CBT for African Americans With Cognitive Impairment

Mild Cognitive Impairment (MCI) can involve problems with memory, language, thinking and
judgment that are greater than normal age-related changes and it maybe a precursor for
Alzheimer's disease. African Americans have a higher risk of developing MCI compared with
Whites. Unfortunately, prevention and management of MCI has been understudied among
African-Americans. Chronic stress (such as perceived discrimination, daily environmental
stress) in African Americans can affect cognition and also plays a role in worsening of
unhealthy behaviors such as smoking, improper diet and physical inactivity.
Cognitive-behavioral therapy (CBT) is a collaborative psychological approach that addresses
the interaction between people's thoughts, feelings and behavior. Existing evidence suggests
that CBT can be an effective strategy for dementia patients with co-morbid anxiety. However,
none of these studies have specifically evaluated African Americans with MCI. The aim of the
study is to test the feasibility and acceptability of a six-month CBT program (group based
and phone-based) compared with usual care, and to determine if the intervention can improve
cognitive performance and reduce chronic stress in a randomized trial including 60 African
American patients with MCI. The CBT program among African Americans with MCI will provide
preliminary evidence about the efficacy and the optimal intensity of the intervention needed
for patients at risk of Alzheimer's disease.

Inclusion Criteria:

- Age: 50 years or older

- Race: African American

- Fluency in English

- Mild Cognitive Impairment (MCI) - defined as subjective memory complaints with a
Montreal Cognitive Assessment (MoCA) 18- 26

Exclusion Criteria:

- Dementia diagnosis or reversible causes of dementia (e.g. if the patient has
hypothyroidism or low vitamin B12 that is contributing to the subject's cognitive
impairment)

- Active medical or psychiatric diseases that in the judgment of the investigator would
affect the safety of the subject or scientific integrity of the study (e.g. actively
manic patient)

- Uncontrolled medical conditions (such as congestive heart failure) reflected by poor
exercise tolerance and shortness of breath

- Any physical ailment (such as stroke with residual impairment) that is a barrier to
perform study procedures and attend sessions.

- Those who are unable to demonstrate that they understood the details of the study
(i.e. lack of decisional- capacity to consent) or linguistic limitations will be
excluded;

- Pregnant women

- Prisoners

- Adults unable to consent