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A bypass budget to sustain momentum for Alzheimer's and related dementias research

Dr. Richard Hodes
Richard J. HODES,
Office of the Director (OD)

I recently had the honor of presenting, on behalf of NIH Director Dr. Francis Collins, the Fiscal Year 2019 NIH Professional Judgment Budget for Alzheimer's Disease and Related Dementias. Outlined at the July 28 meeting of the HHS Secretary's Advisory Council on Alzheimer's Research, Care, and Services. The estimate—commonly referred to as a Bypass Budget—is based on scientific opportunities that NIH could pursue to achieve the research goal of the National Plan to Address Alzheimer's Disease—to prevent and effectively treat Alzheimer's disease by 2025.

The budget calculates the funding that we would need to launch these research opportunities. For Fiscal Year 2019, we foresee that the NIH will need a total of $2 billion to sustain momentum toward reaching this national treatment and prevention goal. In FY 2017, funding for Alzheimer's and related dementias research reached an estimated $1.4 billion. The FY 2019 Professional Judgment Budget figures that $1.2 billion in additional funds will be needed relative to the FY 2018 President's budget proposal—comprising $577 million to compensate for proposed reduced funding in FY 2018 (as reflected in the President's Budget) and $597 million in additional investments.

Capitalizing on recent research investments

The recent, historic levels of support for research in Alzheimer's disease and related dementias have helped pave the way for new and actionable insights into these devastating disorders. The FY 2019 Professional Judgment Budget highlights further areas of study that could be pursued across the research spectrum, from basic science to translational to clinical research to care and services, with a focus across the board on the diversity of populations affected. These include, for example, studies aimed at:

  • Understanding the complex interaction between genes and environment as it relates to Alzheimer's risk
  • Elucidating the mechanisms by which vascular, immune, and metabolic risk factors impact brain aging and how brain aging itself impacts Alzheimer's
  • Understanding mechanisms of brain plasticity—resilience, repair, and rejuvenation—in counteracting brain degeneration in aging and dementia
  • Developing innovative trial designs for disease prevention in community-based cohort studies
  • Finding better ways to detect and predict disease progression before clinical symptoms appear
  • Exploring new digital technologies to help support caregivers and patients, in a next generation of care strategies

Developing the professional judgment budget

We pulled together this estimate by order of Congress, which in 2014 mandated that NIH prepare and share its professional judgment on the scientific opportunities before us and the funding support needed for Alzheimer's disease and related dementias research annually through FY 2025. NIA collaborated with other NIH Institutes and Centers, in particular the National Institute of Neurological Disorders and Stroke, to develop the Bypass Budget.

The FY 2019 effort marks the third such Bypass Budget prepared by NIH. As in the previous iterations, it was constructed using implementation research milestones for Alzheimer's disease and related dementias that NIH staff developed with input from the larger research community. These milestones were the result of a wide range of input, including several research summits; most recently the Alzheimer's Disease Research Summit 2015: Path to Treatment and Prevention and the Alzheimer's Disease-related Dementias 2016 Summit.

Upcoming summits will help us continue to update these milestones and plan for progress. In just a few weeks, a research summit focusing on dementia care and services will get underway. In March 2018, we look forward to the next general Alzheimer's disease research summit.

Funding opportunities to apply for now

As we offer this Bypass Budget plan for research that could be supported in the future, please remember that we have current funding opportunities on the street now. We are seeking innovative, high quality proposals in over 20 areas of interest, and I invite you to apply.

Leaning forward to eliminate dementia

I look forward to working with you on this critical goal of eliminating dementia and adding vital life to these later years. The plan we have laid out in the Bypass Budget is what we believe you can accomplish in the immediate future if given the resources. It is our best hope of a future with tested and successful prevention strategies against this scourge of later life.

I invite you to read through the Bypass Budget and research plan and consider and comment on how you may join us in the quest for a cure for Alzheimer's disease and related dementias.

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