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Older Adults Living with Dementia and Their Informal Caregivers: Reciprocal Impacts of Caregiving and Serious Illness on Health Care Outcomes

Award Number: R00AG075145
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/10/2022
PERIOD OF PERFORMANCE END DATE: 02/28/2027

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Older Adults Living with Dementia and Their Informal Caregivers: Reciprocal Impacts of Caregiving and Serious Illness on Health Care Outcomes - PROJECT SUMMARY Alzheimer’s disease and other dementias are a growing public health concern, currently affecting nearly 8 million older adults and 16 million informal caregivers in the U.S. Informal caregiving—unpaid care by family members or friends—for persons living with dementia (PLWD) is uniquely demanding, with significant financial and emotional impacts. While the population continues to age and the number of PLWD requiring assistance grows, the pool of potential informal caregivers is also contracting, creating intense pressure to maintain the health and wellbeing of both caregivers and the PLWD for whom they provide care. There is an urgent need to understand how informal caregiving impacts both PLWD and caregiver health care use, and how serious illness for a PLWD or caregiver impacts the health care use of the other member of the dyad, to inform future caregiver interventions and policy. The goal of this K99/R00 Pathway to Independence Award is to prepare Dr. Lianlian Lei for a career as a successful independent health services investigator focused on disentangling the links between informal caregiving and how PLWD and their caregivers engage and interact with the health care system. Dr. Lei’s background and training in health services research, policy, and economics provide her with a solid foundation for the proposed work, but in order to transition to independence she requires additional skills and experience that will be gained through a coordinated program of research, mentorship, and didactics during the K99 phase of the award period. This will include training and experiences in: (1) clinical exposure to caregivers of PLWD; (2) skills to analyze complex, nationally representative survey data; (3) advanced methods of causal inference using econometric models; and (4) career skills needed to transition to independence, including research-related leadership and grantsmanship. Building on her previous research and training examining health care use and costs for PLWD, Dr. Lei’s research will use data from nationally representative surveys, including the National Health and Aging Trends Study and the Health and Retirement Study, both linked with Medicare claims data to identify the impact of informal caregiving on health care use of both PLWD (Aim 1.1) and caregivers (Aim 1.2), comparing instrumental variable (e.g., number of daughters, market supply of formal care) models and panel data fixed effects models. Aim 2 will further apply the panel data fixed effects models in HRS-linked Medicare claims to examine the impact of caregiver serious illness on PLWD health care use, while Aim 3 will examine the impact of PLWD serious illness on caregiver health care use. Upon successful completion of the study, findings will yield key knowledge of informal caregiving and serious illness to enable better identification of high-risk PLWD and caregivers, and will inform future targeted interventions to promote the health and wellbeing of both PLWD and caregivers. These results will provide the basis for a future R01 grant application targeting high-risk PLWD and caregivers following serious illness.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $243,996 )
2025	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	001	4	6/17/2025	NON-COMPETING CONTINUATION	$19,918
2025	2025	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE STE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	4	3/6/2025	NON-COMPETING CONTINUATION	$224,078
														Subtotal = $243,996

Issue Date FY: 2024 ( Subtotal = $329,325 )
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	001	3	3/14/2024	EXTENSION WITH OR WITHOUT FUNDS	$24,898
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	002	3	8/8/2024	EXTENSION WITH OR WITHOUT FUNDS	$80,349
2024	2024	REGENTS OF THE UNIVERSITY OF MICHIGAN	1109 GEDDES AVE, SUITE 3300	ANN ARBOR	MI	48109	WASHTENAW	USA	Aging Research	000	3	3/8/2024	EXTENSION WITH OR WITHOUT FUNDS	$224,078
														Subtotal = $329,325

Grand Total All Awards = $573,321

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Older Adults Living with Dementia and Their Informal Caregivers: Reciprocal Impacts of Caregiving and Serious Illness on Health Care Outcomes

Award Number: R00AG075145

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/10/2022

PERIOD OF PERFORMANCE END DATE: 02/28/2027

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