Improving Care of Persons with Cognitive Impairment and their Caregivers

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DESCRIPTION (provided by applicant): The candidate is a PhD nursing research scientist focusing on behavioral interventions to improve the care of older adults with mild cognitive impairment. The candidate seeks to obtain additional training in neuropsychological assessment, mixed methods biostatistics, multi-component clinical interventions, and collaborative clinical research in order to become an independent nursing scientist. She has assembled a multi-disciplinary mentorship team to assist her in her training and research activities. Mild cognitive impairment (MCI) affects as many as 20% of older adults, nearly three times the number affected by dementia. Previous studies have shown that persons with MCI are at high risk for developing Alzheimer disease (AD). MCI is associated with loss of productivity and difficulty in engaging in meaningful activities even before the development of dementia. These losses are associated with both premature disability and depression. There is a need for interventions targeted at the stage of MCI because at this early stage of cognitive decline, patients and their caregivers may have a critical window to develop important self-management skills that will prevent premature disability and disengagement. In the proposed study, the candidate will lead the development of a pilot study of the "daily enhancement of meaningful activities" (DEMA) intervention. It is hypothesized that identification of daily meaningful activities and engaging in these activities can improve physical and emotional function as well as quality of life. It is also hypothesized that the DEMA intervention will reduce care giving burden. Specific aims of this pilot study are: (1) to design and field-test the DEMA intervention among MCI patient caregiver dyads to assess desirability, feasibility, and acceptability; and (2) to obtain preliminary data on participation rates, effect size, and outcome measures for the DEMA intervention to plan for a future randomized controlled clinical trial.