U24AG082930

Alzheimer diagnosis in older adults with chronic conditions ADACC network - project summary / abstract

Approximately 60% of older adults with Alzheimer's disease or a related dementia (ADRD) have three or more chronic conditions. Multiple chronic conditions (MCCs) and frailty are also risk factors for ADRD and can affect the expression of AD pathology with regards to cognitive function, disease stage, and neuropathological burden.

Utilizing biomarkers to diagnose ADRD may provide a more accurate and cost-effective assessment of the underlying etiology contributing to the cognitive impairment and may guide treatments and counseling about individualized care pathways. However, widespread incorporation of these biomarkers into routine clinical care and population screening programs for older adults with multiple MCCs and cognitive impairment has not occurred.

Blood-based biomarkers are now clinically available to aid in the diagnosis of ADRD and are more feasible, especially for older adults with MCCs, and less costly and invasive than CSF or PET-based biomarkers. However, no research has examined these blood biomarkers for the diagnosis and prognosis of ADRD in primary care, especially among diverse populations. It is unknown how and when these blood biomarkers should be used, particularly for diagnosis and prognosis among older adults with MCCs and/or limited life expectancy. Moreover, the effect of MCCs on levels of the biomarkers are not well understood.

Numerous other questions remain, such as:
1) Whether the ADRD biomarkers enhance prognosis among older adults with MCCs and cognitive impairment;
2) For whom it is most beneficial to obtain ADRD biomarkers including blood, CSF or imaging;
3) How the biomarkers can be implemented in a primary clinical healthcare delivery model;
4) Whether there are subgroup differences (e.g. race/ethnicity, sex, MCCs) that affect the interpretation of the biomarkers;
5) Assessment of cost estimates and risk/benefit ratios for reimbursement;
6) How best to communicate the results to patients and their caregivers; and
7) The ethical aspects of biomarker collection and potential for incidental findings due to mixed pathologies, especially among older adults.

The overall goal of this application is to establish a national consortium, the Alzheimer's Diagnosis in Older Adults with Chronic Conditions (ADACC) Network, consisting of multi-disciplinary investigators that will address these and other questions, and develop evidence-backed strategies and guidelines for the use and implementation of biomarkers for ADRD diagnosis in older patients with MCCs and cognitive impairment. The consortium will have an executive committee, steering committee, and data coordinating center. It will fund three pilot projects each year and convene an annual meeting. Working groups will be developed to focus on the questions listed above and others.

Successful completion of the grant aims will advance the diagnosis and care of older adults with MCCs and cognitive impairment by increasing understanding of how and when to implement ADRD biomarkers.

Wake Forest University Health Sciences

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]

Winston Salem, North Carolina 27157 United States

Single Zip Code

Network for Personalization of Diagnostic Tests for Alzheimers Disease (AD) and Alzheimers Disease-Related Dementias (ADRD) in Older Adults with Multiple Chronic Conditions (MCCs) (U24 Clinical Trial Optional) (RFA-AG-23-032)

Amendment Since initial award the total obligations have increased 190% from $1,884,695 to $5,472,632.