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A Longitudinal Network Study of Alzheimer's and Dementia Care in Relation to Disparities in Access and Outcomes

Award Number: R56AG056347
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2017
PERIOD OF PERFORMANCE END DATE: 08/31/2018

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A Longitudinal Network Study of Alzheimer's and Dementia Care in Relation to Disparities in Access and Outcomes - PROJECT SUMMARY/ABSTRACT Alzheimer's disease and related dementias (AD/dementia) represent a looming public health crisis, affecting roughly 5 million people in the U.S. and 11% of older adults. As with other chronic conditions, racial/ethnic and socio-economic disparities exist in the prevalence and burden of illness. However, less is known about how disparities in access to care influence the care trajectories – i.e. the scope, frequency and sequence of services used across health care settings – of those with AD/dementia. This retrospective, longitudinal cohort study will address this gap by using network analysis to examine care trajectories and outcomes in a racially and socioeconomically diverse sample of community-dwelling individuals with AD/dementia and unspecified cognitive impairment (CI) who may be at risk for a delayed AD/dementia diagnosis. The cohort will consist of home health care patients served by the Visiting Nurse Service of New York (VNSNY), a large, non-profit home care provider. Data will include clinical assessments for roughly 89,000 patients admitted to home care during 2010-2012 linked with 4 years of Medicare and Medicaid claims data and geographic data on neighborhood services. The specific aims are to: (1) Describe the population at VNSNY within two diagnostic categories (AD/dementia and unspecified CI) in relation to adverse outcomes (e.g. pressure ulcers, falls, infection, dehydration, preventable hospitalization, and nursing home admission); (2) Map, quantify and compare patterns in the care trajectories of individuals and groups that experience variable and/or disparate outcomes; and (3) Identify strategies for implementing care trajectories with potential to reduce disparities in access and/or outcomes for AD/dementia and unspecified CI. Applying a systems science framework, the study will use innovative network analytics to capture complex patterns in care trajectories that may contribute to adverse outcomes in a racially and socioeconomically diverse sample of individuals with these two conditions. The long-term goal of this research is to identify and, in subsequent studies, test potential home- and community-based interventions that may improve access to services and outcomes for individuals who may be underserved or at heightened risk for unmet healthcare needs. This research will produce new knowledge to aid efforts to mitigate health disparities in this vulnerable and growing population.


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: 2019 ( Subtotal = -$12,122 )
2019	2017	VISITING NURSE SERVICE OF NEW YORK	220 E 42ND ST FL 6	NEW YORK	NY	10017	NEW YORK	USA	Aging Research	000	1	2/26/2019	NEW	-$12,122
														Subtotal = -$12,122

Issue Date FY: 2017 ( Subtotal = $824,085 )
2017	2017	VISITING NURSE SERVICE OF NEW YORK	1250 BROADWAY FL 2	NEW YORK	NY	10001	NEW YORK	USA	Aging Research	000	1	9/15/2017	NEW	$824,085
														Subtotal = $824,085

Grand Total All Awards = $811,963

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A Longitudinal Network Study of Alzheimer's and Dementia Care in Relation to Disparities in Access and Outcomes

Award Number: R56AG056347

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

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

PERIOD OF PERFORMANCE START DATE: 09/30/2017

PERIOD OF PERFORMANCE END DATE: 08/31/2018

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