Improving Person-Environment Fit of Community-Residing Older Adults with Dementia Through Assessment and Individualized Intervention

项目摘要 阿尔茨海默病和相关痴呆（ADRD）的衰老与行为和 精神症状（BPSD）在80%以上的患者中出现。BPSD通常会促使护理人员 负担，制度化护理，死亡率上升。尽管有迫切的需求，但目前很少有 管理BPSD的非药物干预措施和现有的非药物干预措施证据不足。研究：The 项目名为“通过以下措施改善社区老年痴呆症患者的个人与环境适应性” 评估和个性化干预，确定人与环境的关系作为一种机制， 采取行动，指导评估和干预残疾人在家庭环境中的功能行为 ADRD。通过改善ADRD患者与其家庭环境（人- 环境适应），假设ADRD患者的BPSD和活动参与度有所改善 在他们的家里。我们将采用行为干预发展的NIH阶段模型来定义 评估人与环境的适应性（第0阶段;目标1），并试行远程保健干预的可行性， 最大限度地提高农村社区ADRD成年人家中的人与环境的适应性 社区（目标2）。这项研究的结果将为发现非药理学， 对生活在家中的ADRD患者采用BPSD的环境方法。候选人：Elizabeth Rhodus博士 是一个早期的职业调查员，谁是从美国国立卫生研究院T32资助的博士后奖学金过渡到全职 在肯塔基州（英国）医学院的终身教职。三个培训目标将 增强她成为一个独立的，成功资助的研究者的轨迹：1）发展一个强大的 人与环境相互作用综合生理和行为评估知识基础 社区居住的ADRD患者，2）在制定和实施 对老年ADRD患者进行行为干预，3）扩大对研究策略的理解， 将代表性不足的人口纳入老龄化研究。导师/环境：当前职业 发展计划包括大量的指导，教学培训，并在英国中心的经验学习 与英国Sanders-Brown的主任Nancy Schoenberg博士（主要导师）合作进行健康公平转型 老龄化中心与副主任，博士唐娜威尔科克（共同导师），博士安东Porsteinsson（导师）， 著名的临床研究人员和精神病学家治疗BPSD，和一个著名的，跨学科的咨询 以马克思Rhodus博士将通过内部赠款、教师教育、 网络和奖学金Rhodus博士得到了英国的全力支持（见机构支持信）， 职业发展和研究活动。因此，K23应用程序的总体目标是推动 Rhodus博士的职业发展成为ADRD研究的独立科学家， 该项目旨在为BPSD管理的未来校外R 01提供信息，目标是非药物干预。

Project Summary Aging with Alzheimer's disease and related dementias (ADRD) is compounded by onset of behavioral and psychiatric symptoms (BPSD) seen in over 80% of those with the condition. BPSD often precipitate caregiver burden, institutionalized care, and increased rates of mortality. Despite the critical need, there currently are few non-pharmacological interventions to manage BPSD and those that exist have weak evidence. Research: The project titled, Improving Person-Environment Fit of Community-Residing Older Adults with Dementia Through Assessment and Individualized Intervention, identifies person-environment relationships as a mechanism of action to guide assessment of and intervention for functional behavior within the home context for persons with ADRD. By improving the relationship between persons with ADRD and their home environment (person- environment fit), it is hypothesized that people with ADRD will have improved BPSD and activity engagement within their home. We will employ the NIH Stage Model of Behavioral Intervention Development to define assessment of person-environment fit (Stage 0; Aim 1) and pilot the feasibility of a telehealth intervention to maximize person-environment fit within the homes of community-residing adults with ADRD within rural communities (Aim 2). Findings of this research will inform discovery of best practices for a non-pharmacological, environmental approach to BPSD for persons with ADRD living in their home. Candidate: Dr. Elizabeth Rhodus is an early-career investigator, who is transitioning from a NIH T32-funded postdoctoral fellowship to a full-time tenure-track faculty position at the University of Kentucky (UK) College of Medicine. Three training goals will enhance her trajectory toward becoming an independent, successfully funded investigator: 1) Develop a strong knowledge base on integrated physiological and behavioral assessment of person-environment interactions on community-dwelling people living with ADRD, 2) Build expertise in development and implementation of behavioral interventions among older adults with ADRD, and 3) Expand understanding of research strategies for inclusion of underrepresented populations in aging studies. Mentors/Environment: The current career development plan includes substantial mentorship, didactic training, and experiential learning at the UK Center for Health Equity Transformation with Director, Dr. Nancy Schoenberg (primary mentor), UK Sanders-Brown Center on Aging with Associate Director, Dr. Donna Wilcock (co-mentor), Dr. Anton Porsteinsson (mentor), a prominent clinical researcher and psychiatrist for treatment of BPSD, and a renowned, interdisciplinary advisory committee. Dr. Rhodus will receive support from her institution through internal grants, faculty education, networking, and scholarship. Dr. Rhodus has full support from UK (see institutional letter of support) to advance her career development and research activities. Thus, the overall objective of this K23 application is to propel the career development of Dr. Rhodus to an independent scientist in ADRD research using the findings of this project to inform a future extramural R01 targeting non-pharmacological interventions for BPSD management.