# Adult Changes in Thought (ACT) Research Program

> **NIH NIH U19** · KAISER FOUNDATION RESEARCH INSTITUTE · 2024 · $11,040,953

## Abstract

The Adult Changes in Thought (ACT) U19 Program will expand, modernize, and improve ACT's prospective
cohort study to achieve advances in scientific understanding of older adults in general and dementia and
Alzheimer's disease in particular. ACT is set in a healthcare delivery system. The study team identifies incident
cases of dementia and Alzheimer's disease and follows consenting participants to autopsy. The Program will
transform the current ACT U01 to a U19, which envisions complex multi-component programs that will have a
powerful influence on the field. The Program's overarching goal is to identify risk factors across the life course
that provide potential intervention targets for preserving cognition and preventing Alzheimer's disease and
related dementias (ADRD). The Overall Specific Aims are: Aim 1. Expand ACT cohort enrollment and
modernize and improve follow-up with emphasis on increasing racial/ethnic diversity and deep phenotyping of
life course risk factors, cognitive and physical functioning, and outcomes including neuroimaging and
neuropathology based ADRD outcomes. The Cores will expand cohort enrollment from 2,000 to 3,000. The
study will invest in six Cores: A, Administrative; B, Clinical; C, Life Course; D, Neuropathology; E,
Neuroimaging; F, Data and Analysis. These Cores will work together to further enhance the value of ACT's
resources, enabling the ACT study to continue to be the foundation for an extraordinary array of science. To
date, ACT has achieved a completeness of follow-up index of 94.5% and has observed 56,140 person-years of
follow-up. ACT has identified >1,300 incident dementia cases and >1,000 incident Alzheimer's cases. The
study has completed >850 autopsies and will surpass 1,100 autopsies this cycle. Additionally, 1,077 ACT
participants had one MRI scan, and 540 have had ≥2, with funding in place for hundreds more. Aim 2. Support
key Projects studying the spectrum of healthy functioning to ADRD in older adults. The three Projects center
around 24-hour cycle physical activity, sedentary behavior, and sleep patterns in old age (Project 1), the
implications of cognitively defined Alzheimer's disease subgroups (Project 2), and mechanisms underlying
neural protection and toxicity of strong anticholinergic drugs and antihypertensive drugs (Project 3). Aim 3.
Expand and improve ACT's dissemination of exceptional resources to the research community guided by NIA's
adopted FAIR (Findable, Accessible, Interoperable, and Reproducible) principles. ACT has proven to be an
exceptional resource to the research community, providing data and specimens to research colleagues locally,
across the country, and around the world, and provides mentorship to junior investigators. We will continue to
enhance our data sharing capabilities in this U19 Program.

## Key facts

- **NIH application ID:** 10876368
- **Project number:** 5U19AG066567-04
- **Recipient organization:** KAISER FOUNDATION RESEARCH INSTITUTE
- **Principal Investigator:** Paul K Crane
- **Activity code:** U19 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $11,040,953
- **Award type:** 5
- **Project period:** 2021-05-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10876368

## Citation

> US National Institutes of Health, RePORTER application 10876368, Adult Changes in Thought (ACT) Research Program (5U19AG066567-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10876368. Licensed CC0.

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