RR&D Research Career Scientist Award Application

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Dr. Twamley bridges neuropsychology and rehabilitation research by developing Compensatory Cognitive Training (CCT/CogSMART) interventions and conducting randomized controlled trials to test their efficacy in improving cognition, everyday functioning, and quality of life. These outcomes are important to Veterans, their loved ones, clinicians, VHA, and society, as cognition and functional abilities are directly related to disability and community integration. Indeed, cognitive health is considered a “third pillar” of health, alongside physical health and mental health, and is considered vital in the VA’s Whole Health approach to healthcare. Dr. Twamley’s currently funded studies are all focused on Veterans with cognitive impairment (e.g., due to traumatic brain injury, mild cognitive impairment, Parkinson’s disease, hoarding disorder, or other mental health conditions). She is currently PI or Co-PI of studies funded by VA RRD, VA CSRD, Department of Defense, and the National Science Foundation, and serves as a Co-Investigator on studies funded by VA RRD, VA CSRD, and DoD. Her research uses intervention manuals she and her colleagues developed to target impairments in prospective memory, attention, learning and memory, and executive functioning, which have shown efficacy in multiple domains of cognition and functioning in multiple neuropsychiatric populations. Many of the compensatory strategies taught are simple habits used by many successful people (e.g., using a calendar system for all scheduling and checking it regularly; using organizational approaches to learning and remembering; planning to meet goals and deadlines by listing goal steps and assigning them due dates). Her current RRD Merit Award focuses on CCT for homeless Veterans with mental health conditions receiving residential mental health rehabilitation and treatment; her current CSRD Merit Award trial is examining Motivationally-Enhanced CCT for older Veterans with mild cognitive impairment, and combines compensatory cognitive strategies with lifestyle strategies (e.g., physical activity, nutrition, and sleep-related behaviors to reduce dementia risk). Her newer work seeks to find new ways of implementing cognitive rehabilitation interventions (e.g., in combination with pharmaceuticals targeting brain inflammation; in combination with other psychosocial rehabilitation interventions; compensatory cognitive training in combination with computerized cognitive training; delivery via mobile app or telemedicine; briefer, more personalized interventions; delivery via cognitively assistive robots). Other research interests include cognitive impairment and disability in homeless Veterans, supported employment to assist those with cognitive impairments in returning to work, cognitive impairment in PTSD, and the use of technology to improve cognition and mental health. Dr. Twamley has a rich network of collaborators locally, nationally, and internationally, and she collaborates with researchers and clinicians worldwide to develop, adapt, translate, and disseminate cognitive health interventions. Additionally, she commits considerable time and effort toward mentorship of the next generation of VA clinical rehabilitation scientists dedicated to improving cognitive health in Veterans. Her service activities include scientific peer review for the VA and other agencies, administrative service to multiple professional organizations, and local service on the VA Research and Development Committee. Dr. Twamley combines extensive research experience and a high level of scientific productivity with dedication to effective mentorship and support to the clinical, research, and training missions of the VA, with the ultimate goal of improving health and quality of life for our nation’s Veterans.