FY 2019 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 relevent. 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.

While prevalence of dementia has fallen significantly in recent decades, ² Alzheimer's disease (AD) remains a grave public health crisis, with 5.3 million Americans currently affected. ³ NIA's research program on AD and related dementias (ADRD) spans the spectrum of discovery, from basic neuroscience through translational research and clinical application. The National Plan to Address Alzheimer's Disease, 2012 and 2015 AD Research Summits, 2016 Summit on ADRD, 2013 meeting on Alzheimer's and Down syndrome, 2017 AD Care and Services Summit, and the appropriation of additional funds over the past several years have accelerated research momentum. The next AD and ADRD Summits are planned for 2018 and 2019, respectively.

NIA has successfully leveraged partnerships with many other research entities in addressing the complex challenges AD poses. For example, the AMP AD Knowledge Portal – a data sharing and analysis resource developed under the Accelerating Medicines Partnership, itself an innovative collaboration between public, private, and nonprofit sectors – and release of the first wave of data will enable sharing and analyses of large and complex biomedical datasets. The NIA and the Eunice Kennedy Shriver National Institute on Child Health and Human Development have recently launched a new initiative, the NIH Alzheimer's Biomarker Consortium-Down Syndrome, to identify biomarkers and track the progression of Alzheimer's in people with Down syndrome, using brain imaging and fluid and tissue biomarkers to help understand the progression of the disease. Now in its 13th year, the public/private Alzheimer's disease Neuroimaging Initiative (ADNI) continues to break new ground in the identification and validation of new biomarkers. And the Alzheimer's Prevention Initiative, an international consortium of researchers, works together to identify pre-symptomatic treatments or interventions that will postpone, slow, or prevent progression of AD.

An understanding of aging processes at their most fundamental level is a necessary foundation for discovery of new preventive interventions and cures; investment in research on the basic biology of aging is 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 FY 2019, projects will be active under the new Samuel Waxman Cancer Research Foundation Research Collaborations in Aging and Cancer Initiative, which will leverage the efforts of both intramural and extramural investigators with the NIA and the National Cancer Institute to gain a clearer understanding of how aging – in itself a major risk factor – affects the trajectory of cancer.

Clinical research at NIA covers a broad range of age-related diseases and conditions. For example, data from the National Institute on Deafness and Other Communication Disorders indicate that 8.5 percent of adults aged 55 to 64, nearly 25 percent of those aged 65 to 74, and 50 percent of those who are 75 and older have disabling hearing loss. NIA-supported investigators have identified a clear association of hearing impairment with frailty and falls among adults ages 70-79, and epidemiological data suggest a possible link between age-related hearing loss and cognitive decline/impairment. NIA is now supporting the Aging, Cognition, and Hearing Evaluation in Elders (ACHIEVE) trial, which will compare the effectiveness of hearing aids vs. a control intervention on rates of cognitive decline, as well as physical and social functioning, health-related quality of life, and physical activity. Research will also be active in FY 2019 on a new initiative to identify the neural changes that may contribute to age-related hearing loss.

NIA also maintains an ongoing commitment to supporting basic behavioral and social research in aging. For example, the health benefits of exercise and physical activity are an active area of study. The NIA-supported Baltimore Longitudinal Study of Aging has shown that people who have better aerobic fitness in middle age may ward off decreases in brain volume later in life, potentially preserving memory and other functions, and NIA-supported investigators have found that moderate physical activity can improve brain glucose metabolism as well as the function of the dopamine system, which has an important role in cognitive control and reward processing.

In addition, 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, and health behaviors and service use. It will continue in FY 2019.

NIA remains committed to the establishment and support of a diverse and talented biomedical research workforce. For more on these efforts, see the Program Portrait below.

Finally, NIA takes seriously its responsibility to carefully steward its resources in the interest of the American people, and 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