Biology of Aging Program: Understanding Aging Processes, Health, and Longevity
Investigators supported by NIA’s Biology of Aging Program seek to improve our understanding of the basic biological mechanisms underlying the process of aging and age-related diseases. Basic biochemical, genetic, and physiological studies are carried out primarily in animal models, including both mammals and non-mammalian organisms (e.g., flies, worms, yeast). The program’s goal is to provide the biological basis for interventions in the process of aging, which is the major risk factor for many chronic diseases affecting the American population. Initiatives that will remain active during FY 2013 include the Interventions Testing Program to identify compounds that extend median and/or maximal life span in a mouse model; an initiative to explore the basic biology of aging from a systems perspective – i.e., by investigating the complex interactions at the single-cell level among individual gene products, biochemical pathways and cell biological mechanisms that impact aging, as well as interactions between tissues; and studies to identify neural, neuroendocrine, and other mechanisms that influence age-related changes in bone metabolism and health. The program also coordinates the Nathan Shock Centers of Excellence in the Basic Biology of Aging.
Budget Policy: The FY 2013 President’s Budget request is $176.251 million, an increase of $0.097 million, over the FY 2012 Enacted level.
Behavioral and Social Research Program: Understanding and Addressing the Behavioral, Emotional, and Social Dynamics of Aging
NIA’s Behavioral and Social Research Program supports social and behavioral research to increase our understanding of the processes of aging at the individual, institutional, and societal levels. Research areas include the behavioral, psychological, and social changes individuals experience over the adult lifespan; participation of older people in the economy, families, and communities; the development of interventions to improve the health and cognition of older adults, and the societal impact of population aging and of trends in labor force participation, including fiscal effects on the Medicare and Social Security programs. The program also supports research training; development of research resources such as publicly available, cross-nationally comparable studies that support research to understand the sources of international variations in health outcomes; interdisciplinary studies that integrate biological and genetic measures with traditional social, behavioral and economic measures; longitudinal studies; and interventions to maximize active life and health expectancy. The program coordinates the long-running Health and Retirement Study, the nation’s leading source of combined data on health and financial circumstances of Americans over age 50; the Centers on the Demography and Economics of Aging; the Roybal Centers for Translational Research on Aging; and the Resource Centers for Minority Aging Research (RCMARs). A major program activity for FY 2013 will be the coordination of a broad trans-NIH initiative to improve our understanding of the basic mechanisms of behavior change by bridging work in the laboratory and the field.
Budget Policy: The FY 2013 President’s Budget request is $195.167 million, an increase of $0.107 million, over the FY 2012 Enacted level.
Neuroscience Program: Understanding, Preventing, and Treating Cognitive Decline and Disability
NIA’s Neuroscience Program supports a broad spectrum of research and training aimed at better understanding age-related normal and pathological changes in the structure and function of the aging nervous system and how such changes affect behavior. The program’s basic mission is to expand knowledge on the aging nervous system to allow improvement in the quality of life of older people. Activities include basic and clinical studies of the nervous system, clinical trials of treatments and preventive interventions for neurological disease, and epidemiological research to identify risk factors and to establish prevalence and incidence estimates of pathologic conditions. Additionally, this program supports research relevant to problems arising from psychiatric and neurological disorders associated with aging. NIA is also the lead federal agency for research on Alzheimer’s disease (AD). The Institute supports a national network of Alzheimer’s Disease Centers to translate research advances into improved diagnosis and care of AD patients while pursing development of effective preventive and treatment interventions for AD, as well as a broad array of initiatives aimed at improving our understanding of this disease.
Budget Policy: The FY 2013 President’s Budget request is $438.751 million, an increase of $0.244 million, over the FY 2012 Enacted level.
Program Portrait: Prevention and Treatment of Alzheimer’s Disease
FY 2012 Level: $271.4 million
Millions of Americans currently have Alzheimer’s disease, and millions more are at risk. Unfortunately, the only agent shown to delay clinical diagnosis of AD in people with mild cognitive impairment (donepezil [Aricept®]) appears to forestall the transition from MCI to full-blown AD for only a brief period of time, and the few agents that have been approved by the Food and Drug Administration for treatment of AD have demonstrated only modest effects in modifying the clinical symptoms for relatively short periods. However, a number of promising findings are now emerging to provide directions for potential interventions, and the NIA is at the forefront of efforts to prevent and treat AD.
The development of new drugs is a primary focus of our efforts, particularly through our AD Translational and Drug Discovery Initiative, which supports the development of investigational agents from basic discovery through early clinical trials. Over 40 projects are currently funded through this program, including a number of pilot clinical trials. In a recent, highly promising pilot trial, a nasal-spray form of insulin delayed memory loss and preserved cognition in people with cognitive deficits ranging from MCI to moderate AD. A larger-scale study to confirm and extend these results was developed and is under consideration, and the Translational and Drug Discovery Initiative will be active in FY 2013.
The cornerstone of the NIA’s AD clinical trials effort is the Alzheimer’s Disease Cooperative Study (ADCS). Since its establishment in 1991, the ADCS has initiated 30 research studies (23 drug trials and 7 instrument development protocols). There are currently 35 ADCS member sites and over 50 affiliated sites around the nation. Ongoing studies include a phase III clinical trial of intravenous immunoglobulin (IVIg) for the treatment of mild to moderate AD. IVIg is a type of immune therapy that carries antibodies against beta amyloid, the accumulation of which leads to the formation of the AD characteristic amyloid plaques. Research has shown that people who receive IVIg treatment for other conditions (e.g., immune deficiency and autoimmune disease) may also have a reduced risk of developing AD later in life. The IVIg study will be completed in FY 2013.
Alzheimer's research at NIH crosses both budget activity details and mechanisms as part of our efforts to identify preventive/treatment interventions.
Geriatrics and Clinical Gerontology Program: Reducing Disease and Disability among Older People
As we age, our risk for many types of disease and/or disability increases dramatically. NIA’s Geriatrics and Clinical Gerontology Program supports research on health, disease, and disability in the aged (other than neurodegeneration, which is the focus of the NIA’s Neuroscience Program). Areas of focus include age-related physical changes and their relationship to health outcomes, the maintenance of health and the development of disease, and specific age-related risk factors for disease. Program staff work closely with other NIH Institutes to coordinate research on diseases and conditions that are common among older people (for example, a long-term partnership with National Cancer Institute encourages coordination of aging and cancer research) or represent a growing threat (for example, an ongoing collaboration with National Institute of Allergy and Infectious Diseases addresses the increasing incidence of HIV/AIDS among older Americans). The program also plans and administers clinical trials for a number of age-related conditions. In addition, the program coordinates the Claude D. Pepper Older Americans Independence Centers Program, the goal of which is to increase scientific knowledge leading to better ways to maintain or restore independence in older persons.
Budget Policy: The FY 2013 President’s Budget request is $134.504 million, an increase of $0.074 million, over the FY 2012 Enacted level.
Program Portrait: Understanding Menopause and Treating Its Symptoms
FY 2012 Level: $27.1 million
As recently as 20 years ago, scientists knew little about how women navigate the menopausal transition. In 1994, the Study of Women’s Health Across the Nation (SWAN), the first major longitudinal study of the biological, behavioral, and psychosocial changes that occur in women as they transition from pre- to postmenopause, was established. Supported by the NIA, the National Institute of Nursing Research, and the NIH Office of Research on Women’s Health, SWAN has provided a wealth of information about how women age in America. As the original participants reach their postmenopausal years, SWAN is transitioning to a study of aging in women that will advance our understanding of how modifiable risk factors related to the menopause transition are linked to health outcomes later in life. This may lead to improved strategies for preventing disease and maintaining robust health in older women. SWAN will be active in FY 2013.
NIA also supports studies of interventions for menopausal symptoms such as hot flashes. Menopausal hormone therapy (MHT) was once the mainstay of such treatment. However, after landmark results from the NIH-supported Women’s Health Initiative demonstrated that certain forms of MHT were associated with dangerous long-term side effects, researchers began to seek alternative interventions. The MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) network was created to conduct clinical trials aimed at finding new, safe, effective treatment options for women experiencing menopausal symptoms. Recently, MsFLASH investigators found that the antidepressant escitalopram (Lexapro) significantly reduced hot flashes in perimenopausal women. MsFLASH will be active into FY 2013.
Program Portrait: The LIFE Study: Can Physical Activity Prevent Mobility Disability in At-Risk Elders?
FY 2012 Level: $11.0 million
The ability to move without assistance is a vital component of independence. Older people who retain their mobility are more likely than their less active counterparts to remain in their communities; have lower rates of illness and hospitalization; and experience a higher quality of life. Studies have shown that regular physical activity can improve physical performance in older people, but there is no definitive evidence that physical activity can prevent mobility disability.
The NIA-supported Lifestyle Interventions and Independence for Elders (LIFE) Study was designed to provide such evidence. The LIFE Study is a Phase 3, multicenter randomized controlled trial to compare the effects of structured physical activity program to a successful aging health education program in 1,600 sedentary older individuals. The primary study outcome is major mobility disability, defined as inability to walk 400 meters in 15 minutes, but the investigators are also assessing the intervention’s effects on cognition, falls, overall mortality and an array of other functional outcomes of importance to older individuals. The intervention’s cost effectiveness will also be established.
Results of a pilot study (LIFE-P) completed in 2005 suggested that a structured physical activity program could improve physical performance in sedentary older people, and that some of benefits of the intervention could be sustained for up to two years after the intervention ended. The current study, which will confirm and expand the LIFE-P findings, was initially supported through American Recovery and Reinvestment Act funds and is now funded through NIA’s annual appropriation. Recruitment is ahead of schedule, and we anticipate completing the study in 2015.
LIFE is one of a number of ongoing studies to evaluate more precisely the effects of exercise or physical activity programs on physical and cognitive health in older people. Recognizing the value of exercise, the NIA has recently unveiled its nationwide Go4Life campaign, which is designed to motivate older Americans to become physically active for the first time, return to exercise after a break in their routines, or build more exercise and physical activity into weekly routines. The campaign can be found at: www.nia.nih.gov/Go4Life.
Intramural Research (IRP)
NIA’s Intramural Research Program conducts research in the areas of basic, behavioral, clinical, epidemiologic and translational research. High priority research endeavors and areas of specific focus include: Molecular and Cellular Biology, including caloric restriction, cell cycle control, signal transduction, DNA damage and repair, physiology, and medicinal chemistry; Neuroscience, including neurodegenerative diseases, drug design and development, and neuronal cell apoptosis; Genetics, particularly genetic determinants of aging as an integrated part of human development; Behavioral Research, including personality, cognition, and psychophysiology; Clinical and Translational Research in the disciplines of cardiology, oncology, immunology, neurology, and endocrinology; and Epidemiology, including studies of frailty, cognition, body composition, disability, molecular biomarkers of aging. The clinical research effort focuses on the translation of basic research findings, prevention and therapeutic clinical trials focused on age-associated diseases, modulation of treatment efficacy and toxicity in older patients, and establishment of and maintenance of diverse longitudinal cohorts for aging research. Many studies focus on common age-related diseases such as Alzheimer’s disease, Parkinson’s disease, stroke, atherosclerosis, and diabetes. Others, such as the groundbreaking Baltimore Longitudinal Study of Aging, explore the determinants of healthy aging. Work is also continuing on the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study, which is examining the influences of race and socioeconomic status on the development of age-related health disparities among socioeconomically diverse African Americans and whites living in Baltimore.
Budget Policy: The FY 2013 President’s Budget request is $115.525 million, the same as the FY 2012 Enacted level.
Research Management and Support (RMS)
NIA RMS activities provide administrative, budgetary, logistical, and scientific support in the review, award, and monitoring of research grants, training awards and research and development contracts. RMS functions also encompass strategic planning, coordination, and evaluation of the Institute’s programs, regulatory compliance, international coordination, and liaison with other Federal agencies, Congress, and the public. The Institute currently oversees more than 1,300 research project grants and centers, as well as 556 full-time training positions and 100 research and support contracts.
Budget Policy: The FY 2013 President’s Budget request is $42.452 million, the same as the FY 2012 Enacted level.
The NIA participates in the support of the following initiatives funded through the NIH Common Fund:
- Interdisciplinary Research Consortium
- Using Metabolomics to Investigate Biological Pathways and Networks
- Supplements for Methodological Innovations – Behavioral and Social Science