# Midcareer Investigator Award for Patient-Oriented Research in Dementia and Serious Illness

> **NIH NIH K24** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2022 · $66,833

## Abstract

Project Summary / Abstract
Background: Healthcare spending is highly concentrated among a small seriously ill population. Yet, most
high-cost patients are not in the last year of life and, despite high spending, quality of care for this group is
often low, marked by poor communication, high burden of pain and other symptoms, and preference-
discordant treatments. A key subset of this seriously ill population, persons with Alzheimer's disease and
related dementias, may experience the greatest burden of serious illness due to dementia's long course of
illness, progressive functional impairment, and high degree of caregiver strain, the impact of which is often
magnified among vulnerable and underserved subgroups. These issues are not well characterized over the
course of illness and very little is known about the experience of those with both dementia and another serious
illness, such as cancer or heart failure. Only by examining patient and families' experiences prospectively and
over time can we begin to understand how these patterns are associated with patient care quality and family
outcomes and thus appropriately target the interventions needed to improve care.
Aims: Over the award period, I aim to expand my research and mentoring program by 1) building an
innovative prospectively-framed sample, identified at onset of dementia, to examine patient and family
outcomes (i.e., hospital and emergency department admissions, burdensome transitions, nursing home
admission, and exhaustion of household wealth) over time; and 2) examining within this sample, differences in
these patient and family outcomes between those with dementia compared to those who also have another
serious illness (e.g., cancer). In both aims, we will also examine differences across vulnerable subgroups.
Methods: Working in parallel across two nationally-representative, longitudinal cohorts, the Health and
Retirement Study and the National Health and Aging Trends Study, linked to individual-level Medicare claims,
we will identify incident dementia and other serious illnesses. By anchoring to the first observed date of illness,
we will construct a longitudinal person-level dataset, including rich patient and family reported measures as
well as healthcare claims. We will then use these data to examine the experiences and outcomes of older
adults with dementia, with or without another serious illness, over time and also investigate disparities across
vulnerable social and demographic subgroups.
Public Health Significance: Older adults with dementia and other serious illnesses and their families are at
risk for suffering due to low-quality, high-cost care, yet little prospective data on their experiences exist. This
project will examine the longitudinal experience of those with dementia and their families beginning with the
onset of dementia, and compare these experiences to those with another serious illness, such as cancer or
heart failure. This study will also serve as a platform f...

## Key facts

- **NIH application ID:** 10413005
- **Project number:** 5K24AG062785-04
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** AMY STEVES KELLEY
- **Activity code:** K24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $66,833
- **Award type:** 5
- **Project period:** 2019-08-15 → 2022-09-03

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413005

## Citation

> US National Institutes of Health, RePORTER application 10413005, Midcareer Investigator Award for Patient-Oriented Research in Dementia and Serious Illness (5K24AG062785-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10413005. Licensed CC0.

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