This is a Mentored Patient-Oriented Career Development (K23) Award application. The candidate is a Junior Faculty Scholar in the Mental Health Intervention Research Center for Late-Life Mood Disorders at the University of Pittsburgh who proposes to develop skills necessary for geriatric mental health prevention research. Despite the health care policy issues that serve as the impetus for dementia caregiving research, psychosocial interventions evaluated to date have only been moderately effective at improving mental health outcomes in family caregivers. Given that the majority of dementia caregivers report high initial burden levels and spouses are typical caregivers, the field of dementia caregiver research may benefit from interventions designed to prevent the development of psychiatric morbidity among spousal caregiving samples that are just entering the caregiving role and not yet reporting high burden levels. Persons with a consensus diagnosis of mild cognitive impairment (MCI) have an estimated 12 percent annual probability of progressing to dementing disorders and preliminary data suggest that their spouses are beginning to adopt the caregiver role and its burdens as they cope with this condition. Because they are in the earliest stages of caregiving, the timing may be ideal for implementing selective preventive strategies with spouses of persons with MCI in order to protect the mental health and well-being of these caregivers as they cope with their spouses'current and future health care needs. To perform such research, I will undertake training in the theoretical and methodological underpinnings of interventional research utilizing Problem Solving Therapy (PST) with older adults, as well as the statistical and conceptual methods of epidemiology that are used to understand psychosocial risk and protective factors in the prevention of psychiatric morbidity. The proposed research consists of a longitudinal community-based psychoeducational intervention (based on PST) with spouses of persons with MCI.
