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FY 2015 Director's Overview

By 2030, there will be some 72 million Americans ages 65 or older – more than double the number in that age group in 2000. The number of “oldest old” – people age 85 or older – is expected to more than triple between 2010 and 2050.1 Age is a primary risk factor for many disabling diseases and conditions, and recent demographic studies have shown a modest increase in activity limitations among members of the enormous baby boom cohort. Consequently, NIA is actively seeking to discover new and effective ways to make added years healthy and productive.

The National Institute on Aging (NIA) leads a national scientific effort to understand the nature of aging in order to promote the health and wellbeing of older adults. NIA’s mission is to support and conduct genetic, biological, clinical, behavioral, social, and economic research related to the aging process, diseases, and conditions associated with aging, and other special problems and needs of older Americans; foster the development of research and clinician-scientists for research on aging; and communicate information about aging and advances in research with the scientific community, health care providers, and the public. We carry out our mission by supporting extramural research at universities, research centers, and medical centers across the United States and around the world as well as a vibrant intramural research program at NIA laboratories in Baltimore and Bethesda, Maryland.

Because aging is the single biggest risk factor for the development of many chronic diseases, a better understanding of the basic biology of aging may open up new avenues for prevention and cures. Investment in research on the aging process at its most fundamental levels is therefore a major priority for NIA. The establishment of the trans-NIH GeroScience Interest Group (GSIG) to facilitate discovery on the common risks and mechanisms behind age-related diseases and conditions has invigorated the field of basic geroscience, as have groundbreaking recent findings such as the discovery that the protein GDF-11 can reverse aging-related cardiac hypertrophy (a dangerous thickening of the heart muscle) in mice – the first time a circulating factor has been shown to reverse age-related damage in a mammal. In October, the GSIG and several private-sector partners convened a national Summit entitled “Advances in Geroscience: Impact on Healthspan and Chronic Disease.” This meeting drew over 500 expert participants from around the world, and we expect its outcomes to further energize researchers in this field.

NIA also maintains an ongoing commitment to supporting basic behavioral and social research in aging. Ongoing initiatives that will be active in FY 2015 include social neuroscience, studies of the reversibility in later life of effects of adverse early life exposures, and studies of the effects of economic downturn on the health and well-being of older individuals. NIA remains an active participant in the trans-NIH Science of Behavior Change initiative and the Basic Behavioral and Social Science Opportunity Network. NIA has also established an initiative to uncover the causes of why the USA has lagged behind almost all other industrialized countries in health and longevity at older ages. NIA-supported research findings have proven relevant to public policy. For example, the Oregon Health Insurance Experiment capitalized on a statewide lottery from a waiting list for Medicaid to examine the effects of the program using a rigorous randomized controlled design. It showed that Medicaid coverage for uninsured low-income adults increased access to care, improved self-reported health, reduced rates of depression, and reduced bad debt and financial strain, but did not yield measurable improvements in physical health outcomes in the first two years of coverage.

Research focused on “precision medicine” – personalized, effective interventions in disease prevention, diagnosis, and treatment -- is another area of emphasis at NIA. For example, NIA is partnering with the Patient-Centered Outcomes Research Institute on a major intervention study to prevent injurious falls, a key cause of disability in older people. Ongoing studies such as Lifestyle Interventions and Independence for Elders, in which researchers are testing an intervention to preserve mobility in older people, and the ASPirin in Reducing Events in the Elderly trial to determine whether aspirin’s benefits outweigh its risks in people over 70, exemplify NIA’s commitment to reducing disease and disability in the elderly.

NIA’s comprehensive Alzheimer’s disease (AD) research program spans the spectrum of discovery, from basic neuroscience through translational research and clinical application. The National Alzheimer’s Plan, 2012 Research Summit, and allocation of additional funds from the NIH Director in 2012 and 2013 have accelerated momentum in this field. The Institute has recently awarded a number of grants to support innovative translational and clinical research on the disease (see “Program Portrait,” Page NIA-4). In addition, investigators have found that a combination of brain imaging and biomarker testing can be used to predict which cognitively normal individuals will eventually develop AD; in a separate study, investigators found that a decline in mobility may precede AD’s cognitive decline. Because treatment for the disease may be most effective before clinical symptoms are evident, the ability to identify at-risk individuals is critically important.

Our efforts in AD research have been bolstered by the advent of new technologies to generate and analyze enormous data sets. These advances in “big data” have been particularly effective in identifying risk and protective genes for AD. For example, an international group of researchers supported in part by the NIA recently collaborated to scan the DNA of over 74,000 volunteers—the largest genetic analysis ever conducted in Alzheimer’s research—and discovered 11 new genetic risk factors linked to late-onset Alzheimer’s, the most common form of the disorder. By suggesting or confirming processes that may influence Alzheimer’s disease development—such as inflammation and synaptic function—the findings point to possible targets for the development of drugs aimed directly at prevention or delaying disease progression.

Finally, NIA supports several innovative programs dedicated to the task of training the next generation of aging researchers. For example, recognizing the need to promote diversity in the research workforce, in FY 2012 NIA established the Advancing Diversity in Aging Research through Undergraduate Education (ADAR) Program, which supports creative and innovative undergraduate-level research education programs to diversify the workforce in aging. ADAR programs have been established at three universities, and we anticipate funding more such programs, based on resource availability and receipt of compelling applications.

For a comprehensive overview of NIA’s plans and priorities, see Living Long and Well in the 21st Century: Strategic Directions for Research on Aging.

1. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2012: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. 2012.