R01AG074357

Air pollution and Alzheimer's disease and related dementias: A national study

Dementia is a major public health challenge with substantial economic and social burden, affecting more than 47 million people worldwide. Alzheimer's disease (AD) constitutes about two-thirds of dementia cases and is the sixth leading cause of death in the United States, and the only diagnosis among the top 10 that cannot be cured.

There is a pressing need to support Alzheimer's disease and related dementias (AD/ADRD) patients by identifying novel and modifiable risk factors that may reduce morbidity. Emerging evidence suggests that air pollution – in particular fine particulate matter (PM2.5) – plays an important role in AD/ADRD pathogenesis. However, little is known about the relative contributions of different air pollutants (PM2.5, NO2, ozone), nor about PM2.5 components.

To facilitate the targeting of pollution control efforts, the National Academy of Sciences (NAS) and the World Health Organization (WHO) have placed a high priority on determining which air pollutants and/or which components of PM2.5 are most toxic. In addition, one major gap in the emerging epidemiologic evidence on air pollution and AD/ADRD morbidity is that many previous studies have relied on hospitalizations as the measure of morbidity.

Yet, hospitalization is not the typical course for AD/ADRD diagnosis and initial treatment. Instead, if it does occur for patients, hospitalization happens during the more advanced stages of the disease and usually for treating complications of the disease. Thus, hospitalization records do not accurately reflect disease incidence and thus underestimate case numbers.

Therefore, we propose a study that will leverage the massive datasets of high-resolution environmental exposure data and Medicare claims (including doctor visits where most AD/ADRD diagnoses would occur) across the contiguous US to better understand the influence of air pollution on AD/ADRD morbidity among US elderly and identify potential vulnerable subpopulations, with the ultimate goal of informing environmental policy.

We will:

1. Generate and validate a comprehensive, high-resolution, multiple-species air pollution dataset across the contiguous US for 2000-2021, including criteria air pollutants (PM2.5 mass, NO2, and ozone), PM2.5 components (including trace metals), as well as aerosol water and fine particle pH that may influence metal dissolution.

2. Estimate the chronic effects of criteria pollutants (PM2.5, NO2, and ozone) on AD/ADRD risks using the nationwide Medicare Chronic Conditions Warehouse (CCW) database, which includes Medicare inpatient and outpatient claims, doctor visits, skilled nursing facility, and home health-care claims for AD/ADRD among approximately 100 million Medicare beneficiaries.

3. Assess the relative contributions of PM2.5 components and potential effect modification by aerosol water/pH on AD/ADRD risks using the nationwide Medicare cohort.

4. Conduct sensitivity analyses by correcting for exposure measurement error and outcome misclassification.

Our proposed research will fill major knowledge gaps in the epidemiology of environmental exposures and AD/ADRD morbidity and inform policy for targeted source-specific regulations and facilitate actionable measures that can prevent or mitigate the AD health burden due to air pollution.

Emory University

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Atlanta, Georgia 30322 United States

Single Zip Code

Research on Current Topics in Alzheimer's Disease and Its Related Dementias (R01 Clinical Trial Optional) (PAR-19-070)

Amendment Since initial award the total obligations have increased 370% from $732,182 to $3,440,014.