About NIA

Fiscal Year 2012 Budget

Program Descriptions and Accomplishments

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. Recent significant findings include the discovery that the drug rapamycin extends median lifespan in a mouse model and the identification of genetic pathways that regulate the maintenance of the stem cell microenvironment in aging tissues. Of note is the fact that one of NIA’s grantees in aging biology, Dr. Carol Greider, received the Nobel Prize for Physiology and Medicine in 2009 for her research focusing on the structure and function of telomeres and telomerase. Ongoing initiatives that will remain active during FY 2012 include the Interventions Testing Program to identify compounds that extend median and/or maximal life span in a mouse model; an initiative to determine cell fates in various tissues of aged mammals, under both normal and injury conditions; 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 2012 budget estimate for the Biology of Aging Program is $166.231 million, an increase of $3.298 million or 2.0 percent over the FY 2010 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 undergo throughout 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; a number of longitudinal studies; and development of interventions to maximize active life and health expectancy. The program coordinates the long-running Health and Retirement Study (HRS), the nation’s leading source of combined data on health and financial circumstances of Americans over age 50; HRS data have formed the basis for over 1700 scientific papers, and have greatly informed our understanding of the effects of early-life exposures on later-life health, variables associated with cognitive and functional decline in later life, and trends in retirement, savings, and other economic behaviors. In 2010, NIA expanded the HRS to increase minority representation and conduct genome-wide scans of a subset of participants. This program also supports 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). 

Budget Policy: The FY 2012 budget estimate for the Behavioral and Social Research Program is $185.948 million, an increase of $3.689 million or 2.0 percent over the FY 2010 level.

Program Portrait: Comparative Effectiveness Research
FY 2010 Level: $13,000,000
FY 2012 Level: $13,200,000

Comparative effectiveness research (CER) studies compare the outcomes of interventions to prevent, diagnose, or treat diseases, disorders, and other health conditions. Such studies can provide important information about the strengths and weaknesses of different medical interventions and help clinicians and patients make informed decisions about health management. 

CER is an emerging research area at NIA, and the Institute supports an evolving portfolio of research exploring CER issues relevant to aging. These issues include the challenges of analyzing the effects of specific interventions in subpopulations such as older adults; the best ways to define complex outcomes such as quality of life, as well as outcomes assessed over variable time periods; and the challenges of comparing outcomes across differently-based treatments (e.g., behavioral versus drug) and across different health system and care contexts.

In 2009, an influx of Recovery Act funding facilitated the expansion of NIA’s CER portfolio, and many projects initially funded by ARRA will continue in 2012 and beyond. For example, one study will take advantage of a unique health insurance lottery currently underway in Oregon to evaluate the effects of access to enhanced insurance on health care usage and health outcomes among low income adults. This project will powerfully leverage existing resources to allow us to explore the effects of insurance expansions among underserved individuals. The Lifestyle Interventions and Independence for Elders (LIFE) Study compares the effects of a moderate-intensity physical activity program to a health education program on prevention of mobility loss disability in older Americans; cognitive function, falls, and cardiovascular health are also under study in this trial. A third major CER study is comparing the effects of lowering systolic blood pressure to 120 vs. 140 on an array of outcomes, including cognitive health in older adults, in collaboration with the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the National Institute of Diabetes and Digestive and Kidney Diseases. Of particular interest are studies comparing the effectiveness of health management strategies in people with multiple health conditions or complex syndromes; CER among individuals who take multiple medications or who are undergoing complex treatment regimens; and studies exploring the effects of coexisting health conditions on safety and effectiveness of interventions.

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. Ongoing 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. (see Program Portrait below.) In partnership with the McKnight Brain Research Foundation, the program supported a Cognitive Aging Summit in 2010. This meeting, a follow-up to a 2007 summit, brought together experts in a variety of research fields to discuss advances in understanding brain and behavioral changes associated with normal aging, including clinical translational research for prevention of age-related cognitive decline.

Budget Policy: The FY 2012 budget estimate for the Neuroscience Program is program is $467.789 million, an increase of $9.281 million or 2.0 percent over the FY 2010 level.

Program Portrait: Alzheimer’s Disease Research
FY 2010 Level: $328,900,000
FY 2012 Level: $334,800,000

Alzheimer’s disease (AD) researchers suggest that between 2.6 million and 5.1 million Americans aged 65 years and older may have AD, with a predicted increase to 13.2 million by 20501. In April 2010, the NIH held a State of the Science Conference on Preventing Alzheimer’s Disease and Cognitive Decline in which the conference panel determined that there is insufficient scientific evidence to support use of any interventions to prevent cognitive decline or AD. 

The NIA promotes research on the causes, detection, diagnosis, prevention, and treatment of AD. NIA supports numerous investigator-initiated projects as well as targeted initiatives such as the Alzheimer’s Disease Neuroimaging Initiative (ADNI), the largest public-private partnership currently in AD research. Phase two of this initiative is underway to define changes in brain structure and function as people transition from normal cognitive aging to mild cognitive impairment (MCI – often a precursor to Alzheimer’s) to AD. Using imaging techniques and biomarker measures in blood and cerebrospinal fluid (CSF), ADNI investigators have already established a method and standard of testing levels of AD’s characteristic tau and beta-amyloid proteins in the CSF, correlated levels of these proteins with changes in cognition over time, and determined that changes in these two protein levels in the CSF may signal the onset of mild AD. In addition, the advent of genome wide association studies (GWAS) and other high throughput technologies has facilitated the identification of several new candidate risk factor genes for AD in 2009 and 2010, including CR1, CLU, PICALM and SORL1. Identification of new pathways that contribute to the development of AD will provide novel avenues for drug targeting.

NIH’s AD Translational Initiative continues to expand the range of novel compounds to be tested for possible effect on cognitive decline, MCI, and AD and to more quickly move research from the laboratory to clinical trials in humans. Over 40 compounds are currently under study as part of this effort, and several compounds for which NIH funded preclinical development have been picked up by industry partners for full-scale clinical testing. Other preclinical development projects focus on the possible application of drugs that are used to treat other diseases or conditions to treat dementia. Finally, NIH currently supports 38 clinical trials, including both pilot and large scale trials, of a wide range of interventions to prevent, slow, or treat AD and/or cognitive decline.

Geriatrics and Clinical Gerontology Program – Reducing Disease and Disability among Older People: As we age, our risk for many other 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 NCI encourages coordination of aging and cancer research) or represent a growing threat (for example, an ongoing collaboration with NIAID 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. In 2010, NIA-supported investigators identified the distinct roles that diet and exercise play in reducing health risks associated with diabetes and cardiovascular disease and contributing to overall good health and longevity; found that testosterone supplementation was associated with increased risk of cardiovascular events among older men with low testosterone levels and mobility limitations; and found that intensive pain control in hip fracture patients was associated with reduced pain, shorter hospital stay, and improved functional outcomes at 6 months.

Budget Policy: The FY 2012 budget estimate for the Geriatrics and Clinical Gerontology Program is $153.116 million, an increase of $3.037 million or 2.0 percent over the FY 2010 level.

Intramural Research: NIA’s Intramural Research Program (IRP) 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 (BLSA), 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. Recent findings from the NIA IRP include the identification of two genes with mutations known to cause rare familial forms of parkinsonism that are also associated with sporadic Parkinson’s disease; the discovery that diazoxide, a drug once used to treat high blood pressure, improves learning and memory in a mouse model of Alzheimer’s disease; and data from the BLSA suggesting that prostate cancer screening might be safely discontinued in men ages 75 and older who have prostate specific antigen (PSA) levels of less than 3 ng/ml—a cutoff point lower than that proposed in previous studies.

Budget Policy: The FY 2012 budget estimate for the NIA Intramural Research Program is $115.646 million, an increase of $1.118 million or 1.0 percent over the FY 2010 level. This request includes funds for a research biologist to support research in high priority areas.

Program Portrait: Population Aging and Global Health
FY 2010 Level: $47,900,000
FY 2012 Level: $48,800,000

Population aging is a global phenomenon. Within a decade, for the first time in history there will be more people in the world age 65 and over than under age 5. Demographers anticipate that by 2040, the proportion of people aged 65 and older will double from 7 percent to 14 percent of the total world population, with the most rapid growth seen in the developing world, one of the most far-reaching demographic, economic, and health transitions in history. How large countries such as India and China manage population aging will affect the US in many fundamental ways. NIA supports a number of projects devoted to understanding the social, economic, and health implications of population aging at the global level. 

NIA is particularly active in the area of international demographic and economic research. NIA co-supports the development of longitudinal studies similar to the ongoing Health and Retirement Study in Europe, Asia, and Latin America, and a major effort is currently underway to enhance cross-comparability of these surveys and facilitate innovative cross-national research. Investigators on these studies have identified potential causes for why the US has lagged so badly behind other high-income countries in life expectancy since 1980, and found that early retirement is associated with early decline in cognitive function. NIA also works with other agencies and organizations, including the World Health Organization and the Census Bureau, to support international demographic research projects. Most of NIA’s 14 Centers on the Demography and Economics of Aging are also involved in comparative international projects helping to better predict the future course of population aging and its impact on global health and identify best practices.

NIA-supported research on Alzheimer’s disease also has a global reach and impact. For example, although the groundbreaking Alzheimer’s Disease Neuroimaging Initiative is primarily an American effort, clinical, imaging, and biological data from ADNI are being used by scientific investigators worldwide, and tools and methods developed by the study are fueling similar efforts in Japan, the European Union, and Australia. And studies such as the Indianapolis-Ibadan (Nigeria) Dementia Project are providing insight into possible risk factors for AD.

Finally, several NIA-supported studies explore risk factors for age-related disease and disability in populations outside the U.S. Two examples are the InCHIANTI, a longitudinal study looking at risk factors for mobility disability among Italian elders, and the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES) that is seeking genetic and other risk factors for a variety of age-related diseases and conditions. Both studies are providing possible insight for future public health interventions among these and other populations.