Cognitive impairment is common among individuals with Parkinson disease (PD) and is a significant source of disability and reduced quality of life. Existing interventions for PD do not address cognitive impairment, so it is currently considered a prime target for treatment optimization. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program that translates basic cognitive science into practical and effective cognitive interventions for PD The candidate's long term goal is to become an independent clinical investigator able to develop, evaluate and implement cognitive rehabilitation approaches that maximize functional outcomes for individuals with PD. To achieve this goal, training and mentorship are proposed in three key areas: (1) the design and conduct of intervention trials, (2) the neural and cognitive mechanisms relevant to cognitive rehabilitation for PD, and (3) the development of translational cognitive interventions. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. It examines whether a targeted intervention strategy derived from experimental cognitive research improves prospective memory (remembering to do things;e.g., remembering to take medications as prescribed) in PD. Specifically, this project will determine (1) if the strategy improves PD participants'prospective memory in a laboratory setting, and (2) the feasibility and potential efficacy of a novel intervention designed to help PD participants apply the strategy to improve their prospective memory in everyday life. The project will employ a randomized controlled design and a rigorous and systematic approach to new behavioral treatment development. Prospective memory is essential for productive and independent living and necessary for compliance with physician- and therapist-prescribed health behaviors. Importantly, prospective memory impairment is associated with reduced quality of life among individuals with PD. Therefore, strategies to effectively manage prospective memory impairment could improve function and quality of life and significantly impact clinical care for this population. Data and experience from this study will support the development of an R01 application to test the novel prospective memory intervention in a larger controlled efficacy trial. The training and research activities outlined in this proposal will complement the candidate's background in occupational therapy and PD-related cognitive research and place her in a unique position to advance our knowledge and ability to treat cognitive impairment in PD. Ultimately, this work will lead to comprehensive cognitive rehabilitation programs for PD which can be integrated with existing physically-focused rehabilitation programs to improve the lives of these individuals.

Public Health Relevance

Parkinson disease (PD) is the second most common neurodegenerative disease. Over 90% of individuals with PD experience some degree of cognitive impairment, which is a significant source of disability and reduced quality of life in ths population. Unfortunately, there are currently no successful interventions to address cognitive impairment in PD. This proposal will enable the candidate to develop cognitive rehabilitation approaches that maximize function and quality of life for individuals with PD.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Application #
Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Quatrano, Louis A
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Washington University
Other Health Professions
Schools of Medicine
Saint Louis
United States
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Goedeken, Susan; Potempa, Cathryne; Prager, Eliza M et al. (2018) Encoding strategy training and self-reported everyday prospective memory in people with Parkinson disease: a randomized-controlled trial. Clin Neuropsychol 32:1282-1302
Foster, Erin R; Spence, Daniel; Toglia, Joan (2018) Feasibility of a cognitive strategy training intervention for people with Parkinson's disease. Disabil Rehabil 40:1127-1134
Pappa, Katherine; Doty, Tasha; Taff, Steven D et al. (2017) Self-management program participation and social support in Parkinson's disease: Mixed methods evaluation. Phys Occup Ther Geriatr 35:81-98
Foster, Erin R; McDaniel, Mark A; Rendell, Peter G (2017) Improving Prospective Memory in Persons With Parkinson Disease: A Randomized Controlled Trial. Neurorehabil Neural Repair 31:451-461
Babulal, Ganesh M; Foster, Erin R; Wolf, Timothy J (2016) Facilitating Transfer of Skills and Strategies in Occupational Therapy Practice: Practical Application of Transfer Principles. Asian J Occup Ther 11:19-25
Hendred, Sarah K; Foster, Erin R (2016) Use of the World Health Organization Quality of Life Assessment Short Version in Mild to Moderate Parkinson Disease. Arch Phys Med Rehabil 97:2123-2129.e1
Lucero, Carolyn; Campbell, Meghan C; Flores, Hubert et al. (2015) Cognitive reserve and ?-amyloid pathology in Parkinson disease. Parkinsonism Relat Disord 21:899-904
Foster, Erin R; Bedekar, Mayuri; Tickle-Degnen, Linda (2014) Systematic review of the effectiveness of occupational therapy-related interventions for people with Parkinson's disease. Am J Occup Ther 68:39-49
Foster, Erin R (2014) Instrumental activities of daily living performance among people with Parkinson's disease without dementia. Am J Occup Ther 68:353-62
Foster, Erin R (2014) Themes from the special issue on neurodegenerative diseases: what have we learned, and where can we go from here? Am J Occup Ther 68:6-8

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