Advancing diagnosis of dementia in primary care practice(ADDPCP)

Active Project Grant Awarded Last action

Award ID
R01AG085689
Recipient
Awarding agency
Obligated
$10,615,496

Award facts

Assistance listing
93.866 Aging Research
Completion date 46% complete
Place of performance
San Francisco, CA 94143, USA

Award details come from USAspending.gov.

Description

As the agency reported it.

Abstract
As the U.S. Population ages, the number of people with alzheimer's disease and related neurodegenerative diseases (NDDS) that cause dementia will grow. Emerging disease-modifying treatments are/will be designed to address the specific biology of each form of dementia. They are likely to be most effective early in the course of illness, increasing the importance of prompt and accurate diagnosis. Specific identification of the cause of cognitive impairment is routine in neurology and psychiatry, but exclusive reliance on this limited workforce for assessment of cognitive and behavioral changes will result in treatment delays with meaningful clinical impact, particularly for medically underserved communities that face obstacles in accessing specialists. Early evaluation in the primary care (PC) setting can reduce delays, but PC practitioners (PCPS) identify time and a lack of confidence as barriers preventing them from assessing cognitive and behavioral complaints. Biomarkers can facilitate the identification of NDD, but expert guidelines stress that they must be paired with clinical findings to guide diagnosis. In addition, the available biomarkers only address some of the entities that cause NDD. The goal of this project is to support more thorough assessment of cognitive and behavioral complaints in PC by supporting PCPS to use a comprehensive diagnostic toolkit developed by the california alzheimer's disease centers. The toolkit includes a pre-visit questionnaire that can potentially shorten future assessments if the sensitivity of the questions can be established. This project will demonstrate first that assessment with this toolkit, in combination with regular expert-led case conferences, facilitates accurate distinction by PC providers of mild cognitive impairment and dementia likely due to alzheimer's disease from other, less typical NDD syndromes, and second, that the implementation of this approach is feasible and acceptable to PCPS, patients, and families. We will implement the model in five CA PC practices that work with medically underserved communities to facilitate the assessment of approximately 750 patients by at least 30 PC providers. Each participant will be RE-evaluated at an expert center, where blood biomarkers of NDD will be collected. We will support PC practitioners to provide a biomarker-informed diagnostic disclosure to each patient. We will examine the accuracy of PCP diagnoses, using expert opinions and biomarkers as the gold standard, and evaluate the feasibility of toolkit use in the practices through surveys, interviews, and focus groups. To help address the sensitivity of pre-visit questions to atypical symptoms of NDD, we will also recruit 200 patients with atypical presentations at ucsf. Achievement of the project goals will establish an efficient model for earlier, etiologically-specific diagnosis of cognitive and behavioral changes due to alzheimer's disease and other NDDS.

Transactions

Action Obligated Date
Amendment $2,617,551
Amendment $2,549,563
Amendment $2,724,191
Original award $2,724,191

Subawards

Subrecipient Amount Awarded
Subrecipient not on record The team at Fresno Geriatrics Medical Group will perform the following activities: 1. Enroll 20 patients per year into the study in each of the five years,… $111,710
Fresno Community Hospital & Medical Center The Dr. Sigala and her team at Community Health Partners will perform the following activities: 1. Enroll 20 patients per year into the study in each of the… $100,585
Olive View / Ucla Education And Research Institute, Inc. 1. Enroll 40 patients per year into the study in each of the five years, and perform the following activities for each patient/participant: a. Collect… $375,872
On LOK Senior Health Services 1. Enroll 30 patients per year into the study in each of the five years, and perform the following activities for each patient/participant: a. Collect… $127,128
University Of Southern California Dr. Rissman's team at ATRI will take responsibility for activities related to collection and storage of blood specimens for 750 participants for this project.… $410,152
Rancho Research Institute The Rancho los Amigos Geriatric Neurobehavior and Alzhiemers Center, home of the USC- Rancho California Alzheimers Disease Center (CADC), will serve as an… $820,327

Quick answers

Who received award R01AG085689?

R01AG085689 was awarded to The Regents Of The University Of California. San Francisco by National Institute on Aging (National Institutes of Health) on September 1, 2024.

How much is award R01AG085689 worth?

$10,615,496 has been obligated on R01AG085689.

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