Accessible Hearing Care for Reduction of Disruptive Behaviors and Caregiver Burden in Dementia

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ABSTRACT Dr. Carrie Nieman will be joining the faculty in the Department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins School of Medicine, where she will dedicate her clinical practice to hearing loss and otology. She seeks this Mentored Career Development Award to fill knowledge gaps in her training in the care and study of hearing loss and communication impairments among older adults with Alzheimer’s disease and related dementias (ADRD). Her long-term goal is to establish an independent research program devoted to community-delivered hearing care for persons with dementia. The candidate proposes a comprehensive training plan that incorporates didactic coursework, hands-on experiences, active participation in seminars and workshops, and dedicated meetings and tutorials overseen by a transdisciplinary mentor team. The training plan immerses Dr. Nieman in the rich interdisciplinary research and clinical environments of the Johns Hopkins Alzheimer’s Disease Research Center, the Memory and Alzheimer’s Treatment Center, the Johns Hopkins Center on Aging and Health, as well as Gallaudet University and the Center for Research and Education on Aging and Technology Enhancement. Specific training goals include: (1) receive training in cognitive aging and the neuropsychological and clinical assessment and management of older adults with ADRD, (2) complete training in mixed methods and apply skills to the proposed study, (3) integrate a human factors approach to hearing care, (4) incorporate coursework in trial design and analysis and advanced techniques in intervention research, and (5) continue training in responsible research conduct, with emphasis on vulnerable populations. The specific aims of the proposed research are to: (1) characterize hearing loss and hearing care in a diverse cohort of community-dwelling older adults with cognitive impairment to inform the development of a comprehensive communication intervention, (2) develop, via a community-engaged approach, a theory-driven, user-centered communication intervention that integrates low-cost, over-the-counter hearing technology, and (3) assess the feasibility, acceptability, and preliminary efficacy of a home-delivered communication intervention through a randomized controlled pilot study. Study recruitment, retention, and execution will be conducted in partnership with the Johns Hopkins Alzheimer’s Disease Research Center, the local chapter of the Alzheimer’s Association, and the Maryland Institute College of Art Center for Social Design. Completion of the proposed research will establish the potential for affordable, accessible hearing care as a low-risk, low-cost approach to reduction of disruptive behaviors and caregiver burden among persons with dementia and their caregivers. At the conclusion of this award, the candidate will have obtained the skills, knowledge, and preliminary data to successfully compete for independent funding and, ultimately, inform the development of new models of hearing care that expand access to the tools necessary for communication and engagement.