# A Life Course Approach to Identify Risks of Hospitalization in Older Adults with Heart Failure

> **NIH NIH R01** · DUKE UNIVERSITY · 2022 · $340,612

## Abstract

PROJECT SUMMARY
Heart failure (HF) is the leading cause of hospitalization in adults aged 65 and older. More than 3 million
hospitalizations occur each year in older adults with HF and recurrent hospitalizations after discharge are
common, costly, and often preventable. For more than a decade, 30-day hospital readmissions have received
considerable attention as an actionable target to improve quality of care and reduce costs in the older-adult
(Medicare) population. Despite these investments, high rates of (re)hospitalization continue to put enormous
strain on the U.S. healthcare system and on those suffering from the disease. We argue that these strategies
have been largely ineffective because they focus on a single snapshot of a patient’s risk of hospitalization (30-
day readmission) and do not consider the majority of hospitalizations that occur over the course of the illness.
Therefore, efforts to predict and ultimately lower hospital readmissions in older adults will continue to fall short
until the full progession of hospitalizations are recognized and addressed. In response to this urgent need, our
study will address three critically unanswered questions: What are the most common patterns of hospitalization
that occur in older adults diagnosed with HF? Who are the patients most likely to follow these patterns of
hospitalization? And what are the factors that can help prevent hospitalizations during the course of treatment?
Drawing from a life course perspective and using data from a nationally-representative longitudinal study of
older adults, Medicare claims, and electronic health records, our proposed aims are threefold: First, we will
classify the major trajectories of hospitalization that occur in older adults diagnosed with HF. This aim will
provide evidence of how the number and timing of hospitalizations vary among HF patients over the course of
their illness. Second, we will examine how a wide array of demographic, socioeconomic, psychosocial,
behavioral, health-, and hospital-related factors are associated with patterns of hospitalization in HF patients.
This aim will allow us to determine key patient characteristics that can be assessed at the time of diagnosis to
predict a person’s probability of having a given trajectory of admissions over the course of their illness. Third,
we will identify factors that may reduce hospitalizations during the course of HF treatment. Our final aim will
examine a similarly wide range of factors that may alter the course of a trajectory (i.e., timing and/or number) of
hospitalizations, particularly among patients who experience high numbers of hospitalizations and/or face
critical periods of risk. Bringing together a strong team of interdisciplinary investigators, the results from this
project will have enormous potential to inform the design, targeting, and timing of interventions that are most
likely to succeed in reducing the significant burden of hospitalizations in older adults.

## Key facts

- **NIH application ID:** 10341651
- **Project number:** 1R01AG075210-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Matthew E. Dupre
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $340,612
- **Award type:** 1
- **Project period:** 2022-08-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10341651

## Citation

> US National Institutes of Health, RePORTER application 10341651, A Life Course Approach to Identify Risks of Hospitalization in Older Adults with Heart Failure (1R01AG075210-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10341651. Licensed CC0.

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