Health Equity: Identify risk factors across diverse populations (Milestone 1.I)
Timeline Start - End2016 - 2027
Research Implementation AreaPopulation Studies and Precision Medicine
AD-Related Dementias Focus
Identify life course and multi-level mechanisms of and pathways to AD/ADRD inequities and use the discoveries to reduce these inequities.
- One longitudinal community-based cohort study of incident cognitive impairment and dementia in populations that experience heath disparities.
- Two studies on how the impact of multi-level AD/ADRD risk factors differs across diverse populations.
- At least one clinical trial to develop and implement real-world approaches, in primary care to decrease known multi-level risk factors for cognitive impairment and dementia over the life course in diverse populations.
Summary of Key Accomplishments
Recent NIH-funded research studies indicate that one of the highest impact intervention targets for population-level dementia risk, and especially for dementia risk in Black, Hispanic, and rural populations, is elevated mid-life blood pressure (see citation below). NIH continues to study risk factors for dementia and cognitive impairment in several studies, including the VCID and Stroke in a Bi-racial National Cohort (REGARDS) study, which follows more than 6000 participants aged 75+ and is ideal to provide insights about racial and geographic disparities in dementia and stroke risk as well as the Atherosclerosis Risk in Communities (ARIC), is designed to investigate the causes of atherosclerosis and its clinical outcomes including dementia, and variation in cardiovascular risk factors, medical care, and disease by race, gender, location, and date.
Citation: Levine DA, et al. Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals. JAMA Neurol. 2020 Jul 1;77(7):810-819.
The key accomplishments summary is current as of July 2022.
- PAR-15-349: Health Disparities and Alzheimer’s Disease (R01)
- PAR-15-350: Emerging Directions for Addressing Health Disparities in Alzheimer's Disease (R03)
- RFA-NS-19-012: Post-Stroke Vascular Contributions to Cognitive Impairment and Dementia (VCID) in the United States Including in Health Disparities Populations (U19)
- RFA-NS-20-013: White Matter Disease Etiology of Dementia in the U.S. Including in Health Disparities Populations
- NOT-AG-21-033: Health Disparities and Alzheimer's Disease
- NOT-NS-21-047: Administrative Supplements to Promote Diversity for NINDS Alzheimer's Disease and Alzheimer's Disease-Related Dementias (AD/ADRD) Awardees
- PAR-22-221: AD/ADRD, Adverse Childhood Experiences, and Social Determinants of Health Ancillary Studies of Existing Longitudinal Cohorts (R01 - Clinical Trial Not Allowed)
Research Programs and Resources
- VCID and Stroke in a Bi-racial National Cohort (REGARDS)
- Health Disparities and Alzheimer’s Disease (R01)
- Emerging Directions for Addressing Health Disparities in Alzheimer's Disease (R03)
- Post-Stroke Vascular Contributions to Cognitive Impairment and Dementia (VCID) in the United States Including in Health Disparities Populations (U19)
- Diverse VCID: White Matter Lesion Etiology of Dementia in Diverse Populations
- Determinants of Incident Stroke Cognitive Outcomes and Vascular Effects on Recovery (DISCOVERY)
- 24-hour Activity Cycles to Optimize Cognitive Resilience to Alzheimer's Disease in African Americans: The Jackson Heart Study
- Select projects funded in FY21
- Select projects funded in FY22
- Mind Your Risks
- 2016 ADRD Summit: Health Disparities (HD) Focus Area 1: Treatment and Prevention Strategies, Recommendation 1 (PDF, 694K)
- 2019 ADRD Summit: Health Disparities (HD) Focus Area 2: Resolve AD/ADRD Health Disparities by Discovering Culturally Appropriate Pathways to Effective Prevention and Treatments, Recommendation 2
- 2022 ADRD Summit: Health Equity (HE) in AD/ADRD, Milestone 7