EXCEED THE SPACE PROVIDED. This proposal is a resubmission responding to PAR-03-056, topic #8 - Basic Research in Behavioral Medicine. Communication problems are one of the most difficult issues faced by people with AIzheimer's Disease (AD) and their caregivers. It contributes to increased stress, mortality, and decreased quality of life for both AD caregivers and care- receivers. Despite a large literature on caregiver burden and coping, little research has been done on how people with AD cope in general and in particular how they cope with communication problems. The literature suggests that as cognitive impairment progresses, the need for coping strategies by the person with AD increases. Current cognitive tests neither look for nor give credit to coping behaviors and thus may miss important signs of functional behavior. Thus we propose to examine these behaviors of persons with AD by developing a new instrument called the Communicative Coping Behavior Checklist (CCBC). The proposed checklist will measure the frequency and effectiveness of communicative coping behaviors as rated by 70 dyads comprised of normal or persons with AD and their caregivers. For this study, the caregivers or knowledgeable informants will observe and rate communicative coping behaviors for a two week interval, twice in two years. Using multivariate analysis, we will optimize the design and to validate the CCBC with other existing measures of quality of life, cognition and functional communication.
The aims of this project are: 1. To finalize the form and content of the CCBC with focus groups and an expert panel. 2. To describe the statistical properties of the current version of the CCBC. a. To develop scoring rules. b. To determine if there are clinically meaningful subscores from the individual items in the CCBC checklist. 3. To understand how the CCBC score(s) correlate(s) with other psychological, cognitive, and functional measures. 4. To understand how the CCBC score(s) change(s) based on dementia severity and progression of the disease over time. The long-term goal of this research program is to identify and highlight AD communicative coping behaviors and ultimately to improve communication and the quality of life of AD caregivers and care-receivers through awareness and rehabilitation. PERFORMANCE SITE ========================================Section End===========================================