Announcements

  • March 18, 2016

    The Division of Behavioral and Social Research congratulates Drs. Anne Case and Angus Deaton on their selection as winners of the Cozzarelli Prize from the Proceedings of the National Academy of Sciences. Case and Deaton's article, "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century" is one of six papers published in 2015 to earn this distinction.

    The paper reported that deaths among white U.S. men and women aged 45–54 rose significantly between 1999 and 2013, reversing decades of progress in mortality; the change was unique to non-Hispanic whites in the United States. Morbidity rates increased as well, with self-reported declines in health, mental health, and abilities to conduct activities of daily living, accompanied by increases in reports of chronic pain, inability to work, and deterioration of liver function.

    The Cozzarelli Prize acknowledges papers that reflect scientific excellence and originality. The award was established in 2005 and named in 2007 to honor late PNAS Editor-in-Chief Nicholas R. Cozzarelli.

    This year's award winners will be recognized during the PNAS Editorial Board Meeting and the NAS Annual Meeting Awards Ceremony on May 1, 2016, in Washington, DC.

  • February 25, 2016

    When prescribed correctly, antibiotics can be very effective in treating a variety of bacterial infections. However, U.S. clinicians often prescribe antibiotics to patients with non-bacterial infections, particularly those with acute viral respiratory tract infections, a practice that has important repercussions. Not only are antibiotics ineffective against non-bacterial infections, they may also be associated with unpleasant side effects or allergic reactions. And, over-prescription is a significant cause of population-level antibiotic resistance.

    In an NIA-funded randomized clinical trial involving 248 primary care clinicians, Dr. Jason N. Doctor, of the University of Southern California, and his colleagues compared the effectiveness of three different behavioral interventions in an attempt to affect prescribing practices:

    • The accountable justifications intervention prompted clinicians to write justifications for antibiotic prescriptions in the patient’s electronic health record (EHR), following a notification that antibiotics may not be right for the patient. This was associated with an 18.1 percent decrease in inappropriate prescriptions.
    • The peer comparison intervention ranked physicians on the number of inappropriate antibiotic prescriptions they wrote. Those with the highest inappropriate prescribing rates received e-mail messages informing them that they were not “top performers” compared to others in their region who wrote fewer inappropriate prescriptions. The e-mail included the number and proportion of inappropriate antibiotic prescriptions they had written compared to the top performers. This tactic reduced inappropriate antibiotic prescriptions by 16.3 percent.
    • The suggested alternative intervention presented a pop-up message on the EHR indicating that antibiotics may not be right for the patient and suggesting a more appropriate alternative. This was associated with a 5 percent decrease in inappropriate prescriptions.

    Over the 18-month intervention period, the overall number of inappropriate antibiotic prescriptions decreased by 11 percent from baseline. The researchers note that while the study sample was relatively small and depended on the use of EHRs, the use of accountable justification and peer comparison behavioral interventions resulted in meaningfully lower inappropriate prescribing rates and might be useful tools to improve the quality of care by individual clinicians.

    Reference: “Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices: A Randomized Clinical Trial” by Daniella Meeker, et al. Journal of the American Medical Association. 2016 Feb 9;315(6):562-70. doi: 10.1001/jama.2016.0275.

  • February 11, 2016

    In the United States, as many as 5.2 million people age 65 and older are estimated to have Alzheimer’s disease, the most common form of dementia, and these numbers are expected to rise with an aging population. However, a new NIH-funded study showed a progressive, decades-long decline in dementia incidence (newly reported cases) among older people in Framingham, Mass., and examined factors that may influence this trend.

    The report appeared online February 10, 2016, in The New England Journal of Medicine. It was conducted by researchers at Boston University School of Medicine and colleagues.

    Researchers following thousands of older volunteers participating in the NIH-funded Framingham Heart Study reported a steady decline in new cases of Alzheimer’s and related dementias over several decades. They tracked the cognitive status of 5,205 volunteers age 60 and older at 5-year intervals during four periods in the 1970s, 1980s, 1990s and 2000s. They also examined how age, education, and vascular risk factors such as blood pressure might influence dementia rates.

    Their findings suggest that while the number of people with dementia may be rising due to the aging population, the risk of dementia may have been decreasing in high-income communities such as Framingham. They found:

    • There was a progressive decline in dementia incidence, at any given age, with an average reduction of 20 percent per decade since the 1970s.
    • The amount of education appeared to play a significant role in dementia risk. Among volunteers with at least a high school diploma, dementia incidence declined by 22 percent by the 1980s, 38 percent the 1990s, and 44 percent by the 2000s when compared to the first decade. They also noted that more study participants graduated from high school as the study progressed.
    • A parallel trend in improved cardiovascular health (with the exception of obesity and diabetes) over the decades may have influenced the decline in dementia prevalence. Again, this cardiovascular health improvement was seen only among volunteers who had graduated from high school.
    • The average age at which dementia was diagnosed rose from age 80 in the 1970s to age 85 in the 2000s.

    The researchers note that these findings suggest that higher education levels, along with treatment of vascular disease, may have helped delay the onset of dementia. They emphasized that these factors, however, did not explain all of the observed decline, and that more research is needed to fully understand the factors underlying lower incidence of dementia.

    The study was supported by the National Heart, Lung, and Blood Institute and the National Institute on Aging, both components of the NIH.

    Reference: Satizabel CL, et al. Incidence of dementia over three decades in the Framingham Heart Study. New England Journal of Medicine. Published online Feb. 10, 2016.

  • February 1, 2016

    The UC Davis RCMAR (Latino Aging Research Resource Center) and the UC Davis Alzheimer’s Disease Center will be hosting a Cognitive Aging Conference at UC Davis on March 16.

    The goals of the conference are to present a framework for scientific research on cognitive aging in diverse populations, highlight research progress resulting from training efforts of the Alzheimer’s Disease Centers (ADC), Resource Centers for Minority Aging Research (RCMAR), and NIH Support for Scientific Conferences (R13) and promote ADC and LARRC resources for the scholar and pilot programs.

    Dr. Carl V. Hill, will be giving an update on Diversity and Health Disparities Research. The morning session will also provide an overview and guiding principles on cognitive aging research and includes notedresearchers from UC Davis, UC San Francisco and Kaiser. The early afternoon session will highlight the important contributions to the field of research from RCMAR scholars and R13 trainees. The conference will end with a panel discussion, moderated by Dan Mungas, PhD, UC Davis with panelists discussing critical issues for the future of cognitive aging research.

  • January 25, 2016

    Emerging researchers, including those with limited involvement in research on aging, are invited to apply for the next Butler-Williams Scholars Program, to be held July 25-29, 2016, at the National Institutes of Health campus in Bethesda, MD.

    Sponsored by NIA, the 5-day program will explore research design relative to aging, including issues relevant to racial/ethnic minorities and health disparities. The agenda will include:

    • lectures covering the biology of aging; genetics and Alzheimer’s disease; and health, behavior, and aging
    • discussion sessions focusing on methodological approaches and interventions
    • consultation on the development of research interests
    • advice on preparing and submitting research grant applications to NIA

    Applications and letters of recommendation are due by March 25, 2016.

    Learn more about the Butler-Williams Scholars Program and access the online application form.

  • January 11, 2016

    A randomized clinical trial of 100 patients found that diet and exercise—alone or combined—improved exercise capacity in obese older patients with a particular type of heart failure. The trial is the first to show that this dietary intervention was effective in improving exercise capacity and reducing symptoms in patients with heart failure with preserved ejection fraction (HFPEF). The results appeared in the January 6, 2016, issue of the Journal of the American Medical Association. The study was supported primarily by the NIA.

    HFPEF is the most rapidly increasing form of heart failure, especially in older adults. It occurs primarily in overweight and obese older women and is associated with high rates of morbidity, mortality, and health care expenditures. Exercise intolerance—fatigue and shortness of breath with exertion—in HFPEF patients was recently shown to be associated with increased body weight.

    Dr. Dalane Kitzman and colleagues at Wake Forest University School of Medicine randomized trial participants to four groups: diet alone, exercise alone, diet and exercise together, or control. After 20 weeks, people in the three intervention groups showed improved exercise tolerance, measured by peak exercise oxygen consumption. The diet and exercise groups both showed improvement; however, the combination group had almost twice the improvement in oxygen consumption. In addition to improving exercise capacity, diet and exercise decreased the amount of fat cells within the leg muscle, the researchers found; fat, which infiltrates leg muscle, contributes to reduced exercise capacity in heart failure.

    This is the first randomized controlled trial of calorie restriction in this patient population. While the researchers noted that follow-up studies are needed to investigate the loss of muscle mass associated with weight loss, this research supports a treatment for heart failure that relies on diet and exercise, unlike previous treatments which focused on regulating heart function through medication.

    Reference: “Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients with Heart Failure with Preserved Ejection Fraction: A Randomized Clinical Trial” by Dalane W. Kitzman, et al. JAMA. 2016,315(1)36-46. doi: 10.1001.jama2015.17346.

     

  • December 8, 2015

    The death rate among middle-aged, white Americans rose significantly between 1999 and 2013, reversing a decades-long trend of improvement, new research shows. This group also reported worse physical and mental health than other age groups, according to the NIA-funded study, published online Nov. 2, 2015, in the Proceedings of the National Academy of Sciences.

    From 1978 to 1998, the death rate for U.S. non-Hispanic whites ages 45 to 54 fell 2 percent per year on average, matching the rate for some wealthy European countries, reported economists Drs. Anne Case and Angus Deaton of Princeton University. But in the following 15 years, the U.S. group’s death rate rose half a percent per year on average, while the death rate for their European peers continued to fall. The experts analyzed federal survey data.

    In the U.S., this higher death rate was unique to middle-aged whites. During the same period, the average yearly death rate decreased 1.8 percent for Hispanics and 2.8 percent for non-Hispanic blacks in the same age group. Even older Americans age 65–74 had a lower death rate than 45- to 54-year-old whites.

    Drug and alcohol poisoning, suicide, and chronic liver disease and cirrhosis drove up the death rate for white people in this age group, the analysis showed. For those aged 45–54, if the white mortality rate had held at its 1998 value, 96,000 deaths would have been avoided from 1999–2013, the researchers noted. Death rates were highest for people with the least education (a high school degree or less).

    There was also a significant rise in the proportion of middle-aged adults reporting fair or poor health in 2011–13, compared with 1997–99. Individuals reported higher rates of chronic pain, psychological distress, and difficulty with daily activities. Risk for heavy drinking also rose significantly.

    The authors noted that the increase in midlife mortality is only partly understood. Increased availability of opioid prescription drugs, chronic pain (for which opioids are often prescribed), and the economic crisis which began in 2008 may all have contributed to an increase in overdoses, suicide, and increased liver disease associated with alcohol abuse.

    Reference: Case, A., and Deaton, A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences. doi: 10.1073/pnas.1518393112. Published online Nov. 2, 2015.

  • December 11, 2015

    A new online report provides an easy-to-read overview of recent National Institutes of Health-funded research advances and initiatives in Alzheimer’s disease and related dementias. Issued by the National Institute on Aging (NIA) at NIH, the annual report—2014-2015 Alzheimer’s Disease Progress Report: Advancing Research Toward a Cure—discusses research momentum under the National Plan to Address Alzheimer’s Disease, describes research opportunities, and summarizes scientific advances in several areas:

    • Understanding the biology of Alzheimer’s, related dementias, and the aging brain
    • Identifying genetic influences on risk for late-onset Alzheimer’s, the most common form
    • Detecting the earliest Alzheimer’s-related brain changes, including further development of biomarkers to track the onset and progression of Alzheimer’s
    • Understanding gender and racial differences in the impact of Alzheimer’s
    • Stepping up translational research enabling the design and testing of new drugs
    • Testing in clinical trials potential new therapies to prevent, delay or treat Alzheimer’s
    • Finding better ways to support caregivers

    The report includes searchable tables of NIA-funded clinical trials that are testing promising interventions for Alzheimer’s disease, mild cognitive impairment, age-related cognitive decline, delirium and dementia-related psychiatric conditions and symptoms—agitation, apathy and depression.

    Read the report online: 2014-2015 Alzheimer’s Disease Progress Report: Advancing Research Toward a Cure

  • December 2, 2015

    As animals, including humans, age or develop brain diseases such as Alzheimer’s, their brain cells may not produce enough energy to remain fully functional. A new study shows that an enzyme, SIRT3, may protect brain cells against stresses believed to contribute to energy loss. Researchers also found that physical exercise increases the expression of SIRT3, helping to protect the brain against degeneration. The results were published online Nov. 19, 2015, in Cell Metabolism.

    Scientists at NIH’s National Institute on Aging Intramural Research Program, Baltimore, used a new mouse model to investigate whether they could aid brain cells called neurons in resisting the energy-depleting stress caused by neurotoxins and other factors. They found a biochemical hero in SIRT3, located in mitochondria, the cell’s powerhouses. SIRT3 is part of the sirtuin family of proteins, which are thought to play an important role in aging, stress resistance, and metabolic regulation.

    The researchers, led by Mark Mattson, Ph.D., of NIA’s Laboratory of Neurosciences, found that mice that did not produce SIRT3 became highly sensitive to cellular stress when exposed to neurotoxins that cause neurodegeneration and cell death. In mouse models of Huntington’s disease and epilepsy, mice with SIRT3 deficiency had greater brain neuron degeneration and associated behavioral symptoms than those with sufficient SIRT3 after exposure to certain toxins.

    In addition, normal mice that exercised on running wheels for 30 days had significantly higher SIRT3 levels in neurons of the hippocampus, a brain region important for learning and memory, than mice that did not exercise. Researchers concluded that running helped protect neurons against cell death in mice by increasing SIRT3 levels.

    The researchers also found that they could protect neurons against stress using a gene-therapy technology to increase levels of SIRT3 in neurons. Neurons without SIRT3 were significantly more vulnerable to toxic stress than those with SIRT3.

    The findings suggest that bolstering mitochondrial function and stress resistance by increasing SIRT3 levels may offer a promising therapeutic target for protecting against age-related cognitive decline and brain diseases.

    Reference: Cheng A., et al. Mitochondrial SIRT3 mediates adaptive responses of neurons to exercise, and metabolic and excitatory challenges. Cell Metabolism. Published online Nov. 19, 2015.

  • December 1, 2015

    This Notice serves to communicate NIH’s priority areas of health economics research.

    Applicants and potential applicants for NIH research grants are advised to consult with NIH program officers in Institutes and Centers (IC) appropriate to their proposed topic if they have questions about the alignment of their research with IC program priorities.

    You may read the full Notice on the NIH Grants website.

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