grant

Long-term Effects of a Community-based Volunteer Trial on Lifestyle Activity and Risk for Alzheimer's Disease

Organization JOHNS HOPKINS UNIVERSITYLocation BALTIMORE, UNITED STATESPosted 15 Sept 2019Deadline 31 May 2026
NIHUS FederalResearch GrantFY202321+ years oldAD dementiaActive Follow-upAddressAdultAdult HumanAgeAlgorithmsAlzheimer Type DementiaAlzheimer disease dementiaAlzheimer risk factorAlzheimer sclerosisAlzheimer syndromeAlzheimer'sAlzheimer's DiseaseAlzheimer's biomarkerAlzheimer's disease biological markerAlzheimer's disease riskAlzheimers DementiaAlzheimer’s biological markerAlzheimer’s disease biomarkerAmentiaApoplexyBaltimoreBrainBrain Nervous SystemBrain Vascular AccidentCardiac DiseasesCardiac DisordersCaringCause of DeathCerebral StrokeCerebrovascular ApoplexyCerebrovascular StrokeCessation of lifeChronicChronic DiseaseChronic IllnessCognitionCognitiveCognitive DisturbanceCognitive ImpairmentCognitive agingCognitive declineCognitive function abnormalCommunitiesDataData SourcesDeathDementiaDevelopmentDiabetes MellitusDisadvantagedDiseaseDisorderDisturbance in cognitionDrug PrescribingDrug PrescriptionsDrugsED visitER visitEconomically DeprivedElderlyEmergency care visitEmergency department visitEmergency hospital visitEmergency room visitEncephalonExpenditureFinancial HardshipGoalsHealthHealth BenefitHealth Care CostsHealth Care UtilizationHealth CostsHealth ExpendituresHealth Insurance for Aged and Disabled, Title 18Health Insurance for Disabled Title 18Health ServicesHealthcareHealthcare CostsHeart DiseasesHomeHospital AdmissionHospitalizationIADLImpaired cognitionIncidenceIndividualInpatientsInterventionIntervention StrategiesIntervention TrialInterventional trialLifeLife StyleLifestyleLinkLong-Term EffectsLongterm EffectsMarylandMeasuresMedicaidMedicalMedicareMedicare/MedicaidMedicationNeurocognitiveOut-patientsOutcomeOutpatientsOwnershipPersonsPharmaceutic PreparationsPharmaceutical PreparationsPhonePrimary Senile Degenerative DementiaProductivityPublic HealthQOLQuality of lifeQuestionnairesRandomization trialRandomized, Controlled TrialsRecordsReportingRiskSavingsSensitivity and SpecificitySocial NetworkStrokeTelephoneTelephone InterviewsTestingTitle 18active followupadulthoodadvanced ageagesalzheimer riskbrain attackcerebral vascular accidentcerebrovascular accidentchronic disordercognitive dysfunctioncognitive enhancementcognitive functioncognitive losscohortcostdecline in functiondecline in functional statusdementia riskdensitydevelopmentaldiabetesdisabilitydisease riskdisorder riskdrug/agenteconomic disparityeconomic impacteconomically disadvantagedelderselementary schoolexperiencefinancial burdenfinancial distressfinancial strainfinancial stressfollow upfollow-upfollowed upfollowupfrailtyfunctional declinefunctional independencefunctional lossfunctional status declinegeriatricgrade schoolhealth carehealth care expenditurehealth care service usehealth care service utilizationhealth insurance for disabledhealth related quality of lifehealthcare expenditurehealthcare service usehealthcare service utilizationhealthcare utilizationhealthy agingheart disorderhomesimprovedindexinginstrumental activity of daily livinginterventional strategylate lifelater lifemedication prescriptionmortalitymulti-modalitymultimodalitynovelolder adultolder personparticipant enrollmentpatient enrollmentprescribed medicationpreventpreventingprimary degenerative dementiaprogramsrandomized control trialrandomized trialrelative costrelative costsresilienceresilientrisk factor for dementiarisk for dementiasenile dementia of the Alzheimer typesenior citizensocialsocial engagementsocial involvementsocial participationsocio-demographicssociodemographicsstrokedstrokesvolunteer
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Full Description

Abstract
Risk for Alzheimer’s disease is the only cause of death among the top 10 in the US that cannot be prevented,

cured or even slowed using medications and is the most expensive chronic disease. Initiated in 2006, the

Baltimore Experience Corps Trial (BECT) is the largest randomized controlled trial (N = 702) to examine

whether multi-modal social, cognitive, and physical engagement enhanced neurocognitive functions in

cognitively intact older adults. The BECT was novel among intervention trials in its appeal to economically

disadvantaged adults at elevated risk for Alzheimer’s disease. The trial randomized older adults to show that

productive social engagement as volunteers in elementary schools increased lifestyle activity and generative

purpose and improved cognition and brain biomarkers for Alzheimer’s disease over two years of exposure. We

now need to evaluate whether the two-year short-term effects in relatively healthy aging adults

collectively were associated with longer-term health benefits 10-12 years later as these at-risk

individuals enter their 80th and 90th decades of life. We will determine whether increased social

engagement in Experience Corps between 2006-2012 led to long-term lower risk for Alzheimer’s disease,

reductions in Medical Care expenditures, maintained functional and financial independence, improved quality

of life and social network stability, and lower mortality. To achieve these goals, we will leverage a wide range of

linked data, including Medicare and Medicaid Claims, Maryland CRISP healthcare data, National Death Index

(NDI), financial records, and a low-cost 10-12-year follow-up telephone interview to assess cognition,

function, health, lifestyle and social connectivity. This study will allow us to examine the long-term

impact of a social engagement program on key outcomes related to risk for Alzheimer’s disease and

dementia risk, functional and financial independence, quality of life, and mortality.

Grant Number: 5R01AG066153-04
NIH Institute/Center: NIH

Principal Investigator: MICHELLE CARLSON

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