Virginia Wadley Bradley, PhD
Dr. Wadley Bradley is a licensed medical/clinical psychologist and Associate Professor of Medicine within the Division of Gerontology, Geriatrics, and Palliative Care. She is also Director of the Dementia Care Research Program of the Comprehensive Center for Healthy Aging

and Associate Director of the National Institute on Aging (NIA) funded Edward R. Roybal Center for Translational Research on Aging and Mobility at UAB.
Dr. Wadley Bradley completed her undergraduate degree at UAB in 1991 and was selected as a Harry S. Truman Scholar in 1989. She completed her PhD at UAB following an internship in Medical Psychology at Duke University Medical Center (DUMC) in 1997. She received postdoctoral training in Behavioral Medicine at DUMC in 1998. Her research programs examine the relationship of cognitive function to everyday function in the contexts of normal aging, vascular disease, stroke, and Alzheimer’s disease, as well as the development of interventions to prevent and treat loss of function.

Dr. Wadley Bradley is PI of a newly-funded R01 award of nearly $2.3 million from the National Institute on Aging. During this 5-year clinical trial, her team will evaluate a computer-based processing speed training program for persons diagnosed with MCI. She also serves as an investigator overseeing cognitive and functional assessments within multiple national NIH-funded epidemiological, clinical, and experimental research protocols. Among these, she leads the Cognitive Working Group for the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, is vice chair of the MIND sub-study of the Systolic Pressure Intervention Trial (SPRINT), and co-chairs the cognitive assessment component of the Carotid Restenting versus Endarterectomy Trial (CREST-2).

Summary: Processing Speed Training to Preserve Driving and Functional Competencies in MCI

Many individuals with Mild Cognitive Impairment (MCI) experience subtle decrements in everyday function that can signal encroaching dementia. Declines in cognitive processing speed and related declines in everyday functions including driving skills and safety are sequelae of the most common brain pathologies associated with aging and MCI: Alzheimer’s disease (AD) and, commonly, comorbid cerebrovascular disease (CVD). Processing speed declines are modifiable with a specific Processing Speed Training (PST) training protocol even in individuals with memory loss consistent with MCI due to AD.

If these declines can be arrested in individuals with MCI due to AD, speed-dependent functional abilities including driving may be preserved, with positive ramifications for safety, autonomy, and quality of life, even among those who may progress to dementia. The overall aim of the proposed research is to test an enriched version of this cognitive intervention with the goal of preserving functional abilities in a clinical MCI population with quantified genetic and neuroimaging AD and comorbid CVD biomarkers.

We are conducting a single-blind randomized clinical trial of a validated computer-based PST intervention followed by two years of a novel home training protocol among individuals with clinically determined and consensus-diagnosed MCI due to AD. A control group drawn from the same pool of MCI patients undergoes Internet Navigation Training (INT), a substantiated comparison condition. Aim 1 is to examine immediate and longitudinal effects of PST on targeted cognitive and functional tasks among individuals with consensus-diagnosed MCI due to AD with or without comorbid CVD; Aim 2 will examine the magnitude and retention of cognitive and functional training gains by the unique and joint contributions of baseline genetic and MRI-acquired biomarkers of AD and CVD, and by the severity of baseline cognitive impairment.

Training responses, including on-road driving evaluations, will be assessed following 10 1-hour sessions of lab-based training and at two annual follow-ups during the home training phase. Biomarker data will used to explore questions regarding which patients can benefit from training, how much, in what domains, and for how long, enabling future research to target patients who can benefit appreciably from this training approach.

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