Promoting Independence with Compensatory Cognitive Rehabilitation: A Pilot Clinical Trial for Early-Stage Alzheimer's Disease

摘要 候选人：Alyssa Lanzi博士是一位学术语言病理学家和研究助理 特拉华州大学教授。在这个K23应用程序中，Lanzi博士将在她的培训和研究基础上 研究保持轻度认知障碍成人独立性的认知康复方法 (MCI)和阿尔茨海默病（AD）的早期痴呆。该奖项的目的是获得新的 独立进行这些干预措施的临床试验所需的知识、技能和经验，以及 作为未来的传播和实施。她的长期目标是建立一个富有成效的研究计划 开发、评估和传播AD和MCI成人认知康复干预措施。 职业发展简介：Lanzi博士建议：1）学习如何设计和进行随机 对患有MCI和AD痴呆的成年人进行行为干预的对照试验; 2）接受 对这一人群的认知、心理和独立生活技能进行多学科评估; 3） 获得与传播和实施行为干预相关的知识和技能， 康复医生培训计划包括丰富的体验式学习活动，如多学科 在不同的社区环境中开展基于团队的认知评估活动。环境：Lanzi博士将培训 由NIH资助的多学科导师团队，他们在临床试验研究、MCI和痴呆症方面具有专业知识 从AD，和传播/实施研究。Verdolini Abbott博士（U特拉华州），共同主要导师，是 他是一位资深的学术语言病理学家，在行为语言的临床试验方面拥有丰富的专业知识。 干预措施。科恩博士（U特拉华州），联合主要导师，是一位以康复为导向的神经心理学家，拥有 多学科认知评估研究记录。Rodakowski博士（U匹兹堡），共同导师，是一个 学术职业治疗师，具有认知策略培训和独立生活技能方面的专业知识， 成人MCI史密斯博士（U佛罗里达），共同导师，是一位资深神经心理学家和著名的MCI专家， AD和行为干预方法。研究：MCI和痴呆症的大多数治疗方法 专注于恢复认知缺陷。不幸的是，这些都是次优保存或 提高独立生活技能。拟议研究的目的1是进行一项试点试验，以评估 结构化外部记忆辅助治疗的有效性，一种用于MCI成人的补偿方法 通过教授使用策略来弥补认知缺陷， (e.g.,笔记系统）。目的2是评估人口统计学、临床和神经心理学预测因子， 治疗依从性。目标3是完善治疗程序和材料，将用于培训未来 干涉主义者这些培训和研究目标的完成对Lanzi博士的职业生涯至关重要 在研究补偿认知的功效和有效性方面的发展和持续成功 干预措施，提高独立性和生活质量的成年人与AD。

ABSTRACT CANDIDATE: Alyssa Lanzi, Ph.D. is an academic speech-language pathologist and Research Assistant Professor at the University of Delaware. In this K23 application, Dr. Lanzi will build on her training and research studying cognitive rehabilitation approaches that preserve independence in adults with mild cognitive impairment (MCI) and early-stage dementia from Alzheimer’s disease (AD). The objective of this award is to acquire new knowledge, skills, and experiences needed to independently conduct clinical trials of these interventions, as well as future dissemination and implementation. Her long-term goal is to establish a productive research program that develops, evaluates, and disseminates cognitive rehabilitation interventions for adults with AD and MCI. CAREER DEVELOPMENT PLAN: Dr. Lanzi proposes to: 1) learn how to design and conduct randomized controlled trials of behavioral interventions for adults with MCI and dementia from AD; 2) receive training in the multidisciplinary assessment of the cognitive, psychological, and independent living skills of this population; 3) acquire knowledge and skills related to dissemination and implementation of behavioral interventions for rehabilitation clinicians. The training plan includes rich experiential learning activities such as multidisciplinary team-based cognitive assessment activities in diverse community settings. ENVIRONMENT: Dr. Lanzi will train with a multidisciplinary team of NIH-funded mentors with expertise in clinical trials research, MCI and dementia from AD, and dissemination/implementation research. Dr. Verdolini Abbott (U Delaware), co-primary mentor, is a senior academic speech-language pathologist and has extensive expertise in clinical trials of behavioral interventions. Dr. Cohen (U Delaware), co-primary mentor, is a rehabilitation-oriented neuropsychologist with a record of multi-disciplinary cognitive assessment research. Dr. Rodakowski (U Pittsburgh), co-mentor, is an academic occupational therapist with expertise in cognitive strategy training and independent living skills for adults with MCI. Dr. Smith (U Florida), co-mentor, is a senior neuropsychologist and renowned expert in MCI, AD, and behavioral intervention approaches. RESEARCH: Most treatment approaches for MCI and dementia from AD have focused on restoring cognitive weaknesses. Unfortunately, these are suboptimal for preserving or improving independent living skills. Aim 1 of the proposed research is to conduct a pilot trial to evaluate the efficacy of the Structured External Memory Aid Treatment, a compensation-based approach for adults with MCI that promotes independent living skills by teaching the use of strategies to compensate for cognitive weaknesses (e.g., note-taking systems). Aim 2 is to evaluate the demographic, clinical, and neuropsychological predictors of treatment adherence. Aim 3 is to refine treatment procedures and materials that will be used to train future interventionists. The completion of these training and research aims are critical for Dr. Lanzi’s career development and continued success in investigating the efficacy and effectiveness of compensatory cognitive interventions that enhance the independence and quality of life of adults with AD.