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2017 Grants - Kulshreshtha
Cognitive Behavioral Therapy for African Americans with MCI
Ambar Kulshreshtha, Ph.D.
2017 Alzheimer’s Association Clinical Scientist Fellowship to Promote Diversity (AACSF-D)
Can targeted cognitive-behavioral therapy lower Alzheimer’s disease risk in African Americans?
Mild cognitive impairment (MCI) is a condition that causes small but measurable declines in memory and thinking skills. It may also increase a person’s risk of Alzheimer’s disease. African Americans have a higher risk of developing both MCI and Alzheimer’s compared to Caucasians. Chronic stress in the African American community can exacerbate this risk by worsening unhealthy behaviors such as smoking and inactivity.
Cognitive behavioral therapy (CBT) is a collaborative psychological approach that helps people understand the relationship between their thoughts, feelings, and behaviors. Recent studies suggest CBT can be a benefit for people with dementia and anxiety. More research is needed to determine if CBT may also be an effective strategy to reduce stress and improve cognition in people at high risk of developing MCI and Alzheimer’s, such as African-Americans.
Ambar Kulshreshtha, Ph.D., and colleagues have planned a pilot study of CBT in African Americans with MCI. The primary goal of the study is determine if a six-month, culturally-sensitive CBT intervention is a feasible approach to reduce stress or improve cognition in African Americans. The researchers plan to enroll 60 participants in their study: 20 will receive group-based CBT, 20 will receive phone-based CBT, and 20 will receive usual care from their primary physicians. Each CBT session will last one hour, with a total of 12 sessions over the six month period.
Dr. Kulshreshtha’s team plans to measure adherence and retention of participants to the CBT interventions, and will follow all participants for three months after the study to assess longevity of treatment effects. The research team will use standardized behavioral assessments to measure changes in participants’ cognition or perceived stress during the intervention.
This study could help define a culturally appropriate, low-cost, method to reduce Alzheimer’s risk among African Americans. It may also provide a foundation for larger clinical trials testing more intensive CBT interventions in people at risk for MCI and Alzheimer’s disease. Cognitive improvements or decreases in stress could mean a lower risk of developing Alzheimer’s disease in this high-risk population.