# High-Quality Primary Care for Older Adults with Alzheimer's Disease and Related Dementias: A National Mixed Methods Study

> **NIH NIH P01** · DARTMOUTH COLLEGE · 2024 · $325,022

## Abstract

PROJECT SUMMARY – PROJECT 3
Primary care clinicians serve as the predominant source of care for patients with Alzheimer’s disease and
related dementias (ADRD). High-quality primary care plays an important role in the prevention, diagnosis and
treatment of ADRD itself and in the management of the many chronic conditions that are prevalent among
those with ADRD. Little is known, however, about how access to high-quality primary care has changed in
recent years – including changes in access associated with the COVID-19 pandemic -- or about the policy-,
system- or practice-level factors that are associated with better quality of primary care for older adults with
ADRD. Drawing on a unique national dataset that includes annual information on the ownership and staffing of
all U.S. primary care practices from 2015-2024, linked Medicare claims data, and surveys of nationally
representative samples of these practices conducted in 2017 and 2022, we propose 3 aims. Aim 1: Examine
U.S. trends in access to primary care for older adults with ADRD using repeated cross-sectional studies of
primary and relevant subspecialty care for Medicare beneficiaries with and without ADRD diagnoses, and how
these trends varied for less advantaged populations. Aim 2: Use variations across states, delivery systems,
and physician practices in the implementation of initiatives intended to improve the quality of primary care in
order to identify policy-, system- or practice-level factors associated with better quality care for ADRD
patients. Aim 3: Develop practical recommendations on how to improve primary care for less-advantaged
patients with ADRD by purposively sampling respondents from Wave 2 of the practice survey that serve
economically less advantaged and minoritized populations and conduct in-depth qualitative interviews with
their leaders and staff. Findings across our three aims will be triangulated to develop recommendations that
can assist practice leaders, health system leaders, and policymakers in improving primary care for patients
with ADRD. Collaborating closely with Core B and C in this program project grant, this work will also contribute
to Project 1 and 2 by providing local measures of primary care quality and draw from these projects by
including measures of beneficiary access to Home and Community Based Services and Resident Services
Coordinators. The findings will identify opportunities to reduce the magnitude of the disparities in access to
high-quality primary care for older adults with ADRD.

## Key facts

- **NIH application ID:** 10898894
- **Project number:** 5P01AG019783-22
- **Recipient organization:** DARTMOUTH COLLEGE
- **Principal Investigator:** ELLIOTT S FISHER
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $325,022
- **Award type:** 5
- **Project period:** 2001-08-01 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10898894

## Citation

> US National Institutes of Health, RePORTER application 10898894, High-Quality Primary Care for Older Adults with Alzheimer's Disease and Related Dementias: A National Mixed Methods Study (5P01AG019783-22). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10898894. Licensed CC0.

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