The goal of this study is to determine whether increasing participation in activities prevents cognitive decline in African Americans 65 and older with mild cognitive impairment (MCI). We will test the use of Behavioral Activation (BA), a behavioral treatment, as a way to increase activities and thus improve function and mood. As patients do more (through activation) and perceive the benefit (i.e., feel better), their activity levels increase. BA promotes activities that reflect an individual's preferences and goals, which in turn enhances mood and motivation to remain active. The control treatment is Supportive Therapy (ST), which is a nondirective, supportive therapy that is based on empathy, reflection, and support. 

We hypothesize that BA-treated subjects will have fewer declines in cognitive and functional abilities, fewer depressive and neuropsychiatric symptoms, and better quality of life than ST-treated subjects at 24 months. Most clinical trials for MCI have tested pharmacologic treatments and have enrolled mostly Whites; their results may not apply to African Americans, whose life experiences and medical and genetic characteristics may exert unique effects.

Those with MCI are a high-risk population for whom interventions to prevent cognitive decline are particularly important. Because African Americans comprise one of the largest minority groups in the U.S., suffer disparities in health outcomes, and are unlikely to seek pharmacologic treatments or participate in clinical drug trials, there is an urgent need to enroll older African Americans in nonpharmacologic intervention studies of cognition.