Research in dementia has changed dramatically over the last two decades. There have been tremendous advances in clinical characterization of dementia subtypes, in behavioral neuroscience, and in our understanding of the biochemical and genetic abnormalities leading to neurodegenerative diseases. With continued progress, linkages between these different disciplines will become increasingly stronger. Genetic studies already rely heavily on thorough and accurate clinical characterization. Animal models of neurodegenerative diseases are beginning to be used to evaluate potential treatments. At the same time, physiologic techniques, such as fMRI, are now being investigated as tools for diagnosis and staging in dementia. However, as our knowledge in each of these disciplines expands, investigators studying dementia from any of these perspectives will need to incorporate data from the other areas of study into the design and interpretation of their experiments. This will require a clinician-researcher entering the field of dementia research, regardless of their specific focus, to obtain a basic grounding in three (3) key areas: 1) knowledge about the specific clinical features associated with different dementia subtypes, 2) current approaches to characterizing the biochemical, molecular, and genetic alterations that lead to neural degeneration, and 3) state-of-the-art knowledge of cognitive and behavioral neuroscience. This proposal describes a fellowship training program for clinician-researchers interested in any of these areas of study. The program will admit two (2) fellows per year and provide support for three (3) years of training. The first year will provide comprehensive clinical exposure to patients with dementia, as well as other behavioral and cognitive problems and, through directed study, acquaint the fellows with research issues in the three (3) areas of focus described above. The next two (2) years will be devoted to mentored research, with a focus in clinical research in dementia, behavioral neuroscience, or molecular/genetic mechanisms leading to neural degeneration. Individualized coursework will supplement the practical training, as necessary. The goal is to produce clinician-researchers with a well-developed research focus who can understand the significance of findings in other disciplines and incorporate these findings into their own research.
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