# The confluence of extreme heat cold on the health and longevity of an Aging Population with Alzheimers and related Dementia

> **NIH NIH RF1** · HARVARD MEDICAL SCHOOL · 2022 · $2,385,541

## Abstract

Project Summary/Abstract
About ten percent of Americans older than 65 (5.8 million) are estimated to live with Alzheimer’s dementia (AD)
or related dementias (ADRD), constituting the 5th leading cause of death among 65 and older in the U.S. Yet,
our estimates from the prevalence of AD/ADRD outdated and the vulnerabilities of the older adults living with
AD/ADRD to extreme environmental change remain unknown. Understanding the vulnerabilities of these
populations is critical due to two of the most prominent upcoming global challenges: a growing aging
population and a changing climate. On the one hand, the number of Americans ages 65 and older is projected
to nearly double, while those with AD/ADRD are projected to nearly triple by 2050. On the other hand, the
severity and frequency of the extreme environmental changes, such as extreme heat and cold events, are
expected to increase due to climate change. Extreme heat/cold events can increase mortality and healthcare
utilization outcomes (e.g., hospitalization) among older adults. More frequent and intense extreme heat and
cold events can pose disproportionate risks to the elderly population living with AD/ADRD through certain
cognitive biologic pathways. However, we do not know about potential pathways through which exposure to
extreme changes in ambient temperature may directly (or indirectly through other stressors) impact older
AD/ADRD patients, whose responses to extreme environmental change may be disrupted/delayed due to
memory loss, challenges in planning and solving problems, trouble in understanding visual images, and
confusion with time and place. Our goal is to characterize the extent of the exacerbation of cause-specific
healthcare utilization outcomes (i.e., hospitalizations, hospital readmissions within 30 days, primary care visits,
and specialist visits) and mortality due to extreme heat/cold events, among the older adults living with
AD/ADRD. Using a longitudinal cohort of over 63 million Medicare enrollees (≥65 years), we will apply
comprehensive and well-validated computational approaches to study the immediate, short-, and long-term
effects of extreme heat and cold events on healthcare utilization outcomes and mortality. In Aim 1, we will
develop and validate computational methodologies to improve misclassification in AD/ADRD cohort
identification, estimate and project the prevalence of the older adults living with dementia, build high-resolution
spatio-temporal maps of extreme heat and cold events that can be integrated with administrative data (Aim 1c).
In Aim 2, we will estimate the immediate and short-term effects of extreme heat and cold events on mortality
and hospitalization (admission and emergency department visits) among the elderly population with AD/ADRD.
Aim 3 will entail developing and deploying a high-performance computing pipeline to discover de novo and/or
unanticipated causal links between long-term exposure to extreme temperature events and cause-specific
healt...

## Key facts

- **NIH application ID:** 10448053
- **Project number:** 1RF1AG074372-01A1
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Francesca Dominici
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $2,385,541
- **Award type:** 1
- **Project period:** 2022-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10448053

## Citation

> US National Institutes of Health, RePORTER application 10448053, The confluence of extreme heat cold on the health and longevity of an Aging Population with Alzheimers and related Dementia (1RF1AG074372-01A1). Retrieved via AI Analytics 2026-05-30 from https://api.ai-analytics.org/grant/nih/10448053. Licensed CC0.

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