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Dementia epidemiology, health service utilization and treatment costs among American Indian and Alaska Native Elders

Award Number: R01AG061189
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2019
PERIOD OF PERFORMANCE END DATE: 03/31/2026

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Dementia epidemiology, health service utilization and treatment costs among American Indian and Alaska Native Elders - PROJECT SUMMARY As the US population ages, the number of people living with Alzheimer’s Disease and related dementias (ADRD) is projected to triple by 2050. Although the life expectancy of American Indian and Alaska Natives (AI/ANs) is much shorter than that of other US populations, it has dramatically increased in the last few decades, with the expansion of the AI/AN elder population expected to continue. Compared to most US populations, AI/ANs bear a disproportionate burden of many established modifiable risk factors for dementia, such as diabetes, obesity, and smoking. However, our knowledge about dementia in this population remains to be severely limited. So far, only a handful of studies have examined dementia among AI/ANs, with reliable data on the prevalence or incidence of dementia in this population being nonexistent. Given so many gaps in our knowledge about dementia among AI/ANs, a systematic investigation is urgently needed to identify how problematic dementia is in this population and its impact on the Indian health system to enable more precise planning and prioritization of resources needed to support relevant health care policy. Here, leveraging on 16 years of longitudinal data available in the Indian Health Service (IHS) Data Project, a synthesis of existing IHS electronic health data for nearly 30% of the IHS service population (~ 640,000 AI/ANs), we propose to address 4 major knowledge gaps about dementia among AI/ANs as guided by the following specific aims: (1) Estimate dementia prevalence, incidence, and comorbidity rates among AI/AN elders by individual and community characteristics, such as age, gender, location, and county level socioeconomic status; (2) Characterize the association between dementia and potentially modifiable risk factors, such as diabetes, obesity, tobacco use, binge drinking, traumatic brain injuries and depression; (3) Evaluate the influence of dementia and comorbidity status on health service utilization patterns, including inpatient, outpatient, and pharmacy services; and (4) Examine the costs of providing treatment among AI/ANs with dementia, and factors that influence these costs such as comorbidity status. Our proposed analyses will provide a relatively accurate and complete picture for the epidemiology of diagnosed dementia among AI/ANs based on a large and geographically diverse sample, and contribute to the understanding of dementia and associated health service utilization in an extremely underserved population living in disadvantaged communities. Our findings promise to lay groundwork for future studies on dementia to address both the needs of AI/ANs and those of other similarly underserved populations.


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 = -$20,856 )
2026	2023	THE REGENTS OF THE UNIVERSITY OF COLORADO	13001 E 17TH PL STE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	5	7/22/2026	NON-COMPETING CONTINUATION	-$20,856
														Subtotal = -$20,856

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2023	THE REGENTS OF THE UNIV. OF COLORADO	13001 E 17TH PL STE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	5	3/24/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $576,722 )
2023	2023	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	001	5	3/24/2023	SUPPLEMENT FOR EXPANSION	$54,772
2023	2023	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	5	3/22/2023	NON-COMPETING CONTINUATION	$521,950
														Subtotal = $576,722

Issue Date FY: 2022 ( Subtotal = $683,506 )
2022	2022	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	002	4	5/2/2022	NON-COMPETING CONTINUATION	$592,220
2022	2022	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	3	12/23/2021	SUPPLEMENT FOR EXPANSION	$18,257
2022	2022	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	003	4	5/13/2022	SUPPLEMENT FOR EXPANSION	$73,029
2022	2022	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	001	3	2/8/2022	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $683,506

Issue Date FY: 2021 ( Subtotal = $569,906 )
2021	2021	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	001	3	3/8/2021	NON-COMPETING CONTINUATION	$569,906
2021	2020	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	2	10/19/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $569,906

Issue Date FY: 2020 ( Subtotal = $606,991 )
2020	2020	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	2	3/20/2020	NON-COMPETING CONTINUATION	$606,991
														Subtotal = $606,991

Issue Date FY: 2019 ( Subtotal = $442,942 )
2019	2019	REGENTS OF THE UNIVERSITY OF COLORADO, THE	13001 E 17TH PLACE F428	AURORA	CO	80045	ADAMS	USA	Aging Research	000	1	3/25/2019	NEW	$442,942
														Subtotal = $442,942

Grand Total All Awards = $2,859,211

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Dementia epidemiology, health service utilization and treatment costs among American Indian and Alaska Native Elders

Award Number: R01AG061189

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 04/01/2019

PERIOD OF PERFORMANCE END DATE: 03/31/2026

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