RF1AG090341

ADVANCING WOMEN’S CARE IN ALZHEIMER’S DISEASE AND OTHER DEMENTIAS THROUGH EHR - THE AGING POPULATION HAS LED TO AN INCREASE IN COGNITIVE IMPAIRMENT (CI) SUCH AS MILD COGNITIVE IMPAIRMENT OR DEMENTIA. AS THE AGING POPULATION GROWS, THE NEED FOR EFFECTIVE DIAGNOSTIC, MANAGEMENT, AND PREDICTIVE TOOLS IS MORE URGENT. WITH THIS LANDSCAPE, THERE IS GREAT NEED FOR PRECISION MEDICINE APPROACHES CONSIDERING INDIVIDUAL FACTORS, SUCH AS SEX, IN THE UNDERSTANDING AND MANAGEMENT OF DEMENTIA. IN PARTICULAR, WOMEN HAVE A DISPROPORTIONATE BURDEN OF DEMENTIA. HOWEVER, THE EXAMINATION OF WOMEN-SPECIFIC DIFFERENCES HAS NOT BEEN WELL INTEGRATED INTO PRECISION MEDICINE APPROACHES, DESPITE THE EXTENSIVE LITERATURE DEMONSTRATING SEX DIFFERENCES IN BRAIN STRUCTURE AND FUNCTION OVER THE LIFESPAN. WOMEN-SPECIFIC FACTORS EARLIER IN LIFE, SUCH AS MENOPAUSE, MENOPAUSAL HORMONE THERAPY, PREGNANCY, AND HYPERTENSIVE DISORDERS DURING PREGNANCY, ARE HYPOTHESIZED TO AFFECT COGNITIVE HEALTH AND DEMENTIA. SOME STUDIES HAVE IDENTIFIED A STRONGER ASSOCIATION BETWEEN BIOMARKERS, SUCH AS APOLIPOPROTEIN E (APOE) Ε4 GENOTYPE, AND DEMENTIA OR COGNITIVE DECLINE IN WOMEN COMPARED TO MEN. ADDITIONALLY, THE PROGRESSION OF DEMENTIA IN WOMEN CAN ALSO BE UNIQUELY INFLUENCED BY A MYRIAD OF BIOLOGICAL, SOCIAL, AND ENVIRONMENTAL VARIABLES. DESPITE THE HIGH PREVALENCE OF DEMENTIA IN WOMEN, DISPARITIES IN DIAGNOSIS, ACCESS TO HEALTHCARE, CLINICAL TRIALS, TREATMENT, AND CARE MANAGEMENT HAVE BEEN REPORTED. ELECTRONIC HEALTH RECORDS (EHRS), PARTICULARLY CLINICAL FREE TEXT, CONTAIN INVALUABLE INFORMATION ABOUT PATIENTS’ MEDICAL HISTORY TO TRACK LONGITUDINAL HEALTH CONDITIONS. YET, EHRS HAVE NOT BEEN FULLY UTILIZED TO SYSTEMATICALLY CAPTURE OR DISTINGUISH WOMEN-SPECIFIC HEALTH EVENTS, TRENDS, OR PATTERNS THAT COULD BE INVALUABLE IN UNDERSTANDING CI PROGRESSION. TO ADDRESS THIS GAP, WE WILL ANALYZE WOMEN-SPECIFIC HEALTH PATTERNS FROM EHRS THAT CAN ADDRESS DIAGNOSTIC DISPARITIES IN CI PROGRESSION. WE WILL STUDY THESE QUESTIONS USING: (A) THE POPULATION-BASED MAYO CLINIC STUDY OF AGING COHORT (N=6,531) WITH LONGITUDINAL COGNITIVE ASSESSMENTS AND EXTENSIVE CLINICAL CHARACTERIZATION, PROVIDING AN IDEAL GOLD STANDARD FOR CI; AND (B) THE ROCHESTER EPIDEMIOLOGY PROJECT, WHICH LINKS LONGITUDINAL EHRS FOR A LARGE MIDWESTERN POPULATION (~1.4 MILLION PEOPLE IN 27 COUNTIES). ADDITIONALLY, WE WILL USE NATIONWIDE DATA FROM NATIONAL ALZHEIMER’S COORDINATION CENTER TO INCREASE REPRESENTATION OF THE POPULATION AND TO ENHANCE THE GENERALIZABILITY. THE PRIMARY GOAL OF THIS PROJECT IS TO DEVELOP AN INFORMATICS TOOL TO EXTRACT WOMEN’S HEALTH CONDITIONS FROM MULTI-SITE EHRS (AIM 1), ANALYZE DIFFERENCES IN CI SYMPTOMS, DIAGNOSIS, AND PROGRESSION IN WOMEN IN RELATION TO BIOMARKERS (AIM 2), AND DEVELOP FAIR AND EXPLAINABLE PREDICTIVE MODELS FOR CI, ASSESSING THE PROGNOSTIC VALUE OF WOMEN’S HEALTH INDICATORS TO GUIDE TARGETED HEALTH ADJUSTMENTS (AIM 3). THE PROPOSED TOOLS AND METHODOLOGIES WILL ADDRESS DIAGNOSTIC AND TREATMENT DISPARITIES IN WOMEN, ENSURING TRANSPARENT AND FAIR HEALTHCARE DECISIONS. THE PROPOSED AIMS ALIGN CLOSELY WITH THE IMPERATIVE NEED AND COULD SIGNIFICANTLY IMPACT THE LIVES OF WOMEN AT RISK FOR ALZHEIMER’S DISEASE AND OTHER DEMENTIAS.

Mayo Clinic

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]

Minnesota United States

State-Wide

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)