Research Program on Cognition and Neuromodulation Based Interventions (RP-CNBI)

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Abstract Project description: The NIA’s Alzheimer’s disease and related dementia (ADRD) Milestone 8 focuses on the development and translation of non-pharmacologic interventions and is particularly timely given four facts. First, existing pharmacologic agents have shown limited success. Second, the number of older adults with ADRD is rapidly increasing. Third, mounting evidence indicates that non-pharmacologic interventions can enhance cognition and everyday functioning, potentially delaying clinical decline. Fourth, no Milestone 8 goals have been accomplished to date. Thus, the primary goals of the proposed Research Program on Cognition and Neuromodulation Based Interventions (RP-CNBI) are to create a sustainable and robust infrastructure (Goal 1), provide thorough training to the next generation of ADRD researchers (Goal 2), and develop consensus statements and centralized analytic platforms (Goal 3). Infrastructure will include access to well characterized older adults with ADRD, a neuroimaging platform that facilitates treatment planning and outcome evaluation, cutting-edge equipment, a tele-video-health platform, treatment and outcome measure repositories, dedicated staff to support studies, and pilot funding. Training provides a mixture of didactic and experiential- based learning, including mentorship from an international panel of experts in cognition-oriented treatments (COTs) and neuromodulation, and both salary support and travel funds for junior faculty and post-doctoral fellows. We will hold two consensus meetings that establish practice standards and identify knowledge gaps in years 2 (focused on COTs) and 5 (focused on neuromodulation), which directly address Milestone 8A. To provide empirical support for these meetings, we will refine a beta-version of a centralized repository of COT trials, known as CogTale, and develop a neuromodulation-based analogue that will be known as NeuroTale. These repositories contain key methodological and outcome details of relevant clinical trials and automatically calculate quality indices and effect sizes used to perform automated meta-analyses on selected data. The RP- CNBI is extremely well positioned for success given the outstanding research environment at the University of Michigan, including the NIA P30 funded Michigan Alzheimer’s Disease Research Center, and VA Ann Arbor Healthcare System. The PI’s role as vice-chair (ascending to chair in 2021) of the Alzheimer’s Association Non-pharmacologic Intervention Professional Interest Area (NPI-PIA) expands the Program’s reach by making collaborative and mentoring opportunities available to a wide range of professionals interested in ADRD, especially those from underserved populations and developing nations. Although physically located at the University of Michigan, the RP-CNBI leverages the post COVID-19 integration of virtual (tele-/video-/internet- based) to create a collaborative, widely-accessible program that is agnostic to geography. The combination of these resources will enhance methodologic rigor, training, and access to resources necessary for high-quality non-pharmacologic intervention research, collectively enhancing Milestones 8A-E.