# Earlier Introductions to Palliative Care in Older Adults Undergoing High-Risk Surgery

> **NIH NIH R03** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $115,821

## Abstract

ABSTRACT
By 2030, adults older than 65 years will exceed 20% of the U.S. population. In parallel to this rapidly-changing
demographic, rates of surgery in this population are expected to increase by as much as 30%. Although
substantial efforts have been made to reduce perioperative complications and mortality, far less attention has
been aimed at the long-term implications of surgery in older adults. In such patients, functional and
cognitive decline are common, and may persist or progress to permanent disability or dementia and even
death. An in-depth understanding of these long-term implications will shed light on how and when to
introduce palliative care strategies to such patients. Capitalizing on rich and longitudinal data from the
Health and Retirement Study (HRS) linked to Medicare data, we will conduct a mixed methods evaluation of
the clinical, functional, cognitive, and economic outcomes in older adult patients who suffer a serious
complication following high-risk elective surgery (Aim 1). More than 27,000 individuals have participated in
HRS since its inception in 1992, which details specific information on sociodemographics, health status,
spending and utilization, and functional and cognitive status. Through the unique and robust collaborative
infrastructure of surgical programs in the State of Michigan, we will then perform a qualitative analysis of
surgeon-perceived barriers to use of palliative care services directly informed by our findings from the HRS
analysis (Aim 2). This study will have immediate impact on local and national initiatives by revealing
how surgeons and hospitals can better anticipate and manage older adult patients' needs who may
undergo high-risk surgical procedures. Furthermore, results from this study will allow for the design and
implementation of a computer-based, empirically-driven alert to screen for and prompt palliative care referrals
in older adult patients who may undergo high-risk surgery. This proposal is the ideal mechanism for me to
transition my research career to a focus on palliative care and aging. Successful completion of this project will
promote my application for externally-funded career development awards such as the Paul B. Beeson
Emerging Leaders Career Development Award in Aging (K76) and a subsequent R01. The project, mentorship,
and educational plan will prepare me to be an independent investigator and national leader in palliative care
and aging among surgical populations.

## Key facts

- **NIH application ID:** 10000817
- **Project number:** 5R03AG056588-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Pasithorn Suwanabol
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $115,821
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10000817

## Citation

> US National Institutes of Health, RePORTER application 10000817, Earlier Introductions to Palliative Care in Older Adults Undergoing High-Risk Surgery (5R03AG056588-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10000817. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*