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Efficacy of Dyadic Life Review Therapy for Distressed Caregivers of Older Patients with Alzheimer's Disease and Related Dementias (ADRD) and Advanced Cancer

Award Number: K23AG086622
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 08/05/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2030

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Efficacy of Dyadic Life Review Therapy for Distressed Caregivers of Older Patients with Alzheimer's Disease and Related Dementias (ADRD) and Advanced Cancer - PROJECT SUMMARY Caregivers of older patients (age 65+) with both Alzheimer’s Disease (AD)/Alzheimer’s Disease and Related Dementias (ADRD) and cancer are at high risk for psychological distress. Older patients with comorbid AD/ADRD (including Mild Cognitive Impairment (MCI)) and advanced cancer and their caregivers often experience a cycle of mutually reinforcing distress. Psychosocial interventions like Life Review therapy have been shown to reduce distress in caregiver and older adults at end of life. In an NIH Stage IA intervention development study, we adapted individual Life Review therapy into a Dyadic Life Review (DLR) therapy for older patients with AD/ADRD and advanced cancer and their caregivers. Preliminary data suggest relationship quality and dyadic coping may be mechanisms by which DLR reduces caregiver distress. We propose a two- arm randomized controlled trial (N=60 dyads) to evaluate the efficacy of DLR, an 8-week, structured psychosocial intervention, in reducing caregiver psychological distress and improving relationship quality and dyadic coping. Caregivers will be age 50+ with elevated distress (≥4 on Distress Thermometer), and patients will be age 65+ with clinical impressions of AD/ADRD (including mild cognitive impairment) and stage III or IV cancer. Dyads will be randomized to either care-as-usual (CAU; supportive social work call and resource flyer) or DLR+CAU (eight weekly DLR sessions plus CAU). Primary outcomes include caregiver-reported psychological distress, and mechanisms of relationship quality and dyadic coping, measured at baseline and two-week follow-up. Caregivers will complete self-report measures, structured interviews to assess the patient’s functional and neuropsychiatric symptoms, and qualitative interviews to gather feedback on DLR or CAU. Patients will complete brief exploratory self-reports of psychological distress, relationship quality, and dyadic coping. The study aims are: (1) evaluate DLR’s efficacy in reducing caregiver distress; (2) examine whether DLR engages relationship quality and dyadic coping as mechanisms of change in caregivers; and (3, exploratory) identify patient characteristics (e.g., cognitive status, relationship type) associated with caregiver response to DLR. I will pursue the following training goals: (1) design and conduct dyadic RCTs; (2) understand psychosocial care in geriatric oncology; (3) gain experience in ADRD and cognition-informed psychosocial care; and (4) build skills in team science, leadership, and scientific communication. My mentorship team includes national and international experts in aging, geriatric oncology, behavioral intervention science, and ADRD. My mentor team consists of Drs. Kimberly Van Orden and Supriya Mohile (primary mentors), Drs. Anton Porsteinsson, Charles Kamen, and Allison Magnuson (co-mentors), and Drs. Miriam Weber and Michael Sohn (advisors), I will gain the expertise needed to become an independently R01- funded clinician-scientist developing dyadic, mechanistically driven psychosocial interventions for caregivers and older adults with AD/ADRD and advanced cancers.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $188,445 )
2026	2026	UNIVERSITY OF ROCHESTER	910 GENESEE ST	ROCHESTER	NY	14611	MONROE	USA	Aging Research	000	1	8/4/2026	NEW	$188,445
														Subtotal = $188,445

Grand Total All Awards = $188,445

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Efficacy of Dyadic Life Review Therapy for Distressed Caregivers of Older Patients with Alzheimer's Disease and Related Dementias (ADRD) and Advanced Cancer

Award Number: K23AG086622

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 08/05/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2030

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