R01AG080624

Disparities of Alzheimer's disease progression in sexual and gender minorities - Abstract

Sexual and gender minorities (SGM) face unique health issues, but studies on SGM health are scarce. In particular, limited data are available among SGM individuals on age-related conditions such as Alzheimer’s disease (AD) and related dementias.

AD is a fatal degenerative disease with a diverse range of risk factors, ranging from clinical characteristics to social determinants of health (SDOH). AD patients often progress from cognitively unimpaired to (possible) mild cognitive impairment (MCI), followed by increasing severity of dementia with AD clinical syndrome. Nevertheless, evidence suggests there exists heterogeneity in the progression to AD through multiple intermediate stages.

Characterizing the different AD progression pathways and the associated risk factors is crucial for risk stratification and prevention. On the other hand, the proliferation of large clinical research networks (CRNs) with real-world data (RWD), including electronic health records (EHRs), claims, and billing data among others, offers opportunities for generating real-world evidence (RWE) that will have direct translational impacts on AD prevention and care in the SGM populations.

Nevertheless, there are a number of key research and methodological gaps in using RWD for studying AD in SGM, including the lack of (1) validated computable phenotypes (CP) and natural language processing (NLP) tools that can accurately define the SGM populations and extract key patient characteristics and outcomes (e.g., MOCA scores to determine severity), (2) consideration of the heterogeneity in AD and its progression pathways, and (3) consideration of AD disparities in SGM populations, especially structured on both individual- and contextual-level SDOH.

Responding to NOT-AG-21-050, we propose to analyze large collections of RWD in the OneFlorida+ and Insight networks, two CRNs contributing to the National Patient-Centered Clinical Research Network (PCORnet), to: (1) create real-world longitudinal SGM and AD cohorts that can be followed by virtue of routine clinical care, (2) model the heterogeneity in AD progression with novel federated machine learning methods, and (3) examine SGM disparities in AD outcomes (i.e., onset and progression pathways) and in the causal paths via which AD clinical risk factors and SDOH impact these AD outcomes.

Our project is novel and will have direct translational impact as it provides concrete RWE to fill the knowledge gaps by examining whether AD disparities exist between SGM (and SGM subgroups) and non-SGM, and identifies potentially actionable AD risk factors and SDOH significant to SGM and their disparities.

The success of this project will fill important gaps in our knowledge of AD risk and progression pathways in the SGM populations, and establish a framework for creating RWD-based virtual cohort, which can inform national pragmatic trials across PCORnet for future SGM aging clinical studies.

University Of Florida

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]

Gainesville, Florida 326115500 United States

Single Zip Code

Research on Current Topics in Alzheimer's Disease and Its Related Dementias (R01 Clinical Trial Optional) (PAR-22-093)

Amendment Since initial award the total obligations have increased 282% from $809,623 to $3,090,624.