# Dementia caregiving and the cognitive science of surrogate decisions

> **NIH NIH K24** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $191,196

## Abstract

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.

## Key facts

- **NIH application ID:** 10983707
- **Project number:** 1K24AG083117-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Winston Chiong
- **Activity code:** K24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $191,196
- **Award type:** 1
- **Project period:** 2024-08-15 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10983707

## Citation

> US National Institutes of Health, RePORTER application 10983707, Dementia caregiving and the cognitive science of surrogate decisions (1K24AG083117-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10983707. Licensed CC0.

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