Over 6 million Americans live with Alzheimer's disease (AD) or an AD-related dementia (AD/ADRD). Health care systems (HCS) struggle to provide high quality, coordinated, and equitable care to people living with dementia (PLWD) and their care partners (CPs). Scalable and adoptable interventions that are effective in improving the care delivered by HCS to this vulnerable population are desperately needed. Established in September 2019, the National Institute on Aging (NIA) IMbedded Pragmatic Alzheimer's disease (AD) and AD-Related Dementias (AD/ADRD) Clinical Trials (IMPACT) Collaboratory mission is to build the nation’s capacity to conduct embedded pragmatic clinical (ePCTs) of interventions within HCS for PLWD and their CPs. Since its inception, IMPACT has actualized its original aims to advance the conduct of ePCTs, develop and disseminate knowledge, build investigator capacity, and catalyze stakeholder collaboration. IMPACT’s accomplishments and challenges over its initial 5 years inform its next steps and provide rationale for its continuation. A one-year “bridge” supplement between the current award end date of June 30, 2024 and an anticipated competitive renewal start date is requested from July 1, 2024 thru June 30, 2025. The objective of the "bridge" is to maintain the essential administrative services necessary to supervise and support 36 ongoing projects across IMPACT’s five funding mechanisms (Pilots, Demonstration Projects, Health Care System Scholars, Real World Data Scholars, and Career Development Awards). The administrative services to be maintained during the “bridge” year include: tracking project performance, sustaining IMPACT’s knowledge repository and website, monitoring essential financial functions, maintaining regulatory compliance with the centralized IRB, DSMB, clinical trials.gov, and CROMs. Additionally, for the Long-Term Care Data Cooperative, created under a COVID related IMPACT supplemental project, but now serving investigators conducting nursing home based clinical trials, as well as, observational comparative effectiveness studies, the bridge is essential to keep this initiative operational. IMPACT: IMPACT’s bold vision is to transform the delivery, quality, and outcomes of care provided to Americans living with dementia and their CPs by accelerating the testing and adoption of evidence-based interventions within HCS. Its accomplishments to date provide a strong foundation for this vision, but realizing it will require more time, investment, and innovative approaches. Support for a bridge year, with an anticipated 5-year renewal period to follow, is necessary to maintain essential functions for 36 projects in process and the Long-Term Care Data Cooperative, and ultimately, achieve the full potential of this remarkable national infrastructure and ultimately translate its resources to meaningful improve in the quality of care delivered to PLWD and their CPs.