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Cognition After Armed Conflict: Creation of a Harmonized Cognitive Assessment Protocol (HCAP) and Examination of ADRD Risks Related to Older Adult ADRD Risks Related to Early Life War Exposure

Award Number: R01AG093885
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2026
PERIOD OF PERFORMANCE END DATE: 08/31/2031

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Cognition After Armed Conflict: Creation of a Harmonized Cognitive Assessment Protocol (HCAP) and Examination of ADRD Risks Related to Older Adult ADRD Risks Related to Early Life War Exposure - PROJECT SUMMARY: Current cohorts of older adults, especially military veterans in the U.S. and worldwide, were widely and differentially exposed to the violence, trauma, and subsequent mental health problems of twentieth-century wars. These older adults, exposed to numerous, often severe, war-related stressors at various sensitive stages in early life, may experience heightened risk of later life cognitive impairment and dementia. Such ramifications not only impact directly-exposed individuals but also place significant burdens upon family caregivers and healthcare systems. Significant strides in understanding the impact of ADRD have been made through the Harmonized Cognitive Assessment Protocol (HCAP) Network, which has generated flexible but comparable instruments for assessing older adults’ cognitive function, illuminating common and divergent ADRD risk and protective factors around the world. The proposed project will advance understanding of ADRD risk and resilience related to early life war exposures by designing and implementing a new HCAP in a cohort of older adults and their middle-aged children within an ongoing study that has collected rare and highly detailed data on early life war exposure - the Vietnam Health and Aging Study (VHAS). AIM 1 implements a third round of data collection with original VHAS participants (N≈1500) and baseline data collection with participants’ spouses (N≈1100) and two randomly chosen children now in midlife (N≈2500) to support longitudinal and life course investigation of war-related adversities and ADRD risk. This aim includes in-depth interviews on health, social relational, and psychosocial characteristics; the Map of Life Course Events to assess early-life war exposure timing; and biomarkers of cardiometabolic disorder (CMD). AIM 2 develops and implements a protocol to identify mild cognitive impairment (MCI) and dementia, specifically by: designing, piloting, and administering an HCAP in the VHAS sample; implementing Clinical Dementia Rating (CDR) interviews and consensus diagnoses of MCI/dementia in a randomly-selected group of participants with low HCAP scores (N≈200) and randomly-selected controls (N≈100) for HCAP validation and diagnostic algorithms; and assaying plasma-based biomarkers with high discriminative accuracy for detecting AD pathology (Aβ42/40, P-tau217, GFAP, & NfL) in a subset of participants (N=500) stratified by degrees of war-related adversity. AIM 3 estimates associations between early-life war stressors, mediating ADRD risk factors (e.g., CMD, PTSD), and HCAP-based measures of MCI/dementia in mid-late adulthood. The parent-offspring and sibling relational data generated will support future analyses of genetic, epigenetic, and family environmental factors influencing ADRD. In addition to enriching the NIH-supported HCAP network, this study further informs U.S. health by expanding knowledge on the social and biological mechanisms through which early life warrelated stressors contribute to ADRD risk and resilience. Such findings will shed light on approaches to ADRD prevention within war-affected populations, in particular military veterans and families affected by war.


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 = $401,036 )
2026	2026	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Aging Research	000	1	8/31/2026	NEW	$401,036
														Subtotal = $401,036

Grand Total All Awards = $401,036

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Cognition After Armed Conflict: Creation of a Harmonized Cognitive Assessment Protocol (HCAP) and Examination of ADRD Risks Related to Older Adult ADRD Risks Related to Early Life War Exposure

Award Number: R01AG093885

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/01/2026

PERIOD OF PERFORMANCE END DATE: 08/31/2031

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