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.

Public Health Relevance

According to VA estimates, nearly 500,000 Veterans suffer from dementia. There is currently no cure for dementia. Ultimately, dementia will have a large impact on quality of life in Veterans and families, lead to expensive nursing home placement, and decrease life expectancy for patients and family caregivers. The experience of high burden in a caregiver for a Veteran with dementia increases the likelihood of permanent nursing home placement and can separate Veterans from their families. To address the high burden of caring for a Veteran with dementia, we propose to study the effect of a low-cost, rehabilitative intervention for family caregivers of Veterans with dementia. Our novel approach will use video technology that can reach caregivers in rural areas who do not have easy access to major VA medical centers. If this rehabilitative intervention proves successful, it may represent an approach to Veteran- and family-centered dementia care that can be used throughout VA with low staff, resource, and cost burdens.

National Institute of Health (NIH)
Veterans Affairs (VA)
Veterans Administration (IK2)
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Career Development Program - Panel II (RRD9)
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Veterans Admin Palo Alto Health Care Sys
Palo Alto
United States
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Nation, Daniel A; Edmonds, Emily C; Bangen, Katherine J et al. (2015) Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol 72:546-53