FY 2017 Program Descriptions and Accomplishments
Biology of Aging Program
The primary goal of NIA's Biology of Aging Program is to improve our understanding of the basic biological mechanisms underlying the process of aging, which is the major risk factor for many chronic diseases affecting Americans. 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 also coordinates the NIH Geroscience Interest Group (GSIG), a collaborative effort that was established in 2012 to accelerate and coordinate efforts to promote discoveries on the common risks and mechanisms behind age-related diseases and conditions. Ongoing initiatives that will remain active during FY 2017 include work to develop short-term surrogate tests that provide a comprehensive measure of resilience in animal models of aging. Greater resilience has been hypothesized to correlate with longevity and better health span, but scientists lack the appropriate methodology to test this in animal models. The program is also participating in a new trans-NIA initiative to support translational research at the individual and community levels. The highly productive Interventions Testing Program to identify compounds that extend median and/or maximal life span in a mouse model is now in its second decade and will continue, along with a similar program to identify such compounds in the context of extensive genetic heterogeneity using the worm model Caenorhabditis. The program also coordinates the Nathan Shock Centers of Excellence in the Basic Biology of Aging.
The FY 2017 President's Budget request is $183.174 million, a decrease of $0.736 million or 0.4 percent compared to the FY 2016 Enacted level.
Behavioral and Social Research Program
NIA's Behavioral and Social Research Program supports research to understand and improve the processes of aging at the individual and population levels. Research areas include: 1) the behavioral, psychological, and social changes individuals experience over the adult lifespan; 2) participation of older people in the economy, families, and communities; 3) the development of interventions to improve the health, cognition, and well-being of older adults; and 4) the societal impact of population aging, including the effects of associated changes in labor force participation and socioeconomic circumstances on health. The program also supports: 1) development of publicly available, cross-nationally comparable datasets to facilitate research on the sources of international variations in health outcomes; 2) studies that integrate biology, including genetics, with social and behavioral science to elucidate the pathways by which social, psychological, economic, and behavioral factors affect health in middle age and late life; 3) longitudinal studies measuring behavioral and social variables that are relevant to health and change over the lifespan; 4) interventions to ameliorate the impact of disadvantage and reduce health disparities at older ages; and 5) interventions to improve well-being and 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 socioeconomic circumstances of Americans over age 50. It also supports other longitudinal studies focusing on trends in late life disability (National Health and Aging Trends Study) and on the influences of behavioral, psychological, and social factors in midlife on age-related variations in health and well-being (Midlife in the United States Study). The program also coordinates the Centers on the Demography and Economics of Aging; the Edward R. Roybal Centers for Translational Research on Aging; and the Resource Centers for Minority Aging Research.
Major program activities that will be active in FY 2017 include initiatives to stimulate research on mid-life adults that can inform efforts to optimize health and well-being, prevent illness and disability in later years, and potentially reverse the negative impact of early life adversity on later life health. HRS will add respondents representing the Late Baby Boom cohort, expand collection of objective health measures, and conduct a nationally-representative study of cognitive impairment and dementia that will provide a basis for international comparisons. The program will also increase research focus on AD epidemiology, health disparities, and caregiving.
The FY 2017 President's Budget request is $209.558 million, a decrease of $0.842 million or 0.4 percent compared to the FY 2016 Enacted level.
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 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.
A current research focus, which will continue into FY 2017, is the study of how early life factors can influence health and disease as we age. The program also 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 addition, the program plans and administers clinical trials for a number of age-related conditions; for example, program-supported investigators are collaborating with PCORI on a clinical trial to test individually-tailored interventions to prevent fall-related injuries. Projects will also be active under an ongoing initiative to identify behavioral interventions with high potential impact to improve patient-level health outcomes for individuals with three or more chronic health conditions.
The FY 2017 President's Budget request is $148.060 million, a decrease of $0.595 million or 0.4 percent compared to the FY 2016 Enacted level.
Understanding, Treating, and Preventing Cognitive Decline and AD
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 normal brain aging, as well as AD and other neurodegenerative diseases of aging. These include molecular and cellular studies, animal models, genetics, drug discovery and development, diagnosis, clinical course, clinical trials for treatment and prevention of AD and other neurodegenerative diseases, as well as for maintaining or improving cognitive health, sensory and motor function, and epidemiological studies to identify risk factors and establish prevalence and incidence estimates. NIA also supports a national network of AD centers to translate research advances into improved diagnosis and care of AD patients, as well as implementing a broad array of studies aimed at improving our understanding of this disease.
Accelerating Medicines Partnership (AMP) – Alzheimer's Disease
FY 2016 Level: $17.4 million
FY 2017 Level: $14.9 million
Difference: -$2.5 million
Development of effective new medicines for complex diseases is a long, costly process, and one that fails all too often. Because targeting drugs more precisely at the molecular level may reduce the number of late-stage failures and increase the efficiency of the drug development process, the NIH collaborated with the Foundation for NIH and 10 pharmaceutical company partners to create AMP. AMP was established in 2014 with the primary goals of identification and characterization of biomarkers and targets for intervention. All AMP data will be made publicly available, and NIH and industry will share evenly in the $230 million cost over five years for the first projects: AD, type 2 diabetes, and the autoimmune disorders rheumatoid arthritis and systemic lupus erythematosus.
For AD, AMP resources are being used to incorporate an expanded set of biomarkers into three ongoing trials designed to delay or prevent disease and determine their utility in tracking disease progression and/or responsiveness to treatment. The three trials are the Dominantly Inherited Alzheimer' Network Trials Unit Trial (DIAN-TU), which will assess the safety, tolerability, and biomarker efficacy of two experimental drugs, gantenerumab and solanezumab, in people who are genetically at high risk for familial Alzheimer's; the Alzheimer's Prevention Initiative APOE4 trial, testing two anti-amyloid drugs, an active vaccine and a beta-secretase inhibitor, in cognitively normal older volunteers who are at increased risk of developing late-onset Alzheimer's; and the Anti-Amyloid Treatment in Asymptomatic AD (A4) trial to assess the efficacy of the drug solanezumab in clinically normal older people with neuroimaging biomarker evidence of brain amyloid. NIA anticipates that these trials will be complete between 2017 and 2020.
AMP resources also support large-scale systems biology analyses aimed at integrating multidimensional human "omic" data from about 2,500 brains at all stages of AD with clinical and pathological data, to discover, select, and characterize novel therapeutic targets for AD and begin building a better predictive model of the disease. These efforts are carried out by the AMP-AD Target Discovery and Preclinical Validation Consortium, a group of six multi-institutional academic teams. The teams integrate the analyses of large-scale molecular data from human brain samples with cutting-edge network modeling approaches and experimental validation in a variety of cell-based and animal models. Data from this initiative are shared rapidly and widely via the AMP-AD Knowledge Portal; the Knowledge Portal has been launched, and the first wave of data was released in March 2015.
As the lead Federal agency for research on AD, NIA leads implementation of research goals of the National Plan to Address Alzheimer's Disease. Recent initiatives have boosted support for AD research, including an additional $100 million in FY 2014 and $25 million in FY 2015 for the disease. The International Alzheimer's Disease Research Portfolio (IADRP), a publicly available database to capture the full spectrum of current AD research investments and resources throughout the world, will facilitate coordination of these efforts. Finally, NIA coordinated development of NIH's first professional judgment budget for AD. As mandated in the FY 2015 Appropriations Act, this document – which covers FY 2017 – provides an estimate of the funds above the FY 2016 President's Budget that will enable NIA to fully pursue scientific opportunities leading to a cure.
Health Disparities Research at the National Institute on Aging
FY 2016 Level: $132.8 million
FY 2017 Level: $132.8 million
Difference: $0.0 million
Disparities in nearly every indicator of health, well-being, and quality of life persist among racial, ethnic, sex, gender, disability, and socioeconomic groups in the United States. These disparities in health are often most acutely experienced by the older population since they are at the highest risk for most diseases and disability.
Efforts to address health disparities related to aging have been strengthened and energized by NIA's development of a new tool. The NIA Health Disparities Research Framework provides a landscape at multiple levels of analysis for stimulating interdisciplinary research approaches, evaluating research productivity, and identifying opportunities for innovative health disparities research related to aging. The Framework was published in the journal Ethnicity and Disease in July 2015. Also in 2015, NIA released FOAs to: 1) stimulate interdisciplinary health disparities research related to aging that considers the role that stress, stress response, and stress resilience play in differential health outcomes in priority health disparity populations; and 2) motivate studies that examine biological, behavioral, sociocultural, and biological factors that influence population-level health disparities in AD and related disorders; studies awarded under these FOAs will be active in FY 2017.
Another major NIA-supported research project is the HANDLS study, a 20-year project within the NIA IRP to examine the influences of race and socioeconomic status on the development of age-related health disparities among socioeconomically diverse African Americans and whites in Baltimore. In addition, AD centers program's Satellite Diagnostic and Treatment Centers have successfully recruited racial and ethnic minorities to prevention and treatment clinical trials, and the Health and Retirement Study used funding from the American Recovery and Reinvestment Act to increase minority participation. In 2015, NIA also awarded supplemental funding to nine ongoing grants to address issues related to health disparities and health equity.
Training and career development initiatives include the Butler-Williams Scholars Program for emerging scientists to receive in-depth training on research design and program development in aging, including issues relevant to health disparities research related to aging, as well as seven Resource Centers for Minority Aging Research, whose mission is to increase the number and diversity of researchers focused on the health of racial and ethnic minority elders. Finally, NIA's communications and outreach programs include materials tailored to health disparities populations, including Spanish-language versions of most Age Pages and a Spanish version of the NIA web site.
The FY 2017 President's Budget request is $876.235 million, a decrease of $3.557 million or 0.4 percent compared to the FY 2016 Enacted level.
Intramural Research at NIA
Investigators with NIA's Intramural Research Program (IRP) conduct research in the areas of basic, behavioral, clinical, epidemiologic, and translational research. High priority research endeavors and areas of specific focus include: 1) Molecular and Cellular Biology, including caloric restriction, cell cycle control, signal transduction, DNA damage and repair, physiology, and medicinal chemistry; 2) Neuroscience, including neurodegenerative diseases, with particular emphasis on early diagnosis, drug design and development, and neuronal cell apoptosis; 3) Genetics and Genomics, particularly genetic and epigenetic determinants of aging as an integrated part of human development; 4) Behavioral Research, including personality, cognition, and psychophysiology; 5) Clinical and Translational Research in cardiology, immunology, neurology, and endocrinology; and 6) Epidemiology, including studies of frailty, cognition, body composition, disability, and 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 AD, Parkinson's disease, stroke, atherosclerosis, and diabetes. Others, such as the groundbreaking Baltimore Longitudinal Study of Aging, explore the determinants of healthy aging and attempt to define the physiological measures of biological 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. In 2015, the NIA IRP initiated the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing (GESTALT) Study, in which investigators will assess the relationship of blood biomarkers to physiological measures that typically change with aging, including measures of body composition, hormones and inflammatory markers, and neurological function.
The FY 2017 President's Budget request is $132.932 million, an increase of $3.872 million or 2.9 percent compared to the FY 2016 level. Additional funds will be used to partially offset personnel costs and IT infrastructure improvements.
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 1,926 research project grants and centers, as well as 549 full-time training positions and 111 research and support contracts.
The FY 2017 President's Budget request is $48.287 million, an increase of $1.857 million, or 3.8 percent above the FY 2016 level. Additional funds will be used to partially offset personnel costs and IT infrastructure improvements.