Advisory Council January 2019 Meeting Presentation: Care Interventions

Melinda Kelley, Ph.D.
Director, Office of Legislation, Policy, and International Activities
National Institute on Aging

October 2017: Research Summit on Dementia Care -- Building Evidence for Services and Supports
Yielded 58 main recommendations for care/caregiving
NIA will be following up on research-related recommendations
Research on care/caregiving in the Alzheimer's and related dementias field is expanding.
Some programs to improve care and caregiving are already being disseminated and adapted (e.g., REACH).
A rigorous, independent review of which care/caregiving-related interventions are effective and ready for widespread dissemination is needed.
Overall goal of this project:
- Take stock of the current state of knowledge and inform decision making about which care interventions for individuals with dementia and their caregivers are ready for dissemination and implementation on a broad scale.

Agency for Healthcare Research and Quality Evidence-based Practice Centers: Systematic Evidence Review
National Academies Expert Committee: Development of Recommendations
NIA: Next steps

NIA's own communications about dementia care/caregiving
NIA's future research initiative planning
NIA's collaborations with other federal agencies
Examples of relevant CDC HBI Road Map actions:
- E-7: Improve access to and use of evidence-informed interventions, services, and supports for people with dementia and their caregivers to enhance their health, well-being, and independence.
- P-1: Promote the use of effective interventions and best practices to protect brain health, address cognitive impairment, and help meet the needs of caregivers for people with dementia.
https://www.cdc.gov/aging/healthybrain/roadmap.htm

AHRQ offers a highly-refined systematic evidence review process that has been trusted by governmental organizations for its comprehensiveness and independence.
The NAM offers an external, independent committee that can consider:
- The EPC's findings on our current state of knowledge;
- The EPC's findings in a larger context (of ongoing research, etc.); and
- Whether observational studies, expert opinion, and other evidence considered in the review are strong enough to justify specific research priorities, even if not yet enough to justify dissemination & implementation on a broad scale.
The NAM also has well-established conflict of interest guidelines that will enable experts in the field to participate on the committee, without compromising its objectivity.

Alzheimer's plus FTD, LBD, and vascular cognitive impairment/dementia
Non-pharmacological approaches
Outcomes for individuals living with these dementias and outcomes for caregivers -- including health, quality of life, and utilization of healthcare services
Paid and unpaid caregivers
Multiple diverse settings

Input from multiple federal agencies received on:
- NAM committee expertise
- NAM committee nominations
- The EPC's preliminary topic refinement plan
Input from the public received on the topic refinement plan
All National Academies meetings have a public (open) session