and education). We believe that cognitive reappraisal may buffer against loneliness by helping caregivers focus on the more positive aspects of the situation (e.g., areas of preserved functioning in the person with dementia or memories of pleasurable activities in the past).

Positivity resonance is a collective emotion experienced by two or more individuals during moments of shared positive affect; it is theorized to constitute the experience of love, yet this claim has not been empirically tested. Using archival data from 148 long-term married couples, we examined whether dyad-level indicators of positivity resonance are linked to dyad-level indicators of trait and state love. Trait love was assessed as a latent variable using partners' ratings of their spouse on validated adjectives prototypic of love (e.g., affectionate, warm) and previously validated nonverbal cues of love displayed in synchrony (i.e., head tilts, body leans, Duchenne smiles, and nodding) during a recorded spousal interaction. State love was assessed as synchronous nonverbal cues of love during successive 30-s segments of this interaction. A global measure of positivity resonance, as well as measures of its constituent components of co-expressed and co-experienced positive affect (but not physiological linkage), were positively associated with the latent index of trait love. Within-couple variation over time in the global measure of positivity resonance was associated with within-couple variation over time in state love. These findings provide initial support for convergent validity between the measures of positivity resonance and love at trait and state levels.

Investigate prevalence of real-world dyadic driving as a longitudinal predictor of cognitive function in urban and rural dwellers with mild cognitive impairment (MCI) or Alzheimer's disease (AD).

Caring for a person with dementia (PWD) can produce declines in caregivers’ emotional well-being and physical functioning, which could result from disruptions in the emotional linkage between PWDs and caregivers. We examined the effects of interpersonal linkage in emotional behaviors on emotional well-being and physical functioning in caregivers and control partners. Forty-five PWD–caregiver dyads and 12 control dyads had a 10-min unrehearsed conflict conversation in the laboratory. We quantified positive and negative emotional linkage as the covariation between objectively coded positive and negative emotional behaviors during the conversation. Caregivers and one partner in the control dyads completed questionnaires concerning their emotional well-being and physical functioning. We found that lower positive emotional linkage was associated with lower emotional well-being in caregivers and control partners. We did not find similar effects with negative emotional linkage or for physical functioning. We offer possible explanations for these findings and implications for assessing caregiver risk.

Abstract Caregivers for people with dementia or mild cognitive impairment often report sleep problems due to heightened vigilance concerning worrisome behaviors (e.g., falls, wandering) by their care recipients (CRs). Interventions are needed to help alleviate these issues and the associated sleep troubles for caregivers. One promising approach is to utilize scalable and affordable in-home technologies that monitor CR behaviors round-the-clock and alert caregivers to potentially dangerous situations. We conducted two randomized controlled trials with independent samples to determine whether People Power Caregiver (PPCg), a newly developed in-home monitoring and alerting system, benefitted caregivers’ sleep over a six-month period. Combining the two studies, a total of 162 primary caregivers of the CRs were randomly assigned to either an active condition (PPCg system fully activated) or a control condition (Study 1: water leak detection only; Study 2: waitlist control procedure). Caregivers self-reported their sleep quality using the Pittsburgh Sleep Quality Index at baseline, three-months, and six-months. Using latent growth modeling, caregivers in the control conditions reported significantly worsening sleep efficiency compared to caregivers in the active condition (Active: B = -0.30, SE(B) = 0.14; Control: B = 0.74, SE(B) = 0.12; Condition Effect on Linear Slope: p =.038). We observed a similar pattern with PPCg benefitting caregivers’ sleep duration; however, this result was not statistically significant (Condition Effect on Linear Slope: p =.105). These results suggest that in-home technologies such as PPCg may offer an effective way to help caregivers achieve healthy sleep as they contend with the demands of caregiving.

Objectives Dementia caregivers (CGs) are at heightened risk for developing problems with anxiety and depression. Much attention has been directed toward developing and deploying interventions designed to protect CG health, but few have been supported by rigorous empirical evidence. Technology-based interventions that are effective, scalable, and do not add greatly to the CG burden are of particular interest.Methods We conducted a nine-month randomized controlled trial in 63 homes evaluating People Power Caregiver (PPCg), a system of sensors in the home connected to cloud-based software that alerts CGs about worrisome deviations from normal patterns (e.g., falls, wandering).Results CGs in the active condition had significantly less anxiety than those in the control condition at the six-month assessment. Greater anxiety reduction in the active condition at the six-month assessment was associated with greater interaction with PPCg via SMS text messages. There were no differences in anxiety at the three-month or nine-month assessments or in depression at any assessment.Conclusions PPCg shows promise for reducing anxiety associated with caring for a =person with dementia.Clinical implications Technology-based interventions can help reduce CG anxiety, a major adverse consequence of caregiving that may be difficult to treat due to other demands on caregiver time and energy.

Objective: To examine possible autonomic changes associated with progressive supranuclear palsy in response to a strong, unanticipated stimulus. Background: Progressive supranuclear palsy (PSP) is a neurodegenerative disorder that causes serious problems in eye movements, walking, and balance, and is also often associated with cognitive, emotional, and behavioral changes. In other movement disorders such as Parkinson's disease, similar symptoms have often been associated with changes in autonomic nervous system (ANS) functioning. Despite this, previous studies have rarely examined ANS functioning in PSP.. In the present study, we determined whether ANS responses to an emotionally provocative stimulus were altered in PSP. We tested the hypothesis that ANS responses to an unanticipated aversive auditory stimulus (i.e., a brief, loud burst of white noise) designed to induce a startle response would differ between patients with PSP compared to healthy controls (HC). Design/Methods: Participants included 33 PSP patients and 38 HC. Participants sat still for a 60 second baseline and heard a brief (100-ms) loud (115-dB) burst of white noise without warning. Continuous measures of cardiac interbeat intervals (IBI; decreases in IBI correspond to increases in heart rate) and skin conductance levels (SCL) were obtained throughout the task. Results: Compared to HC, PSP patients showed significantly less decrease in IBI (i.e., less increase in heart rate) and less increase in SCL from baseline during the 10 seconds after stimulus onset. Conclusions: Less decrease in IBI and less increase in SCL in the face of a strong external stimulus suggests a diminished sympathetic nervous system response. In light of previous research suggesting that peripheral sympathetic responses are relatively preserved in the setting of orthostatic postural testing in PSP, we suspect this relates to a brainstem degeneration in a pontine circuit that is critical for startle reflexes during emotional challenges. Disclosure: The institution of Dr. Pressman has received research support from Premiere. Dr. Pressman has received personal compensation in the range of $100,000-$499,999 for serving as a Associate Professor with University of Colorado School of Medicine. The institution of Dr. Chen has received research support from National Institute on Aging. Ms. Bullard has nothing to disclose. The institution of Dr. Rankin has received research support from Marcus Foundation. Robert Levenson has nothing to disclose.

Abstract Persons with neurodegenerative diseases (PWDs) often develop profound declines in the ability to recognize emotions in others that lead to diminished social connectedness with their loved ones. Physiological linkage, which refers to the degree that people’s physiological responses change in coordinated ways, can serve as a proxy measure for social connectedness. Physiological linkage has been found to be diminished during interactions between PWDs (i.e., care recipients) and their family caregivers. However, the association between diminished physiological linkage and PWDs’ lower emotion recognition has not been determined. In a sample of 28 PWD-family caregiver dyads, we quantified physiological linkage as the positive (“in-phase”) correlations between PWD’s and caregiver’s somatic activity. Somatic activity was measured remotely via actigraphy using wristwatches worn by both partners in their homes during waking hours for 7 days. PWDs’ emotion recognition was quantified as the ability to recognize positive and negative emotions of their caregivers accurately during a 10-minute conflict conversation in our laboratory prior to the 7-day home assessment. Lower emotion recognition by PWDs of their caregivers’ negative emotions (β = .49, p = .01), but not positive emotions (β = .12, p = .52) in the laboratory assessment was associated with lower physiological linkage between PWDs and caregivers in their home. Establishing a relationship between PWDs’ deficits in emotion recognition and diminished physiological linkage during conversations with their caregivers provides a basis for understanding problems in establishing social connections that are often observed in PWDs.