AD/ADRD Health Disparities

Description

Health disparities are addressed across the entire BSR AD/ADRD research portfolio. BSR supports research on social determinants of health and individual and population sub-group variation in aging and dementia-related outcomes. Inclusion of study participants from relevant population subgroups in sufficient numbers to conduct health disparities and minority aging investigations is a BSR and NIA priority. BSR supports research on disparities in quality, access, and outcomes of dementia care and the development of dementia care and caregiver support interventions that address the unique needs of different population subgroups. Our cognitive and dementia epidemiology and behavioral and social pathways portfolios aim to understand the social, behavioral, and environmental (including structural) sources of AD/ADRD health disparities and identify causal drivers of differences between groups to inform the design of interventions to address health inequities. Early psychological and functional changes associated with dementia may manifest differently depending on social contexts and available supports; developing appropriate tools to assess changes in cognition and other functions in all population subgroups is a priority. Similarly, we support interventions for prevention of cognitive decline and dementia that include consideration of factors including, but not limited to, social determinants of health, structural racism, race/ethnicity, gender, geographic region, and socioeconomic status. BSR has used several strategies—on its own and in partnership with other divisions—to support research advances in the area of health disparities generally—and specifically in the area of AD/ADRD research—including Requests for Applications (RFAs), administrative supplements, and NIH Guide Notices signaling research priorities.

In 2018, a portfolio analysis of 10 years of BSR-supported health disparities research on topics aligned with the NIA Office of Special Populations health disparities research framework identified 200 unique BSR-supported projects, primarily focused on racial and ethnic disparities. Of these, 86 had an AD or dementia focus. The 2019 National Advisory Council Review of BSR (PDF, 433K) recommended that future research go beyond documenting health disparities and seek to identify the causal drivers of those disparities and develop approaches to ameliorate them. These analyses and recommendations are informing priorities for future research investment in health disparities AD/ADRD research in BSR, for example, by signaling a need to solicit work on priority populations in addition to race/ethnicity, such as socioeconomically disadvantaged, rural populations, those living alone, and sex and gender minority groups.

NIA as a whole is committed to supporting efforts to improve scientific workforce diversity and health disparities research programs. Visit the Scientific Workforce Diversity Programs page for information.

Related AD+ADRD Research Implementation Milestones: 1B, 1D, 2J, 4J

Active Projects as of September 2021: Disparities

Research Programs and Contacts

Health disparities research is represented across both BSR branches and almost all Program Official portfolios. Key contacts are provided below.