Nina B. Silverberg, PhD National Institute on Aging George Mason University March 31, 2015 Background on NIH/NIA National Alzheimer’s Project Act and related activities Examples of NIA funded research on: Cognitive Assessment Behavior in Neurodegenerative Disease FTD Down Syndrome Resources Office of the Director National Institute National Institute on Alcohol Abuse on Aging and Alcoholism National Institute of Arthritis and Musculoskeletal and Skin Diseases National Institute on Deafness and Other Communication Disorders National Institute of Dental and Craniofacial Research National Institute of Diabetes and Digestive and Kidney Diseases National Institute of General Medical Sciences National Heart, Lung, and Blood Institute National Institute of Mental Health National Institute of Biomedical Imaging and Bioengineering National Institute on Minority Health & Health Disparities National Library of Medicine Clinical Center National Institute of Allergy and Infectious Diseases National Cancer Institute National Institute on Drug Abuse National Institute of Neurological Disorders and Stroke Fogarty International Center National Center for Advancing Translational Sciences Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institute of Environmental Health Sciences National Institute of Nursing Research Center for Compleme ntary and Integrative Health National Eye Institute National Human Genome Research Institute Center for Information Technology Center for Scientific Review NATIONAL INSTITUES OF HEALTH National Institute on Aging Organizational Structure Office of the Director Richard J. Hodes, M.D. Marie A. Bernard, M.D. Intramural Research Program Luigi Ferrucci, M.D., Ph.D. Michele K. Evans, M.D. Division of Aging Biology Felipe Sierra, Ph.D. Ronald Kohanski, Ph.D. Division of Behavioral and Social Research Richard Suzman, Ph.D. John Haaga, Ph.D. Division of Extramural Activities Robin Barr, Ph.D. Chyren Hunter, Ph.D. Division of Neuroscience Neil S. Buckholtz, Ph.D. Creighton Phelps, Ph.D. Division of Geriatrics and Clinical Gerontology Evan Hadley, M.D. Winifred K. Rossi, M.A. National Alzheimer’s Project Act (NAPA) On January 4, 2011, President Barack Obama signed into law the National Alzheimer's Project Act (NAPA), requiring the Secretary of the U.S. Department of Health and Human Services (HHS) to establish the National Alzheimer's Project. The law requires: o An annually updated national plan submitted to Congress on how to overcome Alzheimer’s. o Annual recommendations for priority actions to both improve health outcomes for individuals with Alzheimer’s and lower costs to families and government programs. o The annual evaluation of all federally funded efforts in Alzheimer’s research, care and services – along with their outcomes. o The creation of an Advisory Council on Alzheimer’s Research, Care, and Services. 5 Goals Goal 1: Prevent and Effectively Treat Alzheimer’s Disease by 2025 Goal 2: Enhance Care Quality and Efficiency Goal 3: Expand Supports for People with Alzheimer’s Disease and Their Families Goal 4: Enhance Public Awareness and Engagement Goal 5: Improve Data to Track Progress 6 Research Goals 1.A. Identify Research Priorities and Milestones 1.B. Expand Research Aimed at Preventing and Treating Alzheimer’s Disease 1.C. Accelerate Efforts to Identify Early and Presymptomatic Stages of Alzheimer’s Disease 1.D. Coordinate Research with International Public and Private Entities 1.E. Facilitate Translation of Findings into Medical Practice and Public Health Programs Research milestones are available at: http://aspe.hhs.gov/daltcp/napa/milesto nes/milestones-p.pdf 7 Session 1: Interdisciplinary Approach to Discovering and Validating the Next Generation of Therapeutic Targets for AD Session 2: Challenges in Preclinical Therapy Development Session 3: Who to Treat, When to Treat and What Outcomes to Measure Session 4: Drug Repurposing and Combination Therapy Session 5: Non‐pharmacological Interventions A blueprint for an integrated translational research agenda Session 6: New Models of Public Private Partnerships Natcher Auditorium, NIH Campus, Bethesda, MD May 1, 2013 8:00 a.m. 8:05 a.m. 8:25 a.m. 8:30 a.m. 9:30 a.m. 1:15 p.m. May 2, 2013 8:30 a.m. 12:30 p.m. 2:45 p.m. 4:00 p.m. Welcoming Remarks: Story Landis, PhD, Director, NINDS Introduction: Ronald Petersen, PhD, MD, Mayo Clinic Developing Research Recommendations and Timelines for the AD‐Related Dementias Thomas Montine, MD, PhD, Scientific Chair Session 1: Non‐AD and Multiple Etiology Dementias Chairs: Bruce Miller, MD, and David Knopman, MD Session 2: Lewy Body Dementias (LBD, PDD) Chairs: Dennis W. Dickson, MD and Karen S. Marder, MD, MPH Session 3: FTD and AD‐Related Tauopathies Chairs: Michael Hutton, William Seeley Session 4: Vascular Contributions to AD‐Related Dementias Chairs: Steven Greenberg, Berislav Zlokovic Session 5: Health Disparities in AD‐Related Dementias Chairs: Maria Glymour, ScD and Jennifer Manly, PhD Final Panel Discussion and Questions Closed Session: Session Chairs, NIH Leads, Steering Committee ALZHEIMER’S DISEASE RESEARCH SUMMIT 2015: PATH TO TREATMENT AND PREVENTION February 9–10, 2015 http://www.nia.nih.gov/about/events/ 2014/alzheimers-disease-researchsummit-2015 Introductory Remarks Francis Collins (NIH Director) NAPA Research Milestones: Process and Progress Richard Hodes (NIA Director) Plenary Lectures Socioeconomic Burden of AD: Update on National and International Trends Kenneth Langa (University of Michigan) Socioeconomic Burden of AD: Update on Global Trends with a Focus on Developing and Under‐ Developed Countries: Implications for Research Martin Prince (King’s College London) Deconstructing the Complexity of AD David Bennett (Rush University) Session I: Interdisciplinary Research to Understand the Heterogeneity and Multifactorial Etiology of Alzheimer’s Disease Session II: Transforming AD Therapy Development: From Targets to Trials Session III: New Strategies for Prevention Session IV: Innovating Disease Monitoring, Assessment, and Care Session V: Empowering Patients, Engaging Citizens Session VI: Enabling Partnerships for Open Innovation Common Alzheimer’s Disease Research Ontology Began May 2010 Collaboration between NIA and Alzheimer’s Association http://www.nia.nih.gov/researc h/dn/cadro-outline International Alzheimer’s Disease Research Portfolio http://iadrp.nia.nih.gov/cadro-web/ The Common Alzheimer’s Disease Research Ontology, (CADRO) is a three‐tiered, dynamic classification system created to capture the complete range of AD research and AD research‐related resources. The first level of classification consists of eight categories: five research, two research resources‐related and one for AD related dementias: Category A – Molecular Pathogenesis and Physiology of Alzheimer’s Disease Category B – Diagnosis, Assessment and Disease Monitoring Category C – Translational Research and Clinical Interventions Category D – Epidemiology Category E – Care, Support and Health Economics of Alzheimer’s Disease Category F – Resources for the Research Community Category G – Consortia and Public Private Partnerships Category H – Alzheimer’s Disease‐related Dementias Research Topic Research Themes Each category is divided into “research topics”; many of these topics are further divided into “research themes” (~225 codes). These research topics and themes will enable identification of research gaps, areas of overlap/duplication of effort, and opportunities for collaboration. IADRP ‐ Tracking AD Research Milestones Tracking AD Research Milestones AD Research Milestones linked to CADRO codes AD Research Milestones linked to funded projects Community Settings Diversity http://projectreporter.nih.gov PURPOSE: To conduct a randomized clinical trial assessing the harms and benefits of screening for dementia compared to no screening for dementia among 4,000 older adults cared for in typical primary care practices. Pharmacological and non-pharmacologic interventions Completed and in progress JAMA 2012 A study of outpatient participants with Alzheimer's disease or a related dementia who have difficult behaviors that are upsetting for them or their caregivers. Prazosin is a medication that is commonly used to treat people with high blood pressure. Research with prazosin has shown that it may be effective in treating behavioral problems by reducing excess adrenalin effects in the brain Example of repurposing This study will test the use of venlafaxine to treat the depression in Alzheimer's Disease (AD). Venlafaxine works by increasing natural substances in the brain (serotonin and norepinephrine) that help maintain mental balance. Depression is a very common symptom of AD, affecting as many as 50% of patients over their illness. Depression in AD contributes greatly to patient disability and caregiver distress. Venlafaxine is approved by the U.S. Food and Drug Administration (FDA) for the treatment of major depression but it is not known whether or not it can help depression in Alzheimer's Disease. http://grants.nih.gov/grants/guide/pa-files/PAR-14-089.html 1-800-438-4380 Home Safety for People with Alzheimer's Disease Sundowning: Alzheimer's Caregiving Tips Hospitalization Happens: A Guide to Hospital Visits for Individuals with Memory Loss Holiday Hints: Alzheimer's Caregiving Tips Disaster Preparedness: Alzheimer's Caregiving Tips Bathing: Alzheimer's Caregiving Tips Alzheimer's Disease Fact Sheet Driving Safety: Alzheimer's Caregiving Tips Helping Kids Understand Alzheimer's Disease: Alzheimer's Caregiving Tips Wandering: Alzheimer's Caregiving Tips Helping Family and Friends Understand Alzheimer's Disease: Alzheimer's Caregiving Tips Hallucinations, Delusions, and Paranoia: Alzheimer's Caregiving Tips Changes in Communications Skills: Alzheimer's Caregiving Tips Managing Personality and Behavior Changes: Alzheimer's Caregiving Tips Rummaging and Hiding Things: Alzheimer's Caregiving Tips Coping with Agitation and Aggression: Alzheimer's Caregiving Tips Exercise and Physical Activity: Alzheimer's Caregiving Tips Caring for a Person with Alzheimer's Disease: Your Easy-to-Use Guide from the National Institute on Aging So Far Away: Twenty Questions and Answers About Long-Distance Caregiving Alzheimer's Disease: Unraveling the Mystery Guía para quienes cuidan a personas con Alzheimer End of Life: Helping With Comfort and Care Thank you! 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