Caregiving
Project Title: “Demonstrating the Efficacy of Unidos en el Cuidado: A Spanish-Language Program for Latino Caregivers of Persons Living with Dementia"
Principal Investigator: Maria Aranda, PhD, MSW, MPA, LCSW
Institution: University of Southern California
Funding Amount: $2,000,000.00
Type: Individual
Project Summary: This project focuses on Spanish-speaking Latino family caregivers of individuals living with dementia, a group facing significant health disparities, including higher Alzheimer's disease rates, delayed diagnosis, and limited access to quality care and interventions. The study will evaluate the effectiveness of Unidos en el Cuidado®, a culturally tailored, three-session group intervention for 226 caregivers in California. Using a waitlist trial design with four observation points, the project aims to measure outcomes like depression, behavioral reactivity, anxiety, caregiver mastery, and coping resources, and to identify whether the intervention's efficacy differs across subgroups based on demographic and patient functioning factors. Additionally, qualitative focus groups will assess participants' satisfaction, experiences, and recommendations for the program. The research leverages the expertise of its scientific team and community partners to address linguistic and cultural needs of diverse Californians.
Publications:
Project Title: “C-CARERS or 'Centering Caregivers in Alzheimer's Research on Equity, Representation, Services and Supports'"
Principal Investigator: Jarmin Yeh, PhD
Institution: University of California, San Francisco
Funding Amount: $2,000,000.00
Type: Individual
Project Summary: The C-CARERS project aims to understand the experiences of dementia caregivers in rural and underrepresented communities in Northern California by surveying 500 caregivers in English, Spanish, Chinese, and Korean, conducting in-depth interviews with 100, and ethnographic fieldwork with 20 using photovoice and docent methods. The study seeks to broaden research on diversity and inclusion in dementia caregiving, centering caregivers' voices to inform future interventions, raise public awareness, and support equitable services aligned with California's Master Plan for Aging and the Governor's Task Force on Alzheimer's Disease Prevention and Preparedness.
Early Diagnosis and Detection
Project Title: “Evaluating and Reducing Disparities from Early Dementia Detection and Genetic Testing in Underrepresented Populations"
Principal Investigator: Timothy Chang, MD, PhD
Institution: University of California, Los Angeles
Funding Amount: $2,000,000.00
Type: Individual
Project Summary: This project addresses the challenges of equitable access to new anti-amyloid therapies for Alzheimer's disease, especially among underrepresented populations with higher prevalence rates. It aims to assess how inclusion criteria for these therapies may differ across racial and ethnic groups and create educational tools for patients and providers. Key objectives include: (1) developing machine learning models using electronic health records to identify early Alzheimer's in several demographic groups; (2) studying the impact of family history and APOE genetics on amyloid PET brain scan results; and (3) evaluating and educating patients, caregivers, and providers about risk factors and therapies related to family history and APOE.
Project Title: “Evaluation of a new cognitive screening approach in primary care among underserved populations"
Principal Investigator: Anna Chodos, MD, MPH
Institutions: University of California, San Francisco
Funding Amount: $4,747,847.00
Type: Consortium
Project Summary: The Dementia Care Aware program was launched by California's Department of Health Care Services in March 2022, following Senate Bill 48, to provide annual dementia screening for adults 65 and older with Medi-Cal coverage. UCSF was contracted to develop an equity-focused cognitive screening approach and related training for primary care teams, aiming to address the diverse needs of older Californians. UCSF developed the Cognitive Health Assessment (CHA), a tool and training program emphasizing both cognitive and functional assessment, care partner involvement, and immediate brain health planning. The program includes comprehensive training resources such as online courses, webinars, and in-person sessions. CHA is currently implemented in several clinics in San Francisco and Los Angeles, with plans to expand to more clinics, evaluate outcomes, and investigate disparities in dementia care. The consortium will monitor training, analyze patient demographics, and use the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) to assess program effectiveness and address equity issues.
Publications:
Project Title: “The California Brain Health Registry (CAL-BHR): Advancing Alzheimer's Disease Research in Diverse Communities"
Principal Investigator: Rachel Nosheny, PhD
Institutions: University of California, San Francisco
Funding Amount: $4,799,155.00
Type: Consortium
Project Summary: The California Brain Health Registry (CAL-BHR) study aims to increase participation and engagement of minoritized older adults in Alzheimer's disease (AD) and dementia research within California. CAL-BHR leverages community-engaged and digital approaches to recruit a diverse cohort, improve research validity, and develop scalable methods to identify those at risk for AD. The main objectives include creating culturally informed recruitment strategies, validating new remote digital assessments for cognitive impairment, studying how social and cultural determinants affect cognitive health, and testing the feasibility of at-home blood spot testing for AD biomarkers. The ultimate goal is to strengthen AD research and reduce health inequities for minoritized older adults.
Long-Term Services and Support Systems/Health Services
Project Title: “Understanding the Health and Long-Term Supports and Services Needs of Refugees and Immigrants with Dementia and their Caregivers in California"
Principal Investigator: Alissa Sideman, PhD, MPH, MA
Institutions: University of California, San Francisco
Funding Amount: $4,609,655.00
Type: Consortium
Project Summary: This project focuses on the increasing population of migrants in California—including immigrants, refugees, and asylum seekers—and their heightened risk for dementia and related challenges. Migrants often face greater health disparities and barriers to care. The study aims to address gaps in understanding the experiences, needs, and access to long-term health services and support systems for migrants with dementia and their caregivers, and to evaluate whether current service providers offer dementia-specific and culturally tailored support.
Prevention
Project Title: “The epidemiology, risk prediction, and health care utilization for Alzheimer's disease and related dementias among California American Indian and Alaska Native Medicare Beneficiaries"
Principal Investigator: Luohua Jiang, MD, PhD
Institution: University of California, Irvine
Funding Amount: $1,839,727.77
Type: Individual
Project Summary: This project aims to: (1) examine differences in modifiable risk factors for Alzheimer's disease and related dementias (ADRD) between California American Indian/Alaska Native (AI/AN) and White Medicare beneficiaries and identify key risk factors for AI/ANs; (2) develop an ADRD risk prediction model for California AI/AN Medicare beneficiaries using both traditional statistics and machine learning; (3) create an econometric model to estimate changes in health expenditures resulting from automated risk assessment tools. The findings will help pinpoint intervention targets, improve prevention and screening practices, and clarify the economic impacts of using automated risk assessment tools in AI/AN health care systems.
Publications:
For questions, please contact AlzheimersD@cdph.ca.gov.