# Project 2: Depression and chronic pain: Modifiable targets for prevention of AD/ADRD

> **NIH NIH P01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $581,589

## Abstract

Summary/Abstract
Depression is a highly prevalent and modifiable risk factor for Alzheimer’s Disease and Alzheimer’s Disease
Related Disorders (AD/ADRD). Severe and untreated depression is associated with substantially higher risk of
AD/ADRD. Older individuals with comorbidities and individuals from marginalized populations are more likely to
be undertreated for depression, possibly increasing disparities in AD/ADRD risk in these groups. Yet the long-
term effects of pharmacological and non-pharmacological treatments of depression on AD/ADRD risk are
currently unknown. Chronic pain is extremely prevalent and commonly co-occurs and exacerbates depression.
Evidence suggests chronic pain is a risk factor for AD/ADRD highlighting the need for a rigorous assessment
of independent and joint effects of depression and chronic pain on AD/ADRD risk. We propose a systematic
approach to interrogating potential biases by comparing patterns across populations, study designs, and
analytic approaches to derive the best possible estimates of the effects of depression, treatment of depression,
and chronic pain on AD/ADRD risk. We will leverage complementary sources of data including large, diverse
cohorts with electronic health record (EHR) databases enriched with survey and genetic information, as well as
diverse, national cohorts with repeated measures of cognition and depressive symptoms. We propose three
aims: Aim 1. Evaluate the effect of depression on AD/ADRD and cognitive decline accounting for
cerebrovascular and other comorbidities, as well as severity, recurrence, and duration of depression and the
effects of treatment. Aim 2. Examine the direct effect and modifying role of chronic pain on AD/ADRD and
cognitive decline in the context of depression. Aim 3: Examine heterogeneity in the distribution and effects of
depression and depression treatment by gender, race, ethnicity, socioeconomic status, and educational
attainment as possible drivers of health disparities in AD/ADRD and evaluate the extent to which these
inequalities could be reduced through improvements in treatment. Working closely with the TIME-AD Cores to
field novel and rigorous science in large, diverse data sets, we will provide more compelling and actionable
evidence than previously achievable on the independent and joint effects of depression and chronic pain on
AD/ADRD and on whether treatment of depression can reduce AD/ADRD risk and AD/ADRD inequities.

## Key facts

- **NIH application ID:** 10934715
- **Project number:** 1P01AG082653-01A1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Paola Gilsanz
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $581,589
- **Award type:** 1
- **Project period:** 2024-09-15 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934715

## Citation

> US National Institutes of Health, RePORTER application 10934715, Project 2: Depression and chronic pain: Modifiable targets for prevention of AD/ADRD (1P01AG082653-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10934715. Licensed CC0.

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