FY 2018 Director's Overview
The mission of the National Institute on Aging (NIA) 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. NIA is also the lead federal agency for research on Alzheimer's Disease (AD). We carry out our mission by supporting research at universities, research centers, and medical centers across the United States as well as a vibrant intramural research program at laboratories in Baltimore and Bethesda, Maryland.
Now more than ever, NIA's work is relevant. The number of Americans aged 65 and older is growing at an unprecedented rate, and by 2030 there will be some 74 million Americans in this age group – more than double the number from 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 it is therefore important that we discover new and effective ways to make added years healthy and productive.
Although studies have shown that the prevalence of dementia has been decreasing in recent decades, the population of elderly persons is increasing at such a rate that the overall number of affected individuals will continue to increase – an estimated 5.5 million Americans will be affected in 2018.2 NIA's comprehensive research program on AD and related dementias spans the spectrum of discovery, from basic neuroscience through translational research and clinical application. The National Plan to Address Alzheimer's Disease, the 2012 and 2015 AD Research Summits, the 2016 Summit on Alzheimer's-Related Dementias, and allocation of additional funds over the past several years have accelerated momentum in this field. A third AD Summit and separate AD Care and Services Summit are planned for FY 2018.
In early FY 2017, NIA released 26 new Funding Opportunity Announcements (FOAs) incorporating themes and recommendations from the Research Summits. The topics of these solicitations fall into five broad categories: leveraging existing resources to facilitate discovery and speed progress; enhancing caregiving and clinical care; rapid translation of new research from the laboratory to the clinic; basic research on AD and related dementias; and training for researchers in key scientific disciplines. Awards made under these FOAs in FY 2017 will be active through 2018.
Our efforts in AD research have been bolstered by the advent of new technologies to generate and analyze enormous data sets. For example, the opening of the AMP-AD Knowledge Portal – a data sharing and analysis resource developed under the Accelerating Medicines Partnership – and release of the first wave of data will enable sharing and analyses of large and complex biomedical datasets. Another exciting new initiative is the M2OVE-AD Consortium, a partnership between NIA and the National Institute of Neurological Disorders and Stroke to dissect the complex molecular mechanisms by which vascular risk factors influence AD and identify new targets for treatment and prevention. This initiative will build on and expand the AMP-AD Knowledge Portal to enable rapid and broad sharing of data and analytical results. Recent research advances in fields such as genetics and brain imaging now permit identification of individuals at high risk for disease years or decades before onset of symptoms. These advances have allowed the planning and initiation of clinical trials before severe and potentially irreversible changes have occurred in the brain, offering new basis for optimism in altering the course of AD and related disorders.
Beyond Alzheimer's and related dementias, NIA supports research on prevention and treatment of a broad range of age-related diseases and conditions. In FY 2016, NIA supported approximately 200 clinical trials, including studies of both drug and non-drug interventions to help older people maintain physical function; trials of non-hormonal treatments for menopausal symptoms; and studies of treatments for heart disease, kidney disease, and arthritis. In partnership with the Patient-Centered Outcomes Research Institute, NIA is continuing its support of a ground-breaking, five-year randomized trial of a multifactorial fall injury prevention strategy. In addition, NIA currently supports an initiative to develop behavioral interventions to modify health behaviors and improve health outcomes in older patients with three or more chronic health conditions – a common situation among older Americans.
Recognizing that up to half of premature deaths in the United States are due to behavioral and social factors,3 NIA also maintains an ongoing commitment to supporting behavioral and social research in aging. The NIA-supported Health and Retirement Study remains the world's premier multidisciplinary source of data on the health and well-being of older Americans, linking objective and subjective measures of health with information about retirement, economic status, family structure, personality, as well as health behaviors and service utilization. NIA also participates in trans-NIH initiatives to understand the connection between education and health; identify factors that contribute to physical, cognitive, and emotional resilience across the life span; and encourage adoption of new and emerging evidence-based preventive, diagnostic, and treatment interventions into clinical practice and community settings.
An understanding of aging processes at their most fundamental level is a necessary foundation for discovery of new preventive interventions and cures, and investment in research on the basic biology of aging remains 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. In 2016, a second Geroscience Summit focused on how chronic illness can accelerate the onset of age-related changes at the cellular and molecular levels, and we anticipate that recommendations from this groundbreaking meeting will continue to energize researchers. A recently-established initiative on changes in cellular architecture that occur with aging will also continue in FY 2018.
Finally, NIA takes seriously its responsibility to steward carefully its resources in the interest of the American people. The Institute supports several innovative programs dedicated to training the next generation of aging researchers. These include the Paul Beeson Career Development Awards in Aging Research for outstanding clinician-scientists and the Butler-Williams Scholars Program, a "boot camp" to prepare emerging investigators in aging research to compete successfully for grant funding. NIA also employs an in-depth process each year to update and refine plans and priorities based on advances in biomedical science. Our Strategic Directions communicate our scientific priorities.4
Overall Budget Policy:
The FY 2018 President's Budget request is $1,303.541 million which is $745.069 million below the FY 2017 Annualized CR Level. These reductions are distributed across all programmatic areas and basic, epidemiology, or clinical research.
1. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2016: Key Indicators of Well-Being. Federal Interagency Forum on Aging-Related Statistics. Washington, DC: U.S. Government Printing Office. 2016. http://www.agingstats.gov.
2. Hebert LE et al. Alzheimer Disease in the United States (2010-2050) Estimated Using the 2010 Census. Neurology 80: 1778-1783, 2013. See Table 1.
3. Schroeder SA. Shattuck Lecture: We Can Do Better – Improving the Health of the American People. New Engl J Med 357: 1221-1228, 2007.