My aim in applying for this Midcareer Investigator Award in Patient-Oriented Research (K24) award is twofold;(1) to enhance my understanding of mild cognitive impairment, and the functional disabilities associated with these dementias so that I can improve psychotherapies for depression in patients with amnestic mild cognitive impairment (aMCI) and patient with cognitive impairment, no dementia (CIND), and (2) to further enhance my skills as a mentor to junior faculty pursing psychotherapy research in older populations. My research to date has focused on the adaptation and effectiveness of psychotherapy for depression in low-income older adults, and older adults with medical disabilities. The findings from my research thus far suggests that learning based therapies, particularly problem solving therapy (PST) is effective in reducing depression symptoms and increasing functioning in low-income older adults. Approximately 33% of older adults in general suffer from CIND, and about 10% from aMCI. I have begun to conduct research on psychotherapy for treating depression in a subpopulation of CIND patients, those with executive dysfunction, and again am finding positive results for PST. I would like to now turn my attention to older, low-income patients with other presentations of CIND and aMCI to improve psychotherapy interventions. However, I will need to dedicate more time to better understanding behavioral neurology and cognitive rehabilitation strategies in order to make truly informed modifications to psychotherapy. In addition, I would like to enhance my skills as a mentor to junior faculty who wish to pursue careers in late-life psychotherapy. The training in behavioral neurology and in state-of-the-art teaching strategies will serve to enhance my ability as a mentor to the next generation of geriatric psychotherapy researchers.
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