# Function Before and After the Institutionalization of Persons with Alzheimer's Disease and Related Dementias

> **NIH NIH P30** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $403,374

## Abstract

PROJECT ABSTRACT
Alzheimer’s Disease and Related Dementias (ADRD) produce progressive impairments that lead older persons
and their caregivers to consider moving into an institution. Given the significance of institutionalization in a
person’s life and increasing fears about the harms of institutional settings,1–4 we need objective descriptions of
outcomes before and after institutionalization to guide persons with ADRD and caregivers through this major
event. The major reason why persons with ADRD seek institutional care is to meet functional needs. We
therefore propose epidemiologic studies of function before and after institutionalization in persons with ADRD,
examining (1) which activities tend to be impaired prior to institutionalization and (2) the average extent to
which moving to a facility leads to functional needs being met. For each aim, we will make comparisons to
those without ADRD who seek institutional care.
The UCSF Older Americans Independence Center (OAIC) studies the prevention of disability in older persons
and its amelioration when irreversible. Institutionalization is a major way through which disabled older
Americans seek support when their functional needs become too great. This administrative supplement
advances the mission of the OAIC by constructing a cohort of persons being institutionalized and examining an
important outcome in this cohort: function. We will leverage the expertise of the OAIC Data Analysis Core and
our experience working with the National Health and Aging Trends Study (NHATS), a nationally representative
study containing an unprecedented amount of detail on function in older persons before and after they are
institutionalized.
Our proposal will determine how function changes with institutionalization for persons with and without ADRD.
In Aim 1, we will describe the prevalence of functional impairments and unmet functional needs in persons with
and without ADRD the year prior to institutionalization. In Aim 2, we will describe how the unmet functional
needs change with institutionalization in persons with and without ADRD. Clinicians can use our results to help
persons with ADRD considering institutionalization know what to expect. Our results will provide the first
nationally representative data about functional impairment before institutionalization in persons with ADRD,
whether patients and caregivers believe those needs were met after placement, and how this compares in
persons without ADRD. Critically, we will also construct a cohort that can be used for future K76 proposals
examining other measures available in NHATS affected by institutionalization, such as caregiver hours. This
research aligns with the “NIA Strategic Directions for Research, 2020-2025” to improve our understanding of
ADRD (Goal D) and to better understand the effects of societal factors on aging, including the mechanisms
through which these factors exert their effects (Goal B).

## Key facts

- **NIH application ID:** 10499185
- **Project number:** 3P30AG044281-09S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** KENNETH E. COVINSKY
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $403,374
- **Award type:** 3
- **Project period:** 2013-07-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10499185

## Citation

> US National Institutes of Health, RePORTER application 10499185, Function Before and After the Institutionalization of Persons with Alzheimer's Disease and Related Dementias (3P30AG044281-09S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10499185. Licensed CC0.

---

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