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National Institute on AgingAging in Alaska Regional Meeting
J Taylor Harden, PhD, RN, FAANAssistant to the Director for Special
Populations NIA/NIH/DHHS
Programs and Priorities:Advances in Aging Research
NIA Organization Chart
Office of the Director
Richard J. Hodes, M.D.(301) 496-9265
Office of theDeputy Director
Judith Salerno,M.D.(301) 496-0216
Planning, Analysis,Evaluation, Legislation,
International,Special Populations
(301) 496-0765
Public Information OfficeChief
Jane Shure(301)496-1752
Office of AdministrativeManagement
Executive OfficerColleen Barros(301) 496-5345
GeriatricsClinical GerontologyAssociate Director
Evan C. Hadley, M.D.(301) 496-6761
Biology of Aging
ProgramAssociate Director
Huber Warner, Ph.D.(301) 496-4996
Behavioral and Social Research
ProgramAssociate Director
Richard Suzman, Ph.D.(301) 496-3136
Intramural ResearchProgram/Gerontology
Research CenterDan Longo, M.D.(410) 558-8110
Neuroscience and Neuropsychologyof Aging ProgramAssociate Director
M. Morrison-Bogorad, Ph.D.(301) 496-9350
Office of ExtramuralAffairs
Associate DirectorMiriam F. Kelty, Ph.D.
(301) 496-9322
National Institute on AgingTrends in AppropriationsFiscal Years 1994 - 2003
0
200
400
600
800
1,000
Fiscal Year
Mill
ions
$ Millions 420.3 433.3 453.5 484.3 517.1 594.6 685.7 785.4 891.3 993.694 95 96 97 98 99 2000 2001 2002 2003
3%increase
5%increase
7%increase
7%increase
15%increase
15%increase
15%increase
14%increase
12%increase
Note: Reflects FY 2003 Appropriation post rescission. 4/10/03
National Institute on Aging
500550600650700750800850900950
1000
FY 2002 Actual FY 2003 Appropriation
11.6% increase
Mill
ions
Note: Reflects FY 2003 Appropriation post rescission. 4/10/03
$891 M
$994 M
National Institute on AgingDistribution of Appropriations by
Budget Category: Fiscal Year 2003
Training2.3%
SBIR/STTR2.3%
Centers8.4% Research
Project Grants 64.5%
Intramural9.7%
Contracts6.2%
Other3.3%
RM&S3.3%
Total NIA: $993,598,000 FY 2003 appropriations post rescission NIA Budget May 2003
Older Population by Age1990 – 2050
0102030405060708090
1990 2000 2010 2020 2030 2040 2050
85+64-85
Num
ber i
n m
illio
ns
U.S. Bureau of Census middle series projections, Jan. 2000
Areas of Emphasis in Aging Research
• Behavioral and social research• Biology of aging• Neuroscience of aging• Geriatrics and clinical gerontology
Behavioral and Social Research
• Health Disparities• Aging and Cognition• Trends in Health Status• Health, Work, and Retirement • Interventions and Behavior Change• Genetics, Behavior & the Social
Environment• Efficiency of Health Systems
Dr. Richard Suzman (301) 496-3136
Health, Wealth and Income
050
100150200250300350400
Excellent Very good Good Fair Poor
WealthIncome
Self Reported Health
Wea
lth a
nd In
com
e(d
olla
rs in
thou
sand
s)
Source: Smith 1994. HRS Wave 1.
NIA Funded Longitudinal Surveys
• Panel Study of Income Dynamics• National Long Term Care Study• Longitudinal Study on Aging• Health and Retirement Study• Wisconsin Longitudinal Study• Seattle Longitudinal Study• Indonesian Family Life Study• English Longitudinal Study on Aging• Victoria Longitudinal Study
Number of Chronically Disabled Americans Age 65 and Over
(In Millions)
6.4 7.0 7.1
7.5
8.3
1982 1984 1986 1988 1990 1992 1994 1996 19984.00
6.00
8.00
10.00
Based on decliningdisability rate since 1982
If disability rate did notchange since 1982
2000
7.0
9.4 9.5 9.6
7.1 7.2
(projected)
Biology of Aging
• Molecular and Cell Biology• Genetics• Immunology• Endocrinology• Cardiovascular• Musculoskeletal• Biologic Resources
Dr. Huber Warner (301) 496-4996
Bone Marrow Cells Repair Infarcted Heart
Source: Orlic et. al., PNAS 98: 10344-10349, 2001.
Neuroscience of Aging
• Basic Neurobiology• Alzheimer’s Disease• Learning and Memory• Sensory/Motor Processes• Sleep• Nutrition
Dr. Marcelle Morrison-Bogorad (301) 496-9350
Estimated Percentage of People over Age 65
with Probable Alzheimer’s Disease
3.0
19
47
0
10
20
30
40
50
65-74 75-84 85+
Age Group
Perc
ent
Source: Evans D , et al. JAMA , Vol. 262, No. 18, 1989.
Alzheimer’s Disease Prevention Initiative
No Disease,No Symptoms
Early BrainChanges,
No Symptoms
Mild MemoryLoss
Mild, Moderate and Severe Impairment
Disease ProgressionDisease Progression
Mild Cognitive
Impairment
Pre-symptomatic
ADNormal AD
PrimaryPrevention
SecondaryPrevention Treatment
0
25
50
75
100
InitialExam
12 24 36 48
Development of Alzheimer’s Disease in Persons with MCI
Perc
enta
g e w
i th A
D
Petersen et al., Arch Neurol, 56:305-308, 1999Months
Funded AD Prevention and Selected Treatment Trials
Vitamins E, AriceptAspirin, Vitamin E
EstrogenB-Carotene, Vit. E, C
Celecoxib, NaproxenGinkgo Biloba
Vitamin E, SeleniumSimvastatin
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Vitamin E, C, B6, B12, Folate, B-Carotene
April 2002
Geriatrics and Clinical Gerontology
• Geriatric syndromes (falls, frailty, disabilities)
• Previously unrecognized conditions of old age
• Healthy aging over the life span • Protective factors against multiple age-
related disorders
Dr. Evan Hadley (301) 435-3044
Survival Probabilities of Centenarian Sibs
Perls TT et al. Proc Natl Acad Sci U S A 2002;99(12):8442-7
Males
Females
Sib Females
Sib Males
0
3
6
9
12
15
25-44(n=1000)
45-59(n=1586)
> 60 (n=648)
Cas
es/1
00 p
erso
n-yr
Lifestyle Metformin Placebo
Diabetes Incidence Rates by Age
Diabetes Prevention Program, 2001
Intramural Research Program
• Multi-disciplinary research program focused on:
• Ten scientific laboratories and specialized branches for clinical research and provision of research resources located in Baltimore and Bethesda.
•understanding biology and pathophysiology of aging•understanding the changes associated with healthy •aging•developing insight about the pathophysiology of age-•related diseases and disability
8
10
12
14
16
18
20
-50 0 50 100 150 200 250
Glu
cose
(mM
)
Time (minutes)
MEALNo EX given
+ EX given 4 hr before the meal
Effect of Exendin on the Glucose Response of Diabetic Individuals
NIA, IRP, 2000
NIA Intramural Research Program Medical Research Vehicle
Health Disparities• Resource Centers for Minority Aging Research
(RCMAR) • Alzheimer’s Disease Center Satellites• Healthy Aging in National and Diverse Longitudinal Studies (HANDLS)• Menopause: Study of Women’s Health Across the
Nation (SWAN)• Vascular Stiffness, and CV Disease• Aging, Race, and Ethnicity in Prostate Disease
Dr. J Taylor Harden (301) 496-0765
Health Disparities
“Differences in the incidence, prevalence,mortality, and burden of diseases and otheradverse health conditions that exist amongspecific population groups in the UnitedStates.”
First NIH Working Groupon Health Disparities, 1999
Health Disparities
• Shorter Life Expectancy• Higher Rates of Most Cancers• Asthma• Diabetes• Dementia• Impaired Functional and Cognitive Abilities• Behavioral and affective disorders• Cardiovascular Disease
Potential causal factors• Socioeconomic position (SEP)• Health risk behaviors• Psycho-social factors• Health care• Acculturation• Biologic/Genetic factors• Environmental and occupational exposures
NIA Strategic Plan to Address Health Disparities
• Research Goals to Reduce or Eliminate Health Disparities
• Research Infrastructure Goals
• Public Information, Outreach and EducationGoals
See the NIA Strategic Plan to Address Health Disparities at: www.nih.gov/nia/strat-planhd/
ALZHEIMER’S DISEASE CENTERS & SATELLITES
Los Angeles(2Los Angeles(2))****
DavisDavis****
PortlandPortland**
Seattle Seattle **
San DiegoSan Diego**DallasDallas** **
HoustonHouston
RochesterRochester,MN,MN
ChicagoChicago (2)(2)
AnnAnn
ArborArbor****
Rochester, NYRochester, NY****
St.St. LouisLouis**** IndianapolisIndianapolis
LexingtonLexington**
AtlantaAtlanta**
DurhamDurham
ClevelandCleveland**
BaltimoreBaltimore ** PittsburghPittsburgh
** PhiladelphiaPhiladelphia
BostonBoston (2)(2)
*** *** New York CityNew York City (3)(3)*
*
*
*
Birmingham
Irvine
*Satellites
Research Supplements for Underrepresented Minorities
Application Procedures: In Brief• Open receipt date• Face page of the 398 application form• Summary of the parent grant• Description of the research experienced proposed
for the minority recipient• Statement of how the experience will advance the
research career of the minority recipient• Signed statement of research objectives and
career goals
National Institute on AgingJ Taylor Harden
Ph.D., R.N., FAAN
Assistant to the Directorfor Special Populations
[email protected]/496-0765
Information on AgingNIA Information Center
1-800-222-2225
NIA Alzheimer’s Disease Education and Referral (ADEAR) Center
1-800-438-4380http://www.alzheimers.org/
NIA Home Page http://www.nih.gov/nia/