School of Public Health aging expert co-writes article covering the National Institute on Aging’s first 50 years

The National Institute on Aging (NIA) was founded under the National Institutes of Health in 1974 to oversee research on aging and to prolong Americans’ healthy and active years of life.

A half-century later, the Baltimore, Md.-based organization manages a budget of $4.425 billion and oversees 1,418 research grant administrators, 75 research and other centers and conducts about 460 clinical trials yearly.

Now, coinciding with its milestone 50th anniversary, the agency’s rich history of leadership and advocacy has been chronicled by Marcia Ory, PhD, Regents and Distinguished Professor of occupational health at the Texas A&M University School of Public Health and Alan B. Stevens, PhD, a noted dementia care researcher who directs the Baylor Scott & White Health Center for Applied Health Research for which Ory often serves as an academic partner.

Their article, in a special issue of The Gerontologist, “highlights some of the remarkable contributions, milestones and initiatives that have formed significant areas of scholarship in aging,” Ory said, noting her dual role in promoting strategies to reduce the burdens of caregiving for patients with dementia and similar conditions for the NIA and at Texas A&M. In addition to her role with the Department of Environmental and Occupational Health, Ory is a faculty member with the university’s Center for Community Health and Aging.

In the 1970s and ’80s, NIA had two primary areas of research, Ory said. One was the development of conceptual models of the psychological, physical and social factors contributing to caregiver stress and burden, a comprehensive and ethical approach to dementia research that Ory said made research findings more applicable to real-world settings. The other was recognizing the importance of understanding aging in different populations and settings.

This led to NIA’s development in the 1990s of its three hallmarks: research on dementia caregiving interventions, creating a data infrastructure to support a population-based study of dementia caregiving and research that is proactive and reactive regarding policy.

A major example of research on dementia caregiving interventions is the two Resource for Enhancing Alzheimer’s Caregiver Health (REACH) Collaboratives between NIA and the National Institute for Nursing Research. The first, established in 1995, developed individual interventions such as education, support groups, family systems therapy, behavioral skills training, environmental skill building and telephone-based support at six participating sites.

Its successor, REACH II, was funded in 2001 to build on the first REACH project by developing and testing a more structured intervention among racially/ethnically diverse caregivers and to provide caregivers with relevant knowledge and skills.

“There is research evidence that REACH II and its adapted interventions are associated with improvements in informal caregiver depression,” Ory said. “In addition, the National Academies of Medicine recommend its broad implementation and dissemination.”

Both Texas A&M and Baylor Scott & White Health have benefited from NIA’s support for technology developments that expand the REACH models by including tailored approaches to understand caregiver needs and build caregiver skills. Other NIA-funded projects at Texas A&M use AI-driven models to link dementia caregivers with personalized information and resources for financial, legal and care options and a comprehensive fall detection and prevention system.

In the domain of proactive and reactive research on policy, Stevens noted the 2011 National Alzheimer’s Project Act, which created an advisory committee that oversees and coordinates federal efforts to address the challenges of Alzheimer’s disease and related dementias, as well as summits for caregivers.

“NIA’s leadership is more significant than ever, given that nearly seven million people in the United States live with dementia and the value of family caregiving is estimated to be $350 billion every year,” Ory said. “I believe NIA will remain at the forefront of such efforts in the years to come.”