# Biomarkers of neurodegeneration in the US and India: A cross-national evaluation of the biological underpinnings of ADRD

> **NIH NIH RF1** · JOHNS HOPKINS UNIVERSITY · 2024 · $2,365,042

## Abstract

PROJECT SUMMARY
Inconsistencies between observed effects on biological versus clinical endpoints of recent disease-modifying
therapies for Alzheimer's Disease and Related Dementias (ADRD) highlight existing gaps in our understanding
of biological processes of ADRD. Better characterization of the interplay between biology and the social
environment may help explain these discrepancies. To address this critical gap, the proposed research takes a
novel approach to understanding ADRD mechanisms by leveraging cross-national comparisons between the
US and India to evaluate biological underpinnings of ADRD, focusing on biomarkers of neurodegeneration,
vascular, nutritional, and inflammatory systems, and their interface with social and economic factors. With over
1.4 billion people India is the world's most populous country with a rapidly growing older population and has
very different social, economic, and demographic patterns of risk for ADRD compared to the US. Given this
novel opportunity for cross-national comparisons of the interface between biological markers of disease and
clinical outcomes, we will be able to identify common biological pathways observed in very different social and
economic contexts. Our overarching goals are to leverage data collected via Harmonized Cognitive
Assessment Protocols (HCAPs) in the US and India to assess the interplay between country, social factors,
and ADRD biology using recently collected and rigorously cross-nationally harmonized data on
neurodegenerative biomarkers, cognitive outcomes, and other markers of vascular, nutritional, and
inflammatory systems. Aim 1 uses neurodegenerative biomarkers to classify people into pathological subtypes,
then evaluates associations of other vascular, nutritional, inflammatory, and demographic factors with these
subtypes. Aim 2 associates each plasma biomarker with cognitive outcomes, while Aim 3 tests for effect
modification by socioeconomic factors. Aim 4 will evaluate the relative contribution of variance in plasma
biomarkers alongside other factors in predicting cognitive outcomes. Key innovations include cross-national
cohort integration, translational potential to interventions, biomarker research equity, and a research framework
centered on the biological and social determinants of ADRD. This proposed research is pivotal in leveraging
biology to understand social differences in cognition because cross-national comparisons between the US and
India, particularly regarding relationships of biomarkers to cognition and effect modification by social and
economic factors, will provide evidence as to the generalizability of findings on ADRD mechanisms in different
contexts. Our results will set the stage for high-quality cross-national research to identify intervention targets
for ADRD, with the ultimate objective of preventing and/or delaying the onset of ADRD from a global
perspective.

## Key facts

- **NIH application ID:** 10939816
- **Project number:** 1RF1AG088003-01
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** EILEEN M CRIMMINS
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $2,365,042
- **Award type:** 1
- **Project period:** 2024-09-22 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10939816

## Citation

> US National Institutes of Health, RePORTER application 10939816, Biomarkers of neurodegeneration in the US and India: A cross-national evaluation of the biological underpinnings of ADRD (1RF1AG088003-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10939816. Licensed CC0.

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