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A Life Course Approach to Understanding Population Heterogeneity in Alzheimer’s Disease and Related Dementias and Health Care Utilization

Award Number: R01AG077529
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/01/2022
PERIOD OF PERFORMANCE END DATE: 05/31/2027

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A Life Course Approach to Understanding Population Heterogeneity in Alzheimer’s Disease and Related Dementias and Health Care Utilization - As the share of U.S. older population and number of people living with Alzheimer's Disease and Related Dementias (ADRD) continue to grow rapidly, the prevalence and incidence of ADRD and ADRD-attributable health care remain high. This study aims to deepen our understanding of the risk of ADRD and related health care utilization among U.S. older adults, using a life course approach. We will utilize appropriate machine learning (ML) approaches to examine how life course factors, especially early-life circumstances, may accumulate over the life course to shape ADRD risk; how risk factors in midlife and later life may explain ADRD-attributable health care use and outcomes for persons with ADRD. Identifying ADRD risk in the preclinical stage is crucial, our holistic life course approach holds promise in enhancing prevention at the population level. Our overarching goal is to address ADRD-related health and health care needs, guided by novel evidence starting from early stages of life, and ideally delay the onset or slow the progression of ADRD. To achieve our overall goal, we will adapt ML to multiple rich data sources linking longitudinal survey, national neighborhood data, medical claims, and life history in 1995-2020 Health and Retirement Study (HRS). ML has demonstrated large potential for early disease detection and cost containment, and may circumvent key statistical challenges. We will pursue four specific aims: 1) develop and validate ML and other models for ADRD prediction, examining multifactorial influences of life course factors; 2) understand individual and collective contributions of early-life circumstances to ADRD; 3) examine the effect of incident ADRD on health care use and its dynamics pre- and post- ADRD diagnosis; 4) investigate the extent to which midlife and later-life factors may mediate the effects of ADRD on health care use. This study will add significant value to understanding ADRD and its health care, by using ML algorithms to explore the role of a uniquely rich set of life course factors in ADRD; by augmenting a nationally representative longitudinal survey with administrative data to systematically examine ADRD and associated health care. Taken together, these findings will inform 1) development of risk prediction models for ADRD to offer a cost-effective approach for population-level screening in the preclinical stage, identification of risk factors and groups at elevated risk of ADRD for targeted preventive interventions; 2) products that can aid individuals and clinicians in making informative assessments; and 3) approaches to address ADRD-attributable health and health care starting from early stages of life, leveraging midlife and later-life mediators, and ideally delaying the onset or progression of ADRD.


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 = $686,960 )
2026	2026	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Aging Research	000	5	7/3/2026	NON-COMPETING CONTINUATION	$686,960
														Subtotal = $686,960

Issue Date FY: 2025 ( Subtotal = $714,871 )
2025	2025	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Aging Research	000	4	8/27/2025	NON-COMPETING CONTINUATION	$714,871
														Subtotal = $714,871

Issue Date FY: 2024 ( Subtotal = $729,460 )
2024	2024	YALE UNIV	150 MUNSON ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Aging Research	000	3	7/1/2024	NON-COMPETING CONTINUATION	$729,460
														Subtotal = $729,460

Issue Date FY: 2023 ( Subtotal = $727,785 )
2023	2023	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Aging Research	000	2	5/26/2023	NON-COMPETING CONTINUATION	$727,785
														Subtotal = $727,785

Issue Date FY: 2022 ( Subtotal = $729,460 )
2022	2022	YALE UNIVERSITY	105 WALL ST	NEW HAVEN	CT	06511	SOUTH CENTRAL CT	USA	Aging Research	000	1	6/20/2022	NEW	$729,460
														Subtotal = $729,460

Grand Total All Awards = $3,588,536

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A Life Course Approach to Understanding Population Heterogeneity in Alzheimer’s Disease and Related Dementias and Health Care Utilization

Award Number: R01AG077529

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 07/01/2022

PERIOD OF PERFORMANCE END DATE: 05/31/2027

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