?PROJECT1 ThepopulationofAmericanswithAlzheimer?sDiseaseandrelateddementia(ADRD)isexpectedtotripleby 2050.Thereisgreathopefornewtreatmentoptions,butcurrentlywearelimitedtomanagingestablished diseaseandavoidingfurthernegativeoutcomes.Whilenobreakthroughtreatmentshaveemerged,thelast20 yearshaveseenlargechangesinthediagnosisandmanagementofADRDwiththeintroductionofthefirst symptomaticdrugsandadvanceddiagnostictechnologies,suchasamyloidpositronemissiontomography (PET)scanningandcerebrospinalfluidbiomarkers.Whetherearlydiagnosisishelpfulisunknownand controversial,asevidencedbynationalguidelinesthatdisagreeonwhethertoscreenforADRD.Themixed messageslikelycontributetowidedifferencesinobservedstate-specificprevalenceofclinicallydiagnosed ADRDfromwhatwouldbeexpectedbasedonepidemiologicalestimates,rangingfrom30%belowto10% abovetheexpectedprevalence.Suchdifferencesinascertainmentofdiseasesuggestthattheprocessof gettingaclinicaldiagnosisofADRDvariesacrosshealthsystems.Usingthisvariationacrosshealthsystems andchangesovertime,weproposetogaininsightsintohowdiagnosticintensityandearlydiagnosisrelateto clinicaloutcomesofhospitalization,pharmaceuticaluse,andend-of-lifecareamongelderlypopulationsinthe U.S.WewillusenationalMedicareadministrativedatalinkedtonursinghomedata,theHealth&Retirement Studyfrom1996-2018andtheNurse?sHealthStudyfrom1995-2018.Ourunderlyinghypothesisisthatin someregions,peoplearebothmorelikelytoreceiveadiagnosisofADRDandmorelikelytobediagnosed early.Wewillusethesequasi-experimentalvariationsintheextentandtimingofdiagnosisacrossregionsand overtimetoassessthevalueofearlydiagnosisonsubsequenttreatmentsandclinicaloutcomes.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Program Projects (P01)
Project #
2P01AG019783-16
Application #
9490975
Study Section
Special Emphasis Panel (ZAG1)
Project Start
2001-09-15
Project End
2023-02-28
Budget Start
2017-12-01
Budget End
2018-11-30
Support Year
16
Fiscal Year
2018
Total Cost
Indirect Cost
Name
Dartmouth College
Department
Type
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
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