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Effects of Changes in the Long-Term Care Environment on Patterns of Care Use and Outcomes for High Need Older Adults with and without Alzheimer's Disease and Related Dementia

Award Number: R01AG080583
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 03/15/2025
PERIOD OF PERFORMANCE END DATE: 01/31/2028

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Effects of Changes in the Long-Term Care Environment on Patterns of Care Use and Outcomes for High Need Older Adults with and without Alzheimer's Disease and Related Dementia - Nearly 20 million adults (38%) aged 65 and older have limitations with one or more self-care activities (e.g., dressing, getting out of bed) and one in ten older adults are living with Alzheimer’s Disease and Related Dementias (ADRD). Together these two overlapping groups of “high-need” older adults typically rely on a variety of long-term care (LTC) sources to assist with daily activities, including family and unpaid care, paid care in the home, residential care such as assisted living and nursing home care. Inadequate care may lead to adverse consequences in daily self-care and avoidable health care utilization. Unanticipated changes in the LTC landscape may have profound effects on access to and use of LTC and contribute to further adverse consequences for high-need older adults, particularly for those living with ADRD. This project will draw upon two complementary longitudinal, nationally representative surveys of older adults–the Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS)– linked to geographic data and Medicare claims. Using statistical approaches that strengthen our ability to draw causal inferences, we will: 1) Evaluate the short-term impact of a rapidly shifting long-term care landscape on the type and amount of LTC use, comparing high-need older adults with and without ADRD and identify arrangements more likely to be “stable” with lower risks of change. 2) Determine whether care trajectories are disrupted in response to unanticipated shifts in the long-term care landscape, comparing high-need older adults with and without ADRD. 3) Assess the impact of changes in the long-term care environment on adverse consequences related to care gaps among highneed older adults with and without ADRD. We will estimate the effect of changes in the long-term care environment on self-reports of unmet need (using NHATS) and claimsbased measures of avoidable hospitalizations and emergency department visits (using HRS) for those with and without ADRD. Detailed geographic data will allow us to take into account local conditions while identifying more “vulnerable” care arrangements with higher risks of adverse consequences. The results of this project will provide a comprehensive understanding of how resilient formal and informal care systems are to unanticipated changes in the long-term care landscape in the short and longer term. This study aligns with NIA’s priority to understand community support for dementia care, in particular the determinants of availability LTC, LTC utilization and how the effects of community level factors including infrastructure and risk environment.


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 = $621,911 )
2026	2026	SYRACUSE UNIVERSITY	900 S CROUSE AVE	SYRACUSE	NY	13244	ONONDAGA	USA	Aging Research	001	4	2/24/2026	NON-COMPETING CONTINUATION	$62,191
2026	2026	SYRACUSE UNIVERSITY	900 S CROUSE AVE	SYRACUSE	NY	13244	ONONDAGA	USA	Aging Research	000	4	1/23/2026	NON-COMPETING CONTINUATION	$559,720
														Subtotal = $621,911

Issue Date FY: 2025 ( Subtotal = $634,224 )
2025	2025	SYRACUSE UNIVERSITY	900 S CROUSE AVE	SYRACUSE	NY	13244	ONONDAGA	USA	Aging Research	003	3	6/20/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$49,753
2025	2025	SYRACUSE UNIVERSITY	900 S CROUSE AVE	SYRACUSE	NY	13244	ONONDAGA	USA	Aging Research	001	3	3/17/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$584,471
2025	2024	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Aging Research	002	2	4/11/2025	NON-COMPETING CONTINUATION	$0
2025	2024	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Aging Research	000	2	3/14/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $634,224

Issue Date FY: 2024 ( Subtotal = $578,083 )
2024	2024	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Aging Research	001	2	6/10/2024	NON-COMPETING CONTINUATION	$57,809
2024	2024	WAYNE STATE UNIVERSITY	5700 CASS AVE STE 4900	DETROIT	MI	48202	WAYNE	USA	Aging Research	000	2	2/2/2024	NON-COMPETING CONTINUATION	$520,274
														Subtotal = $578,083

Issue Date FY: 2023 ( Subtotal = $604,912 )
2023	2023	WAYNE STATE UNIVERSITY	5057 WOODWARD STE 13001	DETROIT	MI	48202	WAYNE	USA	Aging Research	000	1	1/23/2023	NEW	$604,912
														Subtotal = $604,912

Grand Total All Awards = $2,439,130

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Effects of Changes in the Long-Term Care Environment on Patterns of Care Use and Outcomes for High Need Older Adults with and without Alzheimer's Disease and Related Dementia

Award Number: R01AG080583

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 03/15/2025

PERIOD OF PERFORMANCE END DATE: 01/31/2028

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