Internet-based insomnia intervention to prevent cognitive decline in older adults with mild cognitive impairment

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Dr. Meghan Mattos is a nurse scientist with training in gerontological nursing, dementia care and management, sleep disorders, and digital health combined with clinical expertise in the care of patients with neurological disorders. Her current research, research funding, and history of dissemination demonstrate her ability to execute innovative, impactful research in older adults with cognitive impairment, specifically to improve quality of life and disease trajectory. Dr. Mattos’s short-term career goals are to become an independent nurse researcher focused on the use of digital health in older adults and grow as a leader through additional formal leadership training. Her broad, long-term career goal is to implement effective, accessible interventions via the Internet for older adults to maintain cognitive health and well-being. The training and mentorship afforded by the NIA Beeson Career Development Award in Aging will allow her to gain expertise and receive mentorship in the conduct of rigorous Alzheimer’s disease trials using digital therapeutics and Internet-based recruitment methods. This project will be conducted under the outstanding and complimentary mentorship of an international leader in digital health and Internet-based recruitment (Dr. Lee Ritterband), leader in the assessment of health outcomes in aging and chronic disease (Dr. Steven Albert), and nurse innovator and leader in cognitive impairment (Dr. Jennifer Lingler). The University of Virginia is committed to Dr. Mattos’s development as a nurse scientist working in team science and provides the necessary facilities and resources to conduct the proposed research project. Building upon Dr. Mattos and her team’s preliminary work, the proposed randomized controlled trial will evaluate the impact of an Internet-delivered cognitive behavioral therapy for insomnia (CBT-I) intervention on sleep and the extent to which it contributes to cognitive health in individuals with mild cognitive impairment. Participants with insomnia who meet the study criteria for mild cognitive impairment will be recruited to determine the effects of the CBT-I intervention compared to a patient education control condition on sleep and cognition. Internet-based recruitment methods will be used, and outcomes include sleep variables (reduced overall insomnia severity and wake after sleep onset), daytime variables (reduced levels of fatigue, improved quality of life, and improved mood), and cognitive status (memory, attention/psychomotor speed, and executive functioning domains). This proposal will inform a future randomized controlled trial powered to detect the intervention effect on the slope of cognitive decline as well as provide Dr. Mattos training in 1) the conduct of rigorous and reproducible trials and 2) leading recruitment efforts using Internet-based settings and conducting digital health trials in older adults. The Beeson Career Development Award in Aging will allow Dr. Mattos to engage in formal opportunities for leadership at the national and international levels to advance gerontological nursing and establish her independent career in digital health for older adults with cognitive impairment.