Caregiver Preparedness: A Therapeutic Mechanism and Moderating Factor on Outcomes for the Savvy Caregiver Program.

OBJECTIVES: Evidence-based interventions for dementia caregivers, such as the Savvy Caregiver Program (SC), seek to address skills and knowledge deficits, caregiver burden, depressive symptoms, and grief. Little research has examined mechanisms by which these interventions accomplish their goals. Caregiver preparedness may be a possible mechanism by which caregiver interventions may confer benefits. METHODS: The sample included 76 dementia caregivers who completed the 6-session SC. Participants completed the Anticipatory Grief Scale, Center for Epidemiological Studies-Depression Scale, the Preparedness for Caregiving Scale, and the Zarit Burden Interview-Short Form. RESULTS: A repeated measures ANOVA was utilized to determine the interaction between baseline scores and pre-post change in caregiver preparedness. Analysis significantly predicted caregiver burden, (F(1) = 6.68, p=.012, partial η2=.10), depressive symptom endorsement, (F(1) = 6.41, p=.014, partial η2=.09, and anticipatory grief, (F(1) = 6.22, p=.02, partial η2=.1), post-treatment. CONCLUSIONS: Pre-post change in caregiver preparedness significantly predicted pre-post change across measures of caregiver burden, depressive symptom endorsement, and anticipatory grief. Findings suggest that caregiver preparedness may be one mechanism by which the SC confers positive outcomes. These findings provide an empirical and theoretical basis for tailoring future dementia caregiver interventions. CLINICAL IMPLICATIONS: Clinical Interventions may seek to improve caregiver preparedness and subsequent outcomes through utilization of programs like SC.

Depressive symptoms in older adults with and without a history of incarceration: A matched pairs comparison.

OBJECTIVES: Previous research has found that many incarcerated individuals have mental health conditions and that incarcerated women may be at elevated risk. These individuals have been shown to experience mental health concerns shortly after their release, but little is known about their mental health later in life. This study compared depressive symptoms in older adults with and without a history of incarceration and examined the impact of gender on this relationship. METHOD: Data from 160 pairs of adults aged 65 or older (82.5% male, mean age = 73.4 years) who participated in the 2012 wave of the Health and Retirement Study (HRS) was utilized. Older adults with a history of incarceration were matched to those without based on age, gender, race, and education level. Depressive symptoms (CES-D) of older adults with and without a history of incarceration were compared using a repeated-measures ANOVA. RESULTS: The main effect of incarceration history (p=.001, partial eta2=.07) and the interaction between incarceration history and gender (p=.01, partial eta2=.04) were significant. Follow-up analyses revealed that the difference between depressive symptoms for older women with and without a history of incarceration was significant (p=.02, d = 0.69), whereas the difference for older men was not significant (p=.19, d = 0.16). CONCLUSIONS: Findings suggest older adults with a history of incarceration report more depressive symptoms than those without and that the effect is seen among older women. Negative effects of incarceration on mental health may therefore persist into later life, highlighting the importance of pre- and post-release mental health services.

Piloting a Dementia Caregiver Intervention in a Primary Care Setting.

OBJECTIVES: The purpose of this pilot study is to examine the efficacy of a theoretically based, 6-week dementia caregiver support group in a primary care setting. METHODS: Using a quasi-experimental design, 22 participants completed the caregiver support group. Participants were mostly in their mid-60 s (M = 63 years old), female (n = 19), Caucasian (n = 14), and identified as either the care recipient's child or spouse (n = 19). At baseline and 6 weeks, participants completed self-report measures related to demographic information, caregiver preparedness, strain, and depressive symptoms, and care recipient's neuropsychiatric symptoms. Participants also completed a satisfaction survey. Within-subjects t-tests were run to determine if participants' scores changed over time. RESULTS: Results revealed that participants demonstrated a significant increase in mean caregiver preparedness scores. No significant effects were found for caregiver strain, depressive symptoms, and distress related to neuropsychiatric symptoms. Participants rated being largely satisfied with the program. CONCLUSIONS: Results suggest that this 6-week caregiver support group may be a promising caregiver intervention in primary care clinics. CLINICAL IMPLICATIONS: Findings support the importance of caregiver support for persons with dementia in primary care.

Functional limitation in later-life: the impact of sips, socialization, and sadness.

OBJECTIVES: Findings on the health impact of moderate alcohol use in later-life have been discrepant. Unaddressed mechanisms of action and validity concerns may contribute to contrasting results. Several studies have demonstrated a beneficial relationship between moderate alcohol use and functional ability. Research is needed to identify mechanisms of action that explain this relationship, while employing methods to reduce common validity concerns in alcohol use research. This study examines social interaction and depressive symptoms as serial mediators in the relationship between moderate alcohol use and functional limitation in later-life. METHOD: HRS data from 2012-2016 were utilized (n = 1,474); heavy drinkers, adults younger than 65, and respondents with inconsistent alcohol use from 2008 to 2016 were excluded. Hypotheses were evaluated using a longitudinal serial mediation model with bias-corrected bootstrapping. RESULTS: Results indicated that, in the context of demographic variables, medical burden, and previous functional limitation, the relationship between 2012 moderate alcohol use and 2016 reduced functional limitation is only present when considering the mediating effect of 2014 depressive symptoms as a single mediator, and 2012 social interaction and 2014 depressive symptoms as serial mediators, respectively (total effect model R2=.167). CONCLUSIONS: Data indicate that relationships between moderate drinking and reduced functional limitation are explained through increased social interaction and subsequent reduced depressive symptoms. Results identify social interaction as an accessible treatment target to address depressive symptoms and functional limitation, and support increased assessment of IADLs in adults experiencing depressive symptoms (and vice versa) to facilitate early treatment/prevention of functional and emotional decline.

Light field camera study of near-ground turbulence anisotropy and observation of small outer-scales.

Understanding turbulence effects on laser beam propagation is critical to the emerging design, study, and test of many long-range free space optical (FSO) communication and directed energy systems. Conventional studies make the prevalent assumption of isotropic turbulence, while more recent results suggest anisotropic turbulence for atmospheric channels within a few meters elevation above the ground. As countless FSO systems have been and continue to be deployed in such channels, analysis of anisotropic modelings has become one of the fastest growing areas in FSO research. This in turn motivates new tools that can distinguish anisotropic characteristics to improve both modeling accuracy and physical interpretations. Wavefront sensors such as Shack-Hartmann sensors, interferometers, and plenoptic sensors have been devised and used in experiments; however, they all require rigid alignments that lack resilience against temperature gradient buildup and beam wander. We find that by using a light field camera (LFC) that extracts perturbation of individual light rays, the wave structure function of turbulence can be retrieved with high reliability. Furthermore, we find through experiments that the outer scales of near-ground turbulence tend to be a magnitude smaller than conventional theoretical assumptions, agreeing with new findings by others but being absent in current theoretical modelings. As a result, we believe that the LFC is an ideal candidate in the frontier of turbulence research; it is both commercially available and easy to adapt to turbulence experiments.

Quadrant Fourier transform and its application in decoding OAM signals.

We present a new, to the best of our knowledge, concept of using quadrant Fourier transforms (QFTs) formed by microlens arrays (MLAs) to decode complex optical signals based on the optical intensity collected per quadrant area after the MLAs. From a computational optics viewpoint, we show the most promising use of the QFT in low-cost and passive decoding of laser signals carrying optical angular momenta (OAM) that are prevalent in research frontiers of optical communications, computation, and imaging. There are numerous ways of creating, adding, and combining OAM states in optical waves, while decoding or demultiplexing approaches often turn out to be complicated or expensive. The simple OAM decoder formed by a pair of identical MLAs, which are concatenated in the focal plane and transversely offset by half-pitch length, can accomplish the imaging task with four pixels per cell. By sorting the gradient curls of the optical wave into local quadrant cells, the decoder analyzes the intensity reallocation that is proportional to the gradients and computes the gradient curls accordingly. The low-cost, compactness, and simplicity of the proposed OAM sensor will further promote OAM-based applications, as well as many other applications that exploit the spatial complexity of optical signals.

Assisting target recognition through strong turbulence with the help of neural networks.

Imaging and target recognition through strong turbulence is regarded as one of the most challenging problems in modern turbulence research. As the aggregated turbulence distortion inevitably degrades remote targets and makes them less recognizable, both adaptive optics approaches and image correction methods will become less effective in retrieving correct attributes of the target. Meanwhile, machine learning (ML)-based algorithms have been proposed and studied using both hardware and software approaches to alleviate turbulence effects. In this work, we propose a straightforward approach that treats images with turbulence distortion as a data augmentation in the training set, and investigate the effectiveness of the ML-assisted recognition outcomes under different turbulence strengths. Retrospectively, we also apply the recognition outcomes to evaluate the turbulence strength through regression techniques. As a result, our study helps to build a deep connection between turbulence distortion and imaging effects through a standard perceptron neural network (NN), where mutual inference between turbulence levels and target recognition rates can be achieved.

Measuring the turbulence profile in the lower atmospheric boundary layer.

Optical turbulence can have a severe effect on the propagation of laser beams through the atmosphere. In free space optics and directed energy applications, these laser beams quite often propagate along a slant or vertical path. In these cases, the refractive index structure function parameter cannot be assumed constant, since it varies with height. How it varies with height, especially in the first few meters above the ground, is not well behaved. Turbulence height profiles have been measured since the 1970s, mainly for astronomical observations. These profiles are usually measured for the atmospheric boundary layer (the layer of air from the ground up to approx. 1 km during day and 100 m during night) and some kilometers above it. We have measured the temperature fluctuations in the first few meters above ground level using a system containing eight resistance thermometer devices, mounted in a row at different spacings. Measurements were made flying this system under a tethered balloon or mounted on a telescoping mast. The temperature structure function parameter, CT2, can be estimated from the temperature fluctuations measured by the 28 different probe pairs and the unique distances between the two probes. Finally, Cn2 is estimated from this temperature structure function parameter and compared to values predicted by a turbulence profile model.

Quality of Life Enhancement Research Program: Lessons Learned.

The attempted Quality of Life Enhancement program appeared to be a novel method for creating a symbiotic and sustainable relationship between a large Southeastern university and local nursing home and assisted living facilities (ALF), through which ALF residents would attend university arts and sporting events. During implementation, it was discovered that this project was unsustainable, undesired, unneeded by many care centers, difficult to implement, and required a dedicated and specialized staff. After attempting to enroll 14 local care facilities, only 2 were interested in becoming involved and produced 5 eligible participants. During the program itself, coordination with facilities and residents was difficult to maintain and unique transportation and accommodation needs were challenging to overcome. Finally, data collection was time consuming and generally unfruitful. Ultimately the project was discontinued after a year of attempted recruitment and implementation of inclusive changes to protocol. While creating an ongoing relationship with local care facilities and local universities may enhance opportunities for residents and research into important areas, such relationships take time, effort, and specialized staff to maintain.

Cerebrovascular burden and depressive symptomatology interrelate over 18 years: support for the vascular depression hypothesis.

OBJECTIVE: Potentially incongruent research literatures suggest three divergent hypotheses about depressive symptomatology: (1) symptoms are recurrent; (2) later-life depression results from high cerebrovascular burden (CVB); and (3) depressive symptoms contribute to comorbidities causing vascular burden. Past vascular depression research assumes that later-life depressive symptoms relate uniquely to high CVB and not to prior, recurrent depression. This study examines these divergent hypotheses. METHODS: Data include 5175 participants across 18 years from the Wisconsin Longitudinal Study (mean age at 1993 baseline was 53 years; follow-ups in 2004 and 2011). Depressive symptomatology was measured using the Center for Epidemiological Studies Depression. CVB was operationalized as hypertension, high blood sugar, diabetes, and other heart problems. Hypotheses were examined via a cross-lagged structural equation model and logistic regression. RESULTS: Model fit was acceptable (root mean square error of approximation (RMSEA) = 0.047; comparative fit index = 0.963). Hypotheses 1 and 2 were supported. Depressive symptomatology at 2004 and 2011 follow-ups was predicted by earlier depressive symptomatology and prior CVB. Hypothesis 3 was partially supported; depressive symptomatology in 2004 predicted subsequent CVB. Logistic regression results were that CVB predicted clinically significant depressive symptoms based on the Center for Epidemiological Studies Depression clinical cutoff. CONCLUSIONS: Cerebrovascular burden in midlife predicts depressive symptomatology in later-life, even after accounting for prior depressive symptomatology, supporting a fundamental assumption of the vascular depression hypothesis. Midlife depressive symptomatology also predicted escalation of CVB in later-life. Results suggest a process model of later-life depressive symptom development that interrelates CVB and depressive symptoms throughout the life span and have clinical implications for the interruption of this process through the integration of primary care and behavioral health specialists. Copyright © 2017 John Wiley & Sons, Ltd.

The relationship between moderate alcohol consumption, depressive symptomatology, and C-reactive protein: the Health and Retirement Study.

OBJECTIVE: Moderate alcohol use has been broadly associated with health benefits among older adults, including improved mood. Aims of this study were to evaluate the relationship of moderate alcohol use and depressive symptomatology over a period of eight years, and to examine inflammation, indicated by C-reactive protein (CRP), as one mechanism by which this relationship functions. METHODS: The study included 3177 community-dwelling participants over the age of 65 in 2008 drawn from the Health and Retirement Study. Data from the 2006, 2008, 2012, and 2014 waves were used. Alcohol use was measured via self-report and was dichotomized as abstinent (0 drinks per week) and moderate (1-14 drinks per week). Inflammation was measured using CRP, which was collected using an enzyme-linked immunosorbent assay and provided in units of µg/mL. Control variables included gender, age, body mass index (BMI), and medical burden. RESULTS: A latent growth curve model with full information maximum likelihood was used, with results revealing that moderate drinkers endorsed fewer depressive symptoms at baseline and a steeper rate of change over time. Abstinent respondents' depressive symptomatology was characterized by a more linear change rate. Further, moderate drinkers had lower CRP levels suggesting that inflammation partially mediates the relationship between moderate alcohol use and depressive symptomatology. CONCLUSIONS: Moderate alcohol use predicts fewer depressive symptoms among older adults. This relationship is partially moderated by CRP and is eroded by the passage of time. Future research should identify additional mechanisms relating alcohol to positive health outcomes and less depressive symptomatology. Copyright © 2017 John Wiley & Sons, Ltd.

Phase and amplitude beam shaping with two deformable mirrors implementing input plane and Fourier plane phase modifications.

We find that ideas in optical image encryption can be very useful for adaptive optics in achieving simultaneous phase and amplitude shaping of a laser beam. An adaptive optics system with simultaneous phase and amplitude shaping ability is very desirable for atmospheric turbulence compensation. Atmospheric turbulence-induced beam distortions can jeopardize the effectiveness of optical power delivery for directed-energy systems and optical information delivery for free-space optical communication systems. In this paper, a prototype adaptive optics system is proposed based on a famous image encryption structure. The major change is to replace the two random phase plates at the input plane and Fourier plane of the encryption system, respectively, with two deformable mirrors that perform on-demand phase modulations. A Gaussian beam is used as an input to replace the conventional image input. We show through theory, simulation, and experiments that the slightly modified image encryption system can be used to achieve arbitrary phase and amplitude beam shaping within the limits of stroke range and influence function of the deformable mirrors. In application, the proposed technique can be used to perform mode conversion between optical beams, generate structured light signals for imaging and scanning, and compensate atmospheric turbulence-induced phase and amplitude beam distortions.

Multi-aperture laser transmissometer system for long-path aerosol extinction rate measurement.

We present the theory, design, simulation, and experimental evaluations of a new laser transmissometer system for aerosol extinction rate measurement over long paths. The transmitter emits an ON/OFF modulated Gaussian beam that does not require strict collimation. The receiver uses multiple point detectors to sample the sub-aperture irradiance of the arriving beam. The sparse detector arrangement makes our transmissometer system immune to turbulence-induced beam distortion and beam wander caused by the atmospheric channel. Turbulence effects often cause spatial discrepancies in beam propagation and lead to miscalculation of true power loss when using the conventional approach of measuring the total beam power directly with a large-aperture optical concentrator. Our transmissometer system, on the other hand, combines the readouts from distributed detectors to rule out turbulence-induced temporal power fluctuations. As a result, we show through both simulation and field experiments that our transmissometer system works accurately with turbulence strength Cn2 up to 10-12 m-2/3 over a typical 1-km atmospheric channel. In application, our turbulence- and weather-resistant laser transmissometer system has significant advantages for the measurement and study of aerosol concentration, absorption, and scattering properties, which are crucial for directed energy systems, ground-level free-space optical communication systems, environmental monitoring, and weather forecasting.

Using turbulence scintillation to assist object ranging from a single camera viewpoint.

Image distortions caused by atmospheric turbulence are often treated as unwanted noise or errors in many image processing studies. Our study, however, shows that in certain scenarios the turbulence distortion can be very helpful in enhancing image processing results. This paper describes a novel approach that uses the scintillation traits recorded on a video clip to perform object ranging with reasonable accuracy from a single camera viewpoint. Conventionally, a single camera would be confused by the perspective viewing problem, where a large object far away looks the same as a small object close by. When the atmospheric turbulence phenomenon is considered, the edge or texture pixels of an object tend to scintillate and vary more with increased distance. This turbulence induced signature can be quantitatively analyzed to achieve object ranging with reasonable accuracy. Despite the inevitable fact that turbulence will cause random blurring and deformation of imaging results, it also offers convenient solutions to some remote sensing and machine vision problems, which would otherwise be difficult.

Delirium and mental health history as predictors of aggression in individuals with dementia in inpatient settings.

OBJECTIVES: Aggressive behaviors by patients with dementia present risk to health care workers and patients. An information processing model, developed to study aggressive behaviors among children, was applied to study aggression among older hospital patients with dementia. Hypotheses were that delirium and mental health or depression history, would relate to increased risk of aggressive behaviors. METHOD: Electronic medical records were sampled for one year (n = 5008) and screened using the EMERSE search engine and hand review for dementia (n = 505) and aggressive behavior in individuals with dementia (n = 121). Records were reviewed for mental health history and presence of delirium. RESULTS: Regression analyses found interaction effects representing delirium and mental health or depression history associated with greater risk of aggressive behavior. Significant main effects were found for both dementia and mental health or depression history. Of the lowest risk group, 12% of patients exhibited aggression compared to 24%-35% of those with delirium, mental health or depression history, or the combination of these risk factors. CONCLUSION: Delirium is the leading correlate of aggressive behaviors in hospitalized patients with dementia, and delirium or history of mental health diagnosis may lead to increased risk of aggressive behaviors in this setting.

Alcohol Use and Frailty Risk among Older Adults over 12 Years: The Health and Retirement Study.

OBJECTIVES: The primary goal was to examine the relationship between alcohol use and frailty, a variable characterizing late-life decline, in a national, longitudinal survey of older adults living in the United States. METHODS: The sample drawn from the Health and Retirement Study included 9,499 stroke-free participants over age 65 in 2000. The sample was 59.1% female, and had a mean age of 74.25 years (SD = 6.99). Follow-up data was from 2004, 2008, and 2012. Frailty was defined phenotypically using the Paulson-Lichtenberg Frailty Index (PLFI). Alcohol use was measured via self-report. Control variables included age, race, education, socio-economic status (SES), depressive symptomatology, medical burden score, body mass index (BMI), and partner status. With abstinent participants as the reference group, logistic regressions were conducted to determine prevalent frailty at 2000, and Cox's proportional hazard models were utilized to determine time to incident frailty over a 12-year period. RESULTS: Results revealed that age, depressive symptomatology, and medical burden score were significant positive correlates of prevalent and incident frailty (p < .05) for both males and females. Logistic regressions revealed that consumption of 1-7 alcoholic drinks per week was associated with reduced prevalent frailty (OR = .49, p < .001) for females. Survival analysis results reveal that compared with nondrinkers, males and females who reportedly consumed 1-7 drinks per week had a decreased probability of incident frailty (HR = .78-081, p < .05). CONCLUSIONS: Findings suggest that moderate alcohol use confers reduced frailty risk for both older men and women. Future research should examine the mechanism(s) relating alcohol consumption and frailty. CLINICAL IMPLICATIONS: Findings support extant literature suggesting some healthcare benefits may be associated with moderate drinking.

When Employment and Caregiving Collide: Predictors of Labor Force Participation in Prospective and Current Caregivers.

OBJECTIVE: Female caregivers often reduce time spent at work to care for aging family members, which precipitates financial hardship and other adverse outcomes. Little is known about psychosocial correlates of labor force participation (LFP) among female caregivers. The theory of planned behavior posits that social norms, attitudes, and perceived control predict intentions and volitional behaviors, but also that the compelling influence of situational variables undermines enactment of behaviors consistent with one's intentions. The objective of this study was to employ the theory of planned behavior to examine how psychosocial characteristics predict willingness to reduce LFP among prospective caregivers and actual LFP reduction among active caregivers. METHODS: Subsamples of 165 female prospective caregivers and 97 active female caregivers responded to a survey assessing filial beliefs and LFP. RESULTS: Filial obligation and caregiver preparedness predicted intentions to reduce LFP among prospective caregivers, but did not predict actual reduction in LFP in active caregivers. Weekly care demands exceeding 20 hours emerged as the sole correlate of LFP among active caregivers. CONCLUSIONS: Domains of the theory of planned behavior predict LFP intentions, but LFP decisions are subject to external pressures, specifically, time demands of the caregiving relationship. Prospective caregivers may benefit from proactive interventions aimed at reducing conflict between situational demands and filial beliefs.

Cognition Predicts Quality of Life Among Patients With End-Stage Liver Disease.

BACKGROUND: Impaired cognitive functioning and poor quality of life (QoL) are both common among patients with end-stage liver disease; however, it is unclear how these are related. OBJECTIVE: This study examines how specific cognitive domains predict QoL among liver transplant candidates by replicating Stewart and colleagues' (2010) 3-factor model of cognitive functioning, and determining how variability in these cognitive domains predicts mental health and physical QoL. METHODS: The sample included 246 patients with end-stage liver disease who were candidates for liver transplant at a large, Midwestern health care center. Measures, including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Shipley Institute of Living Scale, Short-Form Health Survey-36 Version 2, and Hospital Anxiety and Depression Scale, comprised latent variables representing global intellectual functioning, psychomotor speed, and learning and memory functioning. RESULTS: Confirmatory factor analysis results indicate that the 3-factor solution model comprised of global intellectual functioning, psychomotor speed, and learning and memory functioning fit the data well. Addition of physical and mental health QoL latent factors resulted in a structural model also with good fit. Results related physical QoL to global intellectual functioning, and mental health QoL to global intellectual functioning and psychomotor functioning. CONCLUSIONS: Findings elucidate a relationship between cognition and QoL and support the use of routine neuropsychological screening with end-stage liver disease patients, specifically examining the cognitive domains of global intellectual, psychomotor, and learning and memory functioning. Subsequently, screening results may inform implementation of targeted interventions to improve QoL.

C-reactive protein level partially mediates the relationship between moderate alcohol use and frailty: the Health and Retirement Study.

BACKGROUND: frailty is an indicator of late-life decline marked by higher rates of disability and healthcare utilisation. Research has linked health benefits with moderate alcohol use, including frailty risk reduction. Past work suggests inflammation, measured by C-reactive protein (CRP), as one candidate mechanism for this effect. OBJECTIVE: this study aims to elucidate a possible mechanism - CRP modulation - by which moderate alcohol consumption may protect against frailty. METHODS: a cross-sectional study using data from the 2008 wave of the Health and Retirement Study (HRS) conducted by the University of Michigan. The HRS is a cohort study on health, retirement and aging on adults aged 50 and older living in the USA. A final sample of 3,229 stroke-free participants, over the age of 65 years and with complete data, was identified from the 2008 wave. Alcohol use was measured via self-report. Frailty was measured using the Paulson-Lichtenberg Frailty Index. CRP was collected through the HRS protocol. RESULTS: results from structural equation modelling support the hypothesised model that moderate alcohol use is associated with less frailty and lower CRP levels. Furthermore, the indirect relationship from moderate alcohol use to frailty through CRP was statistically significant. CONCLUSIONS: overall findings suggest that inflammation measured by CRP is one mechanism by which moderate alcohol use may confer protective effects for frailty. These findings inform future research relating alcohol use and frailty, and suggest inflammation as a possible mechanism in the relationship between moderate alcohol use and other beneficial health outcomes.

Prepared to care: adult attachment and filial obligation.

OBJECTIVES: Past work found that close adult attachment dimension scores predict caregiver preparedness. Theory and past research suggests filial obligation (FO) may mediate the relationship between attachment and caregiver preparedness. The goal of this study was to test that hypothesis. METHOD: The sample, collected using Mechanical Turk, included 165 women between the ages of 45 and 65 years who were not providing care to an aging parent.  Participants were reimbursed $0.75 for completing an online survey assessing response validity, dimensions of adult attachment, depressive symptomatology, FO, and caregiver preparedness, among other variables. The mean participant age was 52.2 years (SD = 5.5). RESULTS: The sample was predominantly White/Caucasian (82.6%), and Black/African American (7.3%).  With respect to education, 14.5% completed high school or general education development (GED), 32.7% completed some college, 36.4% completed a Bachelor's degree, and 15.7% completed graduate degrees. The three attachment dimensions (close, dependent, and anxious) and FO were all significantly inner-correlated.  Stepwise multiple regression analyses found that FO fully mediates the relationship between close attachment and caregiver preparedness, even after controlling for age, education, income, depression, and birth order. CONCLUSION: The primary finding is that FO mediates the relationship between close attachment style and caregiver preparedness among prospective caregivers. This suggests that individual differences in attachment style among prospective caregivers indirectly predict preparedness for future caregiving through FO, suggesting a mechanism relating attachment style and preparation for future care.