FY 2020 Program Descriptions

Division of Aging Biology

Aging is a primary risk factor for many diseases and frailties. The NIA Division of Aging Biology (DAB) supports research to determine the basic biochemical and genetic mechanisms underlying the processes of aging at the cell, tissue, and organ levels and the ways these are communicated among cells and tissues of the body. DAB-supported investigators study the changes in molecular and cellular structure and function that characterize normal aging in diverse laboratory organisms, spanning the range from yeast to nonhuman primates, and where the opportunities arise, in humans. The Division also supports research on the mechanisms and interventions that increase or decrease the rate of aging, including natural variants such as progerias (diseases of premature aging) to centenarians (or their laboratory equivalents).

The Division supports the (mouse) Intervention Testing Program and the Caenorhabditis (worm) Intervention Testing Program. Both of these programs test the effectiveness and reproducibility of interventions—including foods, hormones, and pharmaceuticals—in delaying age-related disease and dysfunction and extending lifespan. To date, six compounds have shown significant extension of median lifespan in mice—and differences between males and females were noted in most of them. Both programs encourage collaborations to identify the mechanisms by which these compounds extend life and improve health. DAB-supported researchers have made important discoveries in cellular senescence, exercise, and dietary regimen that impact laboratory animals, and are translating these into practical ways of improving health in humans.

DAB also coordinates the GSIG. Under the hypothesis that slowing the rate of aging will have a beneficial impact on many health parameters, GSIG investigators focus on identifying the links and interactions between the biology of aging and the biology of diseases and age-related loss of resilience. Most NIH Institutes participate in the GSIG, and the group is also engaged in outreach to scientific societies and the pharmaceutical industry. The GSIG has held two Summits to generate scientific ideas and momentum in the field, and a third is planned for spring 2019.

DAB supports the Nathan Shock Centers of Excellence, which provide national leadership and research resources in the basic biology of aging. In collaboration with the Division of Geriatrics and Clinical Gerontology, DAB has established a program to support research to develop biological markers of aging mechanisms that influence the risk and progression of age-related diseases and conditions in humans. DAB maintains selected resources for biology of aging research. They include colonies of aging rodents, collections of cells derived from participants of human longitudinal studies of aging, individuals affected by premature aging disorders and Alzheimer's Disease patients, and tissues from rodents and non-human primates of different ages. All these programs will be active in FY 2020.

Division of Behavioral and Social Research

The NIA Division of Behavioral and Social Research (DBSR) supports research investigating the social, economic and behavioral implications of aging at both the individual and societal level. The portfolio is broad, spanning topics ranging from the genetics of age-related behavior change to sweeping demographic studies with global reach, and including such research areas as age-related changes in cognition, mood, and behavior; the implications of aging on families; the psychology of aging; financial and public policy issues that affect older Americans; and studies of aging around the world.

Notably, DBSR supports the Health and Retirement Study (HRS), the nation's leading source of combined data on health and socioeconomic circumstances of Americans over age 50. NIA researchers have used HRS data to calculate life expectancy and disability trends and to estimate the costs, both to the individual and to society, of age-related diseases and conditions. DBSR also supports other longitudinal studies focusing on trends in late life disability (National Health and Aging Trends Study) and on the influences of behavioral, psychological, and social factors in midlife on age-related variations in health and well-being (Midlife in the United States Study). The program also coordinates the Centers on the Demography and Economics of Aging; the Edward R. Roybal Centers for Translational Research on Aging; and the Resource Centers for Minority Aging Research.

In recent years, the DBSR portfolio has expanded in areas including dementia care research, especially health and long-term care services, research on support for caregivers, and epidemiology and prevention of Alzheimer's disease and related dementias (ADRD). In 2017, DBSR, along with the HHS Office of Women's Health and the Office of the Assistant Secretary for Planning and Evaluation, hosted a National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers. Recommendations were released in April 2018, and planning is currently underway for the next Care and Services Summit in 2020.

An emerging area of research in DBSR is technology development. For example, recent Funding Opportunity Announcements (FOAs) supported by DBSR, issued in collaboration with other divisions within NIA, utilize Small Business Innovative Research (SBIR) and Small Business Technology Transfer (STTR) funds to promote development of assistive technologies (including socially-assistive robotics) to develop new devices to aid individuals with ADRD. Such devices, if successful, would provide another layer of care for these individuals, and would provide respite and support for the often-overburdened caregivers of people with ADRD.

Division of Geriatrics and Clinical Gerontology

As we age, our risk for many types of disease and/or disability increases dramatically. NIA's Division of Geriatrics and Clinical Gerontology (DGCG) supports clinical and translational research on health and disease in the aging population. DGCG's areas of interest include translational research for the development of new interventions for age-related conditions, prevention and treatment of multiple chronic conditions in the elderly, and studies that help to promote evidenced-based geriatric care and inform policies affecting older adults.

DGCG supports clinical trials of interventions for a variety of age-related diseases and conditions. For example, DGCG-supported investigators with the multi-national ASPirin in Reducing Events in the Elderly trial recently reported that in healthy older adults without previous cardiovascular events, daily low-dose aspirin did not prolong healthy, independent living. While these findings do not apply to people under age 65 or those with an established indication for aspirin (e.g., prior stroke, heart attack, or other cardiovascular disease), they do provide important information for clinicians caring for older patients. DGCG is also partnering with the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke on a "pragmatic trial"—a large-scale study conducted in "real-world" offices and clinics among typical patients—to assess the risks and benefits of statins in adults 75 years of age and older without clinical cardiovascular disease. This exciting study will be newly underway in FY 2019.

DGCG also represents NIA in the trans-NIH Health Care Systems Research Collaboratory, a new infrastructure for collaborative research with health care systems. The Collaboratory supports the design and execution of a number of demonstration projects that address questions of major public health importance. For example, one project is implementing palliative care education for providers in hospital emergency departments, where increasing numbers of older adults with multiple medical conditions may be seen. Another is training oncologists to guide older patients with advanced cancer in the creation of advance care plans, which document the patient's wishes with respect to medical care when he or she is no longer able to make those wishes known. With ongoing support from the Patient-Centered Outcomes Research Institute, DGCG is also funding a trial to test the effectiveness in real-world care settings of a multifactorial fall injury prevention strategy that has been found effective in more tightly controlled settings.

DGCG also supports research on multifactorial geriatric syndromes such as falls, frailty, and various types of disability; determinants of rates of progression of age-related changes that affect disease risk; and complications of multiple ailments. Other funded research includes the development of new interventions for age-related conditions, prevention, and treatment of multiple chronic conditions in the aged. Recent DGCG Funding Opportunity Announcements have solicited applications on palliative care, aging in older persons with HIV/AIDS, and possible effects of the commonly-prescribed diabetes drug metformin on the aging process. Other FOAs are soliciting research illuminating the ways that physiological changes early in life can influence health and illness in older age. Studies under these FOAs will be active in FY 2020.

DGCG also coordinates the Claude D. Pepper Older Americans Independence Centers Program, which supports research to identify effective methods to maintain or restore independence in older adults. Funding for this important program was renewed in FY 2018, and the Centers will be active in FY 2020.

Division of Neuroscience (DN)

The Division of Neuroscience (DN) at NIA supports basic, clinical, and epidemiologic research and training to further our understanding of both normal and pathological age-related changes to the nervous system and the influence of these changes on cognition and behavior.

A primary focus is research on AD/ADRD. The Division supports studies to understand AD/ADRD's molecular, cellular, and genetic underpinnings; biomarker discovery and validation; epidemiological studies to establish prevalence and incidence estimates and identify risk factors; and drug discovery, development, and testing. Recently, DN experts and grantees teamed with the Alzheimer's Association to develop a new framework for developing a biologically based definition of Alzheimer's disease. This proposed "biological construct" is based on measurable changes in the human brain and is expected to facilitate better understanding of the disease process and the sequence of events that lead to cognitive impairment and dementia. With this construct, researchers can study the disease from its earliest biological underpinnings to memory loss and other clinical symptoms, which could result in a more precise and faster approach to testing drug and other interventions.

NIA also supports a new Alzheimer's Clinical Trial Consortium (ACTC). The ACTC experts and infrastructure will support the design and conduct of trials across the full spectrum of AD/ADRD, from prevention initiatives to combination trials for advanced symptomatic stages. Innovative trial design, participant recruitment and retention, data analysis and support, and centralized tissue banking are all within the purview of the ACTC. The consortium consists of 35 sites in 24 states and the District of Columbia; additional sites may be added.

NIA supports a national network of 30 AD centers that work to translate research discoveries into AD diagnostics and treatment interventions, as well as executing a wide range of studies to enhance understanding of AD. Current funding opportunity announcements in AD and related dementias aim to investigate the impact of health disparities in AD, develop new care methods and treatments, and understand the spectrum of symptoms in AD and related dementias as a measure for diagnosis. Projects funded under these FOAs will be active in FY 2020. In addition, a new NIA-supported study, the Longitudinal Early-Onset Alzheimer's Disease Study, will provide important insight into the less common early-onset form of the disease. This study began in 2018 and will continue through FY 2020.

In addition to studies of Alzheimer's disease and related dementias, DN supports basic and clinical research aimed at maintaining or improving cognitive health, sleep, and sensory and motor function with age. Ongoing research includes studies of possible associations between disrupted sleep and cognitive decline and AD in older age; studies of sleep disorders in older Americans; and studies exploring alterations in blood flow in the brain as a possible contributor to gait dysfunction and falls. For example, recognizing that hearing loss is not only a common condition among older adults but that it is also connected to a higher risk of dementia, NIA recently funded the Aging, Cognition, and Hearing Evaluation in Elders clinical trial. The study aims to examine the potential of hearing rehabilitation to reduce rates of cognitive decline and will be active in FY 2020.

Intramural Research Program (IRP)

The NIA Intramural Research Program (IRP) supports wide-ranging basic, behavioral, clinical, epidemiologic, and translational research with the goal of understanding the physiological changes and adaptability of the human body in response to age and stress. Knowledge about the biology of aging and chronic disease is necessary to develop new effective interventions that reduce the burden of disease and disability in the older population, and IRP investigators use this understanding to clarify the pathophysiology of age-related diseases and create new therapeutics and interventions for these conditions. While IRP's ten laboratories each focuses on specific areas of research, they share the common goal of expanding our knowledge of the aging process and age-related disease and collaborate in these efforts.

IRP investigators conduct research in three main focus areas: aging biology, neuroscience, and translational gerontology. Specific areas of interest include 1) epidemiologic research, such as investigations into neurologic and blood biomarkers, population diversity, health disparities, body composition, cognition, frailty, and disabilities; 2) behavioral research including studies on neuropsychology, cognition, and personality; 3) genetics and genomics, including genetic and epigenetic causes of aging and transcriptional regulation; 4) clinical and translational research in drug development, treatment efficacy, and treatment toxicity as well as immunology, cardiology, neurology, and other topics; and 5) neuroscience and neurogenetics, with a focus on declining cognition due to age-related physiologic and molecular changes and genetic determinants. Age-associated diseases that are priority areas of research include AD, Parkinson's disease, diabetes, cardiovascular diseases, stroke, osteoporosis and osteoarthritis, autoimmune diseases such as multiple sclerosis and lupus, and cancers.

IRP's longitudinal cohort studies have contributed greatly to aging research. Prominent studies include the trailblazing Baltimore Longitudinal Study of Aging, which looks at the determinants and measures of healthy biological aging over time and is the nation's longest running scientific study of human aging; the Healthy Aging in Neighborhoods of Diversity across the Life Span study, which looks at the impact of racial and socioeconomic diversity on health disparities and healthy aging; and the Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing study, which is aimed at discovering biomarkers and their connections to aging.

IRP also supports training programs for students and recent graduates that give young scientists the opportunity to learn skills in basic and clinical aging research in the biomedical and behavioral sciences. This may help combat the nation's unmet need for aging and geriatric researchers and clinician-scientists.

Research Management and Support

NIA Research Management Support (RMS) activities provide administrative, budgetary, logistical, and scientific support in the review, award, and monitoring of research grants, training awards and research and development contracts. RMS functions also encompass strategic planning, coordination, and evaluation of the Institute's programs, regulatory compliance, international coordination, and liaison with other Federal agencies, Congress, and the public. In FY 2018, the Institute monitored 2,909 research grants as well as 601 full-time training positions and 56 research and support contracts.