Project Summary/Abstract The prevalence of aging adults with Down syndrome (DS) has increased dramatically in the past few decades as their life expectancy has more than doubled. Most adults with DS will develop pathology associated with Alzheimer’s Disease (AD) as early as age 31. By age 65 the cumulative incidence of dementia exceeds 90% and is the leading cause of death in adults with DS. AD in adults with DS is associated with reduced functional independence and associated increased burden on their caregivers. Increased physical activity is associated with improved physical function and performance of activities of daily living in typically developed adults with dementia, resulting in reduced burden for their caregivers. However, interventions designed to increase physical activity in adults with DS and reduce caregiver burden are currently unavailable. Reducing Disability in Alzheimer’s Disease (RDAD) is a 12-week intervention designed for typically developed adults and their caregivers delivered during home visits. RDAD includes increased physical activity for the adult with AD and training for caregivers in the management of dementia-related behavioral symptoms and has been shown to be effective in typically developed adults with dementia and their caregivers. Data from a small sample of adults with intellectual disabilities, including DS, suggest the potential efficacy of the RDAD approach for increasing physical activity and reducing behavioral symptoms in adults with intellectual disabilities and reducing burden in their caregivers. However, RDAD is not tailored to the unique needs of adults with DS and their caregivers and is delivered by interventionists during individual home visits which limits the potential for reach, adoption, implementation, and maintenance of the interventions. Our objective is to support the training of Dr. Amy Bodde through an NIH INCLUDE initiative KL2 Scholar slot. This training will include didactic and mentored experiential opportunities to develop her skills in: 1) clinical and translational research, including adapting evidence-based interventions, remote delivery of physical activity interventions, assessment of intervention usability, feasibility, safety, acceptability and efficacy, and dyadic analysis; 2) the physiologic and psychosocial aspects of the development, identification and care of dementia in adults with DS, and; 3) professional development required to become an independent clinical investigator. Completion of the proposed training and research plan to adapt and evaluate the feasibility of RDAD for Down syndrome (RDAD-DS) will provide Dr. Bodde with the knowledge and experience to move forward with her research career and will generate preliminary data to inform the development of a proposal to seek R01 funding to conduct an adequately powered randomized Stage II/III trial to evaluate the efficacy of the RDAD-DS intervention. If ultimately shown to be successful, the remotely delivered RDAD...