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

Taylor_Harden@nih.gov301/496-0765

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/