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Upstream drivers of healthy aging: Assessing the role of state and county expenditures in early life on midlife cognition and later-life dementia risk

Award Number: R00AG086672
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 06/01/2024
PERIOD OF PERFORMANCE END DATE: 05/31/2029

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Upstream drivers of healthy aging: Assessing the role of state and county expenditures in early life on midlife cognition and later-life dementia risk - Alzheimer’s Disease and Related Dementias (AD/ADRD) affect 15% of older US adults. Events in early life can directly and indirectly contribute to later-life AD/ADRD risk. For example, adverse childhood experiences, like parental incarceration, may induce physiologic dysregulation during sensitive developmental stages with implications for accelerated biological aging. Further, these early-life experiences shift accumulated exposures over time toward other known AD/ADRD risk factors (e.g., lower educational attainment). Importantly, such mechanisms may be shaped by contextual factors that remain underexplored in the AD/ADRD literature. State and county expenditures are one such set of contextual factors conditioning early life across place and time. For example, variation in county education expenditures over time co-occur with variation in county legal expenditures. Increased education spending has been shown to improve educational attainment as well as reduce incarceration – both of which are associated with lower AD/ADRD risk. Thus, while state and county expenditures in early life could be linked to AD/ADRD risk - and therefore serve as an innovative and efficient lever to protect and improve population health - this has yet to be empirically tested. This R00 leverages a novel longitudinal expenditures database and two large, nationally representative, prospective datasets (National Longitudinal Survey of Youth 1979; US Health and Retirement Study) to estimate effects of state and county expenditures in early life on midlife cognition and later life dementia probability. Triangulating across the strengths of confounder-control and quasi-experimental methods, this R00 advances a nascent evidence base by (1) examining if county K-12 education expenditures and legal expenditures over early life are independently associated with midlife cognition and later life AD/ADRD; (2) characterizing how such expenditures jointly co-vary over early life and estimating associations with midlife cognition and later life AD/ADRD; and (3) estimating effects of increasing education expenditures in early life on midlife cognition and later life AD/ADRD. The proposed solutions-oriented research aligns with several NIA strategic goals on identifying environmental and social factors in early life that create and sustain differences in cognitive function and AD/ADRD risk among older adults. Consistent with broader NIH goals, it links data from various real-world sources to rigorously test individual and external factors that may influence health and explores a potential innovative strategy for improving population health into older age.


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: 2026 ( Subtotal = $249,000 )
2026	2026	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Aging Research	000	3	8/14/2026	EXTENSION WITH OR WITHOUT FUNDS	$249,000
														Subtotal = $249,000

Grand Total All Awards = $249,000

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Upstream drivers of healthy aging: Assessing the role of state and county expenditures in early life on midlife cognition and later-life dementia risk

Award Number: R00AG086672

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 06/01/2024

PERIOD OF PERFORMANCE END DATE: 05/31/2029

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