Project Summary/Abstract Older adults living with Alzheimer’s disease and related dementias (ADRD) are at a sharply elevated risk for falls and fall-related injuries resulting in traumatic brain injury (TBI) and hip fracture.1 After a fall-related trauma, evidence indicates this population is at a persistently elevated risk for poor outcomes (e.g., morbidity, mortality, nursing home admission). One outcome of importance to patients is home time, or the number of days alive and out of the hospital. However, there are currently few useful tools to help clinicians prognosticate home time for patients with ADRD. Failure to identify patient subgroups will perpetuate the clinical practice of restricting patients with ADRD to one common care pathway without consideration of individualized recovery trajectories. Translating evidence from other clinical settings, the development of tools to guide precision medicine and shared decision-making can facilitate desired patient outcomes. Tools to help predict home time could be used for shared decision-making during a critical juxtaposition in the life of an older adults—the recovery period following a serious fall-related trauma. The parent K76 grant for this proposal evaluates factors associated with home time after hip fracture, but does not specifically focus on trauma survivors with ADRD. Early results from our team on the parent grant highlighted tremendous variability in home time among trauma survivors by dementia status, which is difficult to reconcile with current treatment pathways. Thus, the overall objectives of this administrative supplement expand meaningfully on the parent grant research and career development goals supporting additional research and training to 1) develop, validate, and assess the equity of a predictive tool designed to help clinicals prognosticate home time for older adults following fall-related trauma, and 2) determine how older adults living with ADRD, their care partners, and clinicians caring for them could best utilize these predictions to guide care decisions. Using prediction model outputs as a starting point, this project will inform an R01 testing tailored care pathways based on these predictions to optimize home time for older trauma survivors living with ADRD.