Dementia Caregiver Rehabilitation: Enhancing Veteran and Family-Centered Care

说明： 这是为退伍军人事务部帕洛阿尔托医疗保健系统塞拉利昂-太平洋精神疾病研究、教育和临床中心(MIRECC)的老年/痴呆症研究员Blake Scanlon博士申请CDA-2奖。斯坎伦博士正在确立自己作为临床医生兼科学家的地位，他在痴呆症和神经退行性疾病方面开展以老兵和家庭为中心的临床研究。这项CDA-2奖项将为Scanlon博士提供必要的支持和指导，以实现以下目标：1)发展Scanlon博士在康复干预方面的技能；2)加强他在临床试验和翻译科学方面的培训；3)通过更先进的方法学培训，增强他在纵向数据分析方面的基本技能；4)扩展他的专业知识，通过视频远程保健等先进技术提供教育和技能建设；以及5)为Scanlon博士提供必要的培训机会和指导，使他成为退伍军人管理局的独立临床研究员。为了实现这些目标，斯坎伦博士组建了一支导师团队，其中包括一名主要导师：杰罗姆·耶萨维奇博士(老年精神病学家，一生中著名的认知和精神功能专家)；两名共同导师：喜悦·泰勒博士(认知心理学家，认知衰退轨迹专家)和丽莎·木下丽莎博士(痴呆症认知和行为症状的评估和治疗专家)；和三位顾问：[Mary Mittelman博士(国际著名的痴呆症护理人员干预专家)]]，Booil Jo博士(具有临床试验设计/分析、纵向数据分析和缺失数据分析专长的生物统计学家)，以及Betty Wexler女士(具有痴呆症和家庭护理专长的临床护士专家)。拟议的项目研究教育和技能培养康复干预的效果，旨在低成本和 通过视频远程保健，对患有痴呆症的退伍军人的家庭照顾者进行临床翻译。干预效果将在干预后6个月、12个月和24个月进行纵向检查。斯坎伦博士将使用先进的统计技术来确定干预措施对以下方面的影响：痴呆症退伍军人照顾者的生活质量(主要目标1)、照顾者的抑郁症状(次要目标2)以及社区任期、长期护理安置时间和存活率(次要目标3)。这项拟议的研究将利用MIRECC的基础设施来调查这种照顾者干预的创新方法。这一奖项将创造一个理想的环境，使斯坎伦博士能够将他的时间完全集中在以退伍军人和家庭为中心的临床研究上，并使他能够追求自己的长期职业目标：开发一个完全独立的研究计划，研究低成本、实用和临床可翻译的方法，以改进神经退行性疾病和痴呆症的康复和管理。

DESCRIPTION: This is an application for a CDA-2 award for Dr. Blake Scanlon, an aging/dementia fellow in the Sierra- Pacific Mental Illness Research, Education, and Clinical Center (MIRECC) at the VA Palo Alto Health Care System. Dr. Scanlon is establishing himself as a clinician-scientist who conducts Veteran- and family- centered clinical research on dementia and neurodegenerative disease. This CDA-2 award will provide Dr. Scanlon with the support and mentorship necessary to achieve the following goals: 1) develop Dr. Scanlon's skills in rehabilitative intervention; 2) enhance his training in clinical trials and translational science; 3) augment his basic skills in longitudinal data analysis with more advanced methodological training; 4) expand his expertise to include the provision of education and skill-building through advancing technologies including video telehealth; and 5) provide Dr. Scanlon the necessary training opportunities and mentorship to develop as an independent clinical investigator in VA. To accomplish these goals, Dr. Scanlon has gathered a mentoring team that includes one primary mentor: Dr. Jerome Yesavage (a geriatric psychiatrist and renowned expert in cognitive and psychiatric functioning across the lifespan); two co-mentors: Dr. Joy Taylor (a cognitive psychologist and expert in the trajectory of cognitive decline) and Dr. Lisa Kinoshita (a clinical neuropsychologist with expertis in the assessment and treatment of cognitive and behavioral symptoms in dementia); and three consultants: [[Dr. Mary Mittelman (an internationally renowned expert in dementia caregiver intervention)]], Dr. Booil Jo (a biostatistician with expertise in design/analysis of clinical trias, longitudinal data analysis, and missing data analysis), and Ms. Betty Wexler (a clinical nurse specialist with expertise in dementia and family caregiving). The proposed project studies the effects of an education and skill-building rehabilitation intervention, designed to be low-cost and clinically translatable through video telehealth, on family caregivers of Veterans with dementia. Intervention effects will be examined longitudinally at six, 12, and 24 months post-intervention. Dr. Scanlon will use advanced statistical techniques to determine the impact of the intervention on: quality of life in caregivers of Veterans with dementia (Primary Aim 1), depressive symptoms in caregivers (Secondary Aim 2), and community tenure, time to long-term care placement, and survival (Secondary Aim 3). The proposed study will utilize the infrastructure of the MIRECC to investigate this innovative method of caregiver intervention. This award would create an ideal environment where Dr. Scanlon could wholly focus his time on Veteran- and family-centered clinical research and would enable him to pursue his long-term career objective: developing a fully independent research program investigating low-cost, pragmatic and clinically translatable methods for improving rehabilitation and management of neurodegenerative disease and dementia.