Project Abstract for Supplement: This project will adapt the BEhavioral Community-based COmbined Intervention for MEntal Health and Noncommunicable Diseases (BECOME) intervention to fit the unique needs of people with dementia or mild cognitive impairment and their caregivers to manage non-communicable diseases (NCDs), like diabetes and hypertension, and common mental disorders (CMDs), like depression and anxiety. The comorbidities among people with dementia or mild cognitive impairment with NCDs and CMDs negatively impact cognitive functioning, exacerbate neuropsychiatric symptoms, increase caregiver burden, and reduce overall quality of life. Although there is no definitive cure for Alzheimer's Disease and Related Dementias, managing co- occurring CMDs and NCDs can decelerate disease progression and alleviate caregiver stress. Medications side effects and concerns about polypharmacy to manage NCDs and CMDs make behavioral interventions attractive, especially for people with dementia or mild cognitive impairment. There is considerable evidence that supports the effectiveness of skills-based behavioral interventions in improving mental health benefiting both patients and caregivers. Despite the significance of these interventions, challenges persist. Interventions need to be adapted to accommodate the cognitive capacity of people with dementia or mild cognitive impairment, and incorporation of caregiver’s preferences, capacities, and needs. The parent project, BECOME, integrates three evidence-based behavioral skills, behavioral activation, evidence-based stress reduction and motivational interviewing targeting depression, anxiety and behavioral changes respectively. The interventions are delivered by community health workers (CHWs), who play a pivotal role in extending access to care for in low-and-middle-income-countries. This supplement aims to adapt BECOME into a dyadic intervention for both people with dementia or mild cognitive impairment and their caregivers, tailored to their unique needs. The adaptation will be guided by feedback from an advisory board consisting of people with dementia or mild cognitive disorder, caregivers, experts on dementia care, NCDs, and CMDs, and community leader working to bring awareness about dementia, Alzheimer’s disease and mild cognitive disorders in Nepal and advocate for needed services for the community. Using the ADAPT-ITT framework, we will adapt the intervention content and delivery into a dyadic approach to match the cognitive capacities of people with dementia or mild cognitive impairment and integrate caregiver preferences, capacities and needs. We will pilot the intervention with 5 dyads of people with dementia or mild cognitive impairment and their caregivers. Finally, using mixed methods, we will evaluate improvements in symptoms of NCDs and CMDs, and assess facilitator and barriers based on feedback from the dyads and the CHWs with goals to further refine the intervention to be tested under a f...