Research training spotlight: NIA-funded clinician-scientist supports people with dementia to speak for themselves
When Andrea Gilmore-Bykovskyi, Ph.D., decided to pursue a career in science and nursing, she wanted to understand the human experience in health care. In her early clinical work at a skilled nursing facility, she recognized that despite system inadequacies, different approaches to care had a significant impact on residents.
“How you approach people who are living with dementia matters,” Gilmore-Bykovskyi said. “Staff are able to produce moments of beautiful joy with residents.” But how can staff replicate those moments?
Gilmore-Bykovskyi is now tackling that question as an associate professor and the associate vice chair for research in the BerbeeWalsh Department of Emergency Medicine at the University of Wisconsin–Madison (UW). With research training and early-career support from NIA and others, Gilmore-Bykovskyi established a program to examine how people living with dementia experience their disease and how caregivers and health care staff can make patients’ lives better.
Lining up the right support
Gilmore-Bykovskyi has spent much of her career at UW. As an undergraduate, she entered an accelerated B.S.N.-to-Ph.D. program, where she met her advisor and first mentor, Barbara Bowers, Ph.D., R.N., FAAN.
“She gave me so much rein for my intellectual curiosity and encouraged me to think with breadth,” Gilmore-Bykovskyi said. Bowers also challenged her to attend focused training courses at Bradford University in the United Kingdom, where she visited care facilities, met with faculty, and expanded her training on personhood in dementia research and care.
“Personhood is the idea that people are worthy, that ‘people are people,’” Gilmore-Bykovskyi explained. “I know it sounds very basic, but for a long time, that idea needed to be articulated in the field of dementia care.”
As she progressed toward her doctorate, Gilmore-Bykovskyi secured financial support from the John A. Hartford Foundation, which led major efforts to establish clinician-scientists in gerontology. In her research, Gilmore-Bykovskyi used video observations to explore how the approaches that caregivers take with nursing home residents relate to dementia symptoms that residents exhibit. Her results showed that patients were less likely to experience symptoms like agitation when staff were more person-centered than task-focused — for example, when staff offered choices and did not ignore residents.
Near the completion of her postdoctoral studies, Gilmore-Bykovskyi applied for diversity supplement funding through UW’s NIA-supported Alzheimer’s Disease Research Center (ADRC), which provides infrastructure and training support for early-career researchers. She also followed a recommendation from NIA staff to expand her mentor pool. One of those mentors was UW’s Manish N. Shah, M.D., M.P.H., and Gilmore-Bykovskyi considers their relationship one of her most fruitful mentoring experiences.
Findings from the diversity supplement, along with other research on disparities in care utilization for diverse populations with dementia, fueled Gilmore-Bykovskyi’s search for a way to equitably include underrepresented populations in Alzheimer’s and related dementias research. This search formed the basis of her first major award from NIA, the Paul B. Beeson Emerging Leaders Career Development Award in Aging. She used Beeson funding to launch the Brain Health Community Registry, which engages people in research by connecting those living with dementia, caregivers, and individuals interested in brain health research with pertinent research opportunities on aging, brain health, and caregiving. The registry also connects interested participants to services that address social, medical, or caregiving needs.
NIA and other early-stage supporters have enabled Gilmore-Bykovskyi and her team to make broad advances in the field of aging research. Some of these advances include interventional studies to improve acute illness care for people with dementia and advances in acute care research engagement for this population.
Gilmore-Bykovskyi is also the principal investigator on an NIA R33-funded study that explores lucidity, which is the unexpected return of communication and functional abilities in people with advanced dementia. It is the first prospective observational study to investigate the phenomenon.
“I want to pay close attention to what people living with dementia are telling us,” Gilmore-Bykovskyi said. “That lived experience is a key missing piece in many scientific puzzles.”
It takes a village
Throughout Gilmore-Bykovskyi’s training, mentors provided invaluable guidance for her career. She values mentoring even more now that she is often on the other side of the relationship, having mentored more than three dozen trainees, from undergraduates to junior faculty.
Gilmore-Bykovskyi also found that the professional networks that she joined through different NIA programs have been vital to her career growth. They have all aided her at different times. She recommends that early- and mid-career researchers take advantage of whatever group they find themselves in, be it the ADRCs or the Resource Centers for Minority Aging Research (RCMAR).
Today, Gilmore-Bykovskyi is a thought leader in the field, receiving a 2023 UW–Madison Outstanding Women of Color Award last November. She also recently co-chaired NIA’s Dementia Care Summit and has several NIA grants.
“Dr. Gilmore-Bykovskyi brings an expansive and inclusive view of science and of the people she brings together in pursuit of better public health,” said Elena Fazio, Ph.D., director of NIA’s Office of AD/ADRD Strategic Coordination, who has worked with Gilmore-Bykovskyi on the summit and several grants. “She has inspired many investigators, both new and experienced, to think holistically about health and health care research conduct.”
Could NIA’s training and career development funding help take your research success to the next level? Learn more about advancing your scientific growth with support from NIA’s Training and Career Development Programs.