# Primary care based collaborative approach to care management for older adults with dementia

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2021 · $197,590

## Abstract

Care for the growing population of older adults with Alzheimer's Disease and Related Dementias (ADRD) is
challenging. Care management programs are a common approach to streamlining care for persons with
conditions such as ADRD. Care management programs are typically siloed in individual settings; however, as
older adults with ADRD utilize care in many settings, they are often contacted by multiple care management
programs. Simultaneous enrollment in more than one care management program (hereafter “simultaneous
enrollment”) may paradoxically lead to less coordinated care if the programs do not collaborate. The
prevalence and consequences of simultaneous enrollment in ADRD are unclear. This K23 proposal builds
upon the candidates' work funded by the Grants for Early Medical/Surgical Subspecialists' Transitioning to
Aging Research (GEMSSTAR, R03) to advance understanding of the consequences of simultaneous
enrollment and the acceptability and potential design of a primary care-based collaborative approach to care
management for older adults with ADRD. Aim 1 will result use a novel linked dataset that includes care
management enrollment data from two health systems in Baltimore and statewide hospital and emergency
department utilization data to determine whether simultaneous enrollment in care management is: (1) more
common among older adults with ADRD and (2) associated with preventable hospital and emergency
department use. Aim 2 will use qualitative interviews with four groups of stakeholders (care management
program leaders and staff, primary care clinicians and office staff, health information technology experts, older
adults with ADRD and their family caregivers) to identify barriers and facilitators to and the design of a primary
care-based collaborative approach to care management for older adults with ADRD. Aim 3 will pilot test a
primary care based collaborative approach to care management for older adults with ADRD focused on
feasibility and acceptability. The proposed research will contribute needed evidence about how to best
approach care for older adults with ADRD in the context of population health initiatives such as care
management. The candidate is a geriatrician who has already demonstrated a strong track record of academic
scholarship with numerous publications and early investigator grants. She has proposed a comprehensive set
of training activities that are geared toward her development as a clinician investigator and national leader who
informs improvements to care delivery for older adults with ADRD. The project will foster her continued career
development in the following ways (1) additional coursework and experience in advanced statistical methods,
(2) developing a foundational understanding of bioinformatics, (3) applied experience in intervention design in
the context of ADRD care, (4) improving her understanding of population health initiatives. She has assembled
an exemplary mentoring team with expertise in the subject ...

## Key facts

- **NIH application ID:** 10192059
- **Project number:** 1K23AG072037-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Stephanie Nothelle
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $197,590
- **Award type:** 1
- **Project period:** 2021-04-15 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10192059

## Citation

> US National Institutes of Health, RePORTER application 10192059, Primary care based collaborative approach to care management for older adults with dementia (1K23AG072037-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10192059. Licensed CC0.

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