R33AG078523

Detection of elder mistreatment through emergency care technicians - revised for primary care (DETECT-RPC) - Elder mistreatment (EM) is commonly defined as an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes harm or creates a risk of harm to an older adult.

EM may be intentional or unintentional and includes financial exploitation, neglect, emotional/psychological abuse, physical abuse, and sexual abuse.

This is concerning as there is an estimated 11% annual prevalence among cognitively intact older adults, and a 30-75% annual prevalence among older adults with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD).

Further, EM is linked with increased risk of poor quality of life, loss of property and security, physical injury, hospitalizations, emergency room visits, psychological distress, morbidity, and early mortality.

Nevertheless, EM is difficult to detect and often goes unrecognized.

Effective and efficient EM screening tools are urgently needed to improve early detection efforts.

This proposal will address this need by adapting an evidence-based EM screening tool for home-based primary care and rigorously evaluating its potential harms and benefits.

In direct response to RFA-AG-22-024, we propose Stage IA research (R61 phase) to adapt the DETECT screening tool for home-based primary care — with special emphasis on older adults who were recently diagnosed with Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) — the DETECT revision for primary care (DETECT-RPC).

We also propose a Stage III multi-site randomized (at the provider level) controlled efficacy trial (R33 phase) of DETECT-RPC.

The specific aims of the R61 phase of the proposed project are:

(1) Evaluate the potential impact of state-specific laws and site-specific policies on the reporting guidance that will be provided by the DETECT-PRC tool (mixed-methods);

(2) Investigate provider-level barriers to recognizing and reporting EM in home-based primary care environments (qualitative - structured interviews, focus groups); and,

(3) Adapt the DETECT screening tool for home-based primary care (qualitative - structured interviews, focus groups).

The specific aims of the R33 phase of the proposed project are:

(1) Rigorously evaluate the effect of DETECT-RPC on targeted mechanisms of action (i.e., current barriers to identification and reporting) elucidated in the R61 phase of the study (mixed-methods);

(2) Rigorously evaluate the impact of DETECT-RPC on clinician identification and reporting of older adults with increased risk of EM to the appropriate authorities (RFA key question KQ3); and,

(3) Rigorously evaluate the benefits (i.e., reduce exposure to abuse and neglect, reduced physical or mental morbidity, and reduced mortality) and harms of screening with DETECT-RPC (RFA key questions KQ1 and KQ4) (mixed-methods).

University Of Texas Health Science Center At Houston

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]

Houston, Texas 770303870 United States

Single Zip Code

Primary Care-Based Screening and Intervention Development for Prevention of Abuse in Older and Vulnerable Adults in the Context of Alzheimers Disease and Related Dementias (R61/R33 Clinical Trial Required) (RFA-AG-22-024)

Amendment Since initial award the total obligations have increased 112% from $1,549,632 to $3,279,476.