Monday, July 21, 2014
NAPA Research Progress Report
Richard J. Hodes, M.D.
National Institute on Aging
What contributions has research made?
Resources for Enhancing Alzheimer's Caregiver Health (REACH II)
- Objective of Intervention
- Improve quality of life and reduce clinical depression in caregivers.
- Reduce the rate of institutional placement of care recipients.
- Intervention addressed
- Caregiver depression, burden, self-care and social support, and care recipient's problem behaviors.
Resources for Enhancing Alzheimer's Caregiver Health (REACH II) Study Design
- Randomized Clinical Trial
- Active treatment and control implemented in five sites: (Birmingham, Memphis, Miami, Palo Alto, and Philadelphia)
- Stratified by spouse and non-spouse caregivers
- Recruited equal numbers of African Americans, whites, and Hispanic Americans (N=200 each group)
- Veterans Health Administration in 29 sites from 24 facilities in 15 States, with a total of 127 caregiving dyads participating, and was implemented by 2 Area Agencies on Aging in Kentucky and Illinois.
- Translated in Spanish.
The JAMA Network
|From: Translation of a Dementia Caregiver Support Program in a Health Care System—REACH VA
Arch Intern Med. 2011;171(4):353-359. doi:10.1001/archinternmed.2010.548
|Figure Legend: Department of Veterans Affairs Medical Center (VAMC) Facilities Participating in REACH VA
Copyright © 2014 American Medical Association. All rights reserved.
Date of download: 7/9/2014
Translation Studies of REACH II
|Hawaii||RCI and J&J||2012|
|Nevada||RCI and J&J||2012|
|New York||RCI and J&J||2012|
|North Carolina||AoA/ADSSP||2008, 2010|
|Texas||RCI and J&J||2007, 2012|
|Administration on Aging (AoA); Alzheimer's Disease Supportive Services Program (ADSSP); Rosalynn Carter Institute for Caregiving (RCI); Johnson & Johnson (J&J)|
Alleviating Stress for Caregivers:Benefits of Adult Day Services
|Zarit, SH et al. (2013) Gerontologist Epub Jun 19.
© The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
Making Caregiving Easier:Improving Mobility for Older Individuals
- The ability to walk without assistance is critical for older people to live in a community and function well.
- The study showed that a regular, balanced and moderate exercise program followed for an average of 2.6 years reduced the risk of major mobility disability by 18 percent in an elderly, vulnerable population.
- Exercises included walking, and strength, flexibility, and balance training activities.
Pahor, M et al. (2014) JAMA 2014 May 27 [Epub ahead of print].
Making Caregiving Easier: Reducing Risks for Caregivers and Those Receiving Care
- NIA & Patient Centered Outcomes Research Institute (PCORI) Collaboration on Falls-Injury Prevention
- Falls are a common and serious problem among the elderly
- The best prevention strategy is not known
- Funds a large clinical trial on prevention of fall-related injuries in non-institutionalized older adults
- Meaningful involvement of patients and stakeholders as partners with researchers
- $30 million, 5-year study supported with funds from PCORI and led by NIA and team of investigators: “Randomized Trial of a Multifactorial Fall Injury Prevention Strategy”
- Investigators at Brigham and Women's/Harvard, Yale, and UCLA
- Award announced June 4th
- Falls are a common and serious problem among the elderly
Generating/Collating Data on Population Impact
- Findings from the newly-released “65+ in the United States: 2010” Report:
- Fewer than 1/5 of older people have enough personal resources to live in a nursing home for more than 3 years, and nearly 2/3 cannot afford 1 year
- Home and community-based services for long-term care are becoming increasingly popular; Medicaid funding for these services increased from 13% of total funding in 1990 to 43% in 2007
- NIA-funded Health and Retirement Study data suggest that a significant percentage of older Americans engage in caregiving:
- Among individuals aged 65-74, 37.8 percent provided caregiving
- Among individuals aged 75 and older, 19.2 percent provided caregiving
- An estimated value of these unpaid activities was $83.4 billion in 2002
Alzheimer's Disease Research Summit 2015
February 9-10, 2015
National Institutes of Health
U.S. Department of Health & Human Services Bethesda, MD
2015 Summit Features
- An agenda reflecting input from the Trans-NIH AD Working Group and National Advisory Council on Aging
- International involvement, including representatives from G7 countries
- Expanded international perspective in the plenaries
- A presentation from the World Health Organization on its international research plan analysis (tentative)
Updated Draft Summit Agenda Outline
- NAPA Research Milestones: Process and Progress
- Plenary Lecture(s):
- Socioeconomic Burden of AD: Update on National and International Trends
- Socioeconomic Burden of AD: Global Trends with a Focus on Developing and Under-Developed Countries
- Deconstructing the Complexity of AD
- Session I: Interdisciplinary Research to Understand the Heterogeneity and Multifactorial Etiology of AD
- Session II: Transforming AD Therapy Development: from Targets to Trials
- Session III: New Strategies for Prevention
- Session IV: Innovating disease monitoring, assessment and care
- Session V: Enabling Partnerships
- Session VI: Empowering Patients, Engaging Citizens
United Kingdom 2013
- G8 Dementia Summit Declaration and Communique
- Identify a cure, or a disease-modifying therapy, for dementia by 2025
- Significantly increase the amount spent on dementia research
- Increase the number of people involved in clinical trials and studies
- G7/8 Summit Legacy Meetings 2014-2015
- Social impact investment -- United Kingdom
- New care and prevention models -- Japan
- Academia-industry partnerships -- Canada and France
- International research coordination -- treatment, cure, and prevention -- USA
- G7/8 Legacy Wrap-Up
- Tentatively to be organized by the World Health Organization, in Geneva in March 2015
NIH Conference on Small Vessel Disease
- Two-day workshop to be held on the NIH Main Campus -- September 18-19, 2014.
- Sponsored by NINDS, in collaboration with NHLBI and other NIH ICs
- Focus will be on sharing discoveries, identifying challenges, and fostering collaboration
- Topics include: basic biology of small vessels, vascular dynamics, vessel-cellular interactions, small vessels and disease, effects of the environment, research tools and innovation
- This workshop will inform research on the basic mechanisms of and experimental models for Vascular Cognitive Impairment/Dementia, which are among the recommendations from the ADRD 2013 workshop.
International Alzheimer's Disease Research Portfolio (IADRP)
- Web-based portal developed by NIA and the Alzheimer's Association: Alzheimer's and related dementias research funded projects since 2008
- Enables funders to coordinate planning, leverage resources, avoid duplication, and identify new opportunities
- Currently includes: U.S. federal agencies, state agencies, not-for-profit organizations, foundations, and international funders from the public and private sectors
- Summer 2014: 2013 data will be available
IADRP – Current Members
- US Organizations
- US Federal Government (6 agencies)
- Alzheimer's Association
- Alzheimer's Drug Discovery Foundation
- Ellison Medical Foundation
- Cure Alzheimer's Fund
- Geoffrey Beene Foundation
- Patient-Centered Outcomes Research Institute
- State of Texas
- State of California
- State of Wisconsin
- State of Oregon
- State of Virginia
- International Organizations
- Government of Poland
- Government of Australia
- Alzheimer's Society of Canada
- Alzheimer's Research UK
- Alzheimer's Society of UK
- Alzheimer's Australia Dementia Research Foundation
- Currently in discussion with:
- UK MRC
- Brain Canada
- Other US States