PROJECT SUMMARY/ABSTRACT Decision-making by and on behalf of people with dementia poses especially complex clinical, ethical and policy problems. Addressing these complexities will require combined expertise at many different levels, e.g.: neurobiological (brain function and degeneration), psychosocial (effects on family/caregiving relationships), sociological (stigma), legal (elder abuse), and conceptual (changes in values over time). This K24 grant proposal will support the mentoring activities of Winston Chiong, MD PhD, a behavioral neurologist and Director of Bioethics at the University of California, San Francisco whose clinical and research practice addresses Alzheimer’s disease and related dementias. Drawing on his advanced training in clinical neurology, philosophy/bioethics and cognitive neuroscience, Dr. Chiong mentors junior scholars in an interdisciplinary research program encompassing both (1) decision neuroscience in aging and disorders of aging, and (2) the ethical, policy and health equity implications of alterations to brain function. The primary goal of this proposal is to expand Dr. Chiong’s mentoring in patient-oriented research, with a focus on training scholars with diverse expertise to make novel contributions to the challenges associated with decision-making in Alzheimer’s disease and other disorders of aging. In his plans for career development and mentoring, Dr. Chiong will (1) increase his engagement with mentees and national leaders in geriatrics and palliative care, (2) build knowledge in geriatrics and caregiver research, (3) enhance his ability to mentor trainees from underrepresented backgrounds, and (4) grow as a national leader in aging and dementia research. The research specifically supported by this award will build upon new work in the cognitive science of making decisions for others, applying this to the difficult clinical and ethical challenges associated with caregivers’ decisions on behalf of people with dementia. This will provide opportunities for trainees with expertise in neurology, cognitive science, dementia, geriatrics, palliative care bioethics and other fields. The project is supported by collaborations with accomplished scholars who have complementary expertise: Alex Smith, MD MS MPH, a national leader in geriatrics and palliative care who directs the UCSF T32 fellowship in aging research; Robert Levenson, PhD, a psychologist who has extensively studied dementia caregivers and changes in caregiving relationships; Howard Rosen, MD, a behavioral neurologist who has previously mentored Dr. Chiong and will guide Dr. Chiong’s own career development; and Nicole Rosendale, MD, a national leader in addressing neurologic health disparities and in advancing the training of junior scholars from marginalized groups. Their expertise will contribute to the research specifically funded by this award, and also to the learning opportunities available to Dr. Chiong’s trainees.