Cognitive Impairment in Aging Strategy and Partnership

Cognitive Impairment in Aging Partnership - a Strategic Initiative of the CIHR Institute of Aging

Table of Contents

Summary

The Cognitive Impairment in Aging Partnership: Uniting forces to improve health

The Cognitive Impairment in Aging Partnership is a consortium of private, non-governmental, voluntary and government organizations established to work together to further research in Alzheimer Disease and other dementias (AD&D) and the application of that research to improve the quality of life of those suffering with AD&D.

Since its inception, the Cognitive Impairment in Aging Partnership has invested over $26 million in targeted areas.

Why a Cognitive Impairment in Aging Partnership? Cognitive impairment in aging, including Alzheimer disease and other types of dementia, affects one in four Canadians over the age of 65. The incidence of cognitive impairment rises dramatically to two out of three Canadians over the age of 85. With our aging population, the number of cases of cognitive impairment is expected to double in Canada over the next 30 years, reaching epidemic levels.

The effects of cognitive impairment are far-reaching. Those who suffer from cognitive impairment experience a decline in their quality of life. The emotional suffering of their families and loved ones is considerable, and the financial burden on the health care system is significant.

Prevalence of Cognitive Impairment in Canada

Graph of Prevalence of Cognitive Impairment in Canada

While the need for cognitive impairment research is great, there are not enough researchers, in training or experienced, to meet the growing demand. The Cognitive Impairment in Aging Partnership, established in 2002, addresses this need by bringing together organizations with a shared interest in finding solutions.

Partners

The Partners engaged in the Cognitive Impairment in Aging Initiative, through its funding opportunities and other research-related activities, include the following:

  • Alzheimer Society of Canada
  • AstraZeneca Canada Inc.
  • Canadian Coalition for Seniors' Mental Health
  • Canadian Neurological Sciences Federation
  • Canadian Nurses Foundation
  • CIHR Institute of Aging
  • CIHR Institute of Neurosciences, Mental Health and Addiction
  • Consortium of Canadian Centres for Clinical Cognitive Research
  • FRSQ Réseau québécois de la recherche en vieillissement/Network on Aging
  • Heart and Stroke Foundation of Canada
  • Janssen-Ortho Inc.
  • Lundbeck Canada Inc.
  • Neurological Health Charities Canada
  • NeuroScience Canada
  • Novartis Pharmaceuticals Canada Inc.
  • Parkinson Society Canada
  • Pfizer Canada Inc.
  • Public Health Agency of Canada
  • Veterans Affairs Canada

Mechanisms of Support

Joint investments among the partners under the Cognitive Impairment in Aging Partnership Initiative total over $26M.

Funding Opportunities to Build Research Capacity

Fellowship: Veterans and Dementia (Institute of Aging in partnership with Ste. Anne's Hospital - Veterans Affairs Canada; St. Joseph's Health Care London Veterans Care Program; Capital Care Group Inc.) to build research capacity to advance clinical knowledge and practice in the field of Dementia and Veterans Care.

Mobility in Aging and Dementia: Fellowship (Alzheimer Society of Canada and CIHR Institute of Aging) to build capacity and encourage more research into the issue of mobility in aging and dementia.

Focus on Stroke: Doctoral Research Awards and Fellowship Awards (Institute of Aging in partnership with the Heart and Stroke Foundation of Canada, the Canadian Stroke Network and CIHR's Institute of Circulatory and Respiratory Health) to encourage more students, recent graduates and postgraduates, including health professionals to train in the field of stroke. CIHR's Institute of Aging is interested specifically in increasing research capacity to address functional limitations of older individuals as a consequence of stroke.

Doctoral and Young Investigator Awards (Alzheimer Society of Canada and CIHR's Institute of Aging)

  • Various launches (2001-2006) / Results

Funding Opportunities for Research, Teams and Networks

Operating Grant: Collaborative Research to Action in Dementia (Alzheimer Society of Canada and CIHR's Institute of Aging) to support knowledge translation research and related activities involving Canadian, and where relevant foreign, researchers, initiatives and networks in the fields of Alzheimer Disease and related dementias.

Operating Grant: Care Practice in Cognitive Impairment in Aging (numerous partners) to better inform nursing care practice and improve the quality of clinical care provided to the cognitively impaired older adult in various care settings, such as institutional, home, and community.

Operating Grant: Knowledge Translation Network in Alzheimer and Dementia (numerous partners) to support the design and implementation of the Research to Action Program in Dementia (RAPID) - a Network for Translation of Research in Alzheimer Disease and Dementia (AD&D).

Vascular Health and Dementia Operating Grants (Heart and Stroke Foundation, CIHR/Rx&D and Institute of Aging and Institute for Neurosciences, Mental Health and Addiction, Pfizer Canada and Alzheimer Society of Canada)

Caregiving and Alzheimer Disease Research Grants Program (Alzheimer Society of Canada, Canadian Nurses Foundation, CIHR Institute of Aging and CIHR Institute of Gender and Health)

  • Various launches (2003-2006) / Results

Biological Mechanisms and Treatment of Alzheimer Disease Grants Program (Alzheimer Society of Canada, Astra Zeneca Canada and AstraZeneca US/Sweden, and CIHR Institute of Aging)

  • Various launches (2001-2004) / Results

Background

Alzheimer Disease and related dementias (AD&D) currently affect 8% of seniors aged 65+, with rates increasing to 1 in 3 seniors or higher among the oldest seniors (85+). Estimated direct and indirect health costs of AD&D in Canada (1994 figures) are $5.5 billion annually (i.e. $15 million daily). On top of these costs are the inestimable social costs to families and caregivers. The annual cost of care per individual with severe Alzheimer Disease is $36,794. As the population ages, the number of seniors with dementia will increase dramatically, from an estimated 435,000 in 2006 to 750,000 by 2031. In 2006 alone, there will be approximately 97,000 new cases of dementia. Although AD&D cannot be cured or prevented yet, there is emerging evidence that early intervention shows promise in delaying progression of the intellectual and/or functional decline, sometimes for the remainder of the senior's life.

Research within and across CIHR's four research themes: biomedical, clinical, health services and societal and environmental determinants of health is required to achieve the goal of this initiative. Thus, fundamental to this initiative are multi-disciplinary approaches to addressing the larger health issues and questions within Cognitive Impairment in Aging. Collaborations and partnerships are integral to this approach.

Maximizing the impact of research in Cognitive Impairment in Aging requires knowledge translation. While ideally research underpins evidence-based practices, programs and policies, there are areas in Cognitive Impairment in Aging where the research results are available, but are not in a format readily accessible to the relevant users. Identifying and addressing these gaps requires research methods designed to systematically scope and synthesize evidence and methods of communication appropriate to the target audience(s). Input from users on research issues, design, through to evaluation ensures relevance of the research and its impact. Again collaborations and partnerships are also an essential component.

Recognizing the need for coordinated and partnered efforts, a consortium of private, non-governmental, voluntary and government organizations have joined forces to establish the Cognitive Impairment in Aging Partnership. Initiated in 2001, this consortium worked together to develop a National Research Strategy for Canada to further research in Alzheimer Disease and other dementias.

The Institute of Aging continues to nurture additional relationships with other CIHR Institutes and other research funding agencies, as well as government, private sector and non-governmental organizations.

Objectives of the Strategic Initiative

National Research Strategy

To reduce the prevalence and impact of cognitive impairment, the participants of the Cognitive Impairment in Aging Partnership have developed a National Research Strategy on cognitive impairment that aims to:

  • build research capacity by training and attracting new researchers
  • make optimum and efficient use of available resources of Cognitive Impairment in Aging Partners
  • co-ordinate research more effectively
  • improve research infrastructure (teams, groups, centres, cohorts of subjects, neuro-imaging, brain banks, etc.)
  • increase funding available through grants and awards to retain researchers
  • implement initiatives to enhance the use of newly acquired knowledge through its translation into policy, practice, products and services

Eligible Research and Research-related Activities

Scope of research inquiry

Research conducted as part of the Cognitive Impairment in Aging Partnership's National Research Strategy covers a broad range of topics, disciplines and issues related to cognitive impairment including Alzheimer disease and other dementia such as:

  • vascular dementia
  • biomolecular basis
  • neuropsychological aspects
  • social, psychological and lifestyle influences
  • normal vs. abnormal changes in cognitive function
  • diagnosis
  • natural history and influence of age
  • genetics and environment
  • epidemiology
  • treatment (pharmacological and non-pharmacological)
  • preventive strategies
  • caregiving
  • health services
  • rehabilitation
  • ethics
  • quality of life

Within or across any of the above areas, eligible activities also include addressing ethical issues/impact of the research, research translation and research outcomes. There is potential overlap between the above areas, and restriction to solely one area is not expected. Similarly, addressing multiple areas is not an absolute requirement, although multi-disciplinary approaches are encouraged.

All areas of eligible research are clearly laid out in the different funding opportunities launched under the Cognitive Impairment in Aging Partnership Initiative, and are based on the interest of the partners involved and the overall goal of the initiative.

Key Themes

With in the context of the scope of research under the Cognitive Impairment in Aging Partnership Initiative, various workshops and meetings have been sponsored to determine the key themes and elements that should comprise a comprehensive research strategy in AD&D. Essential elements fall under two main categories: research platforms and research themes.

Five Core Research Platforms:

  1. Clinical Cohort Group
  2. A National Data Warehouse
  3. MRI database and Imaging Analysis
  4. Genotyping and DNA Storage
  5. Plasma and Tissue Samples

Six Research Themes:

  1. Molecular/Cellular Foundations of Neurodegeneration
  2. Early Diagnosis
  3. Prevention of Cognitive Impairment and Dementia
  4. Treatment of Dementia
  5. Health Services Research and Access to Care
  6. Caregivers and Maintenance in the Community

Relevance Review Process

Relevance review is undertaken for all funding opportunities launched under the Cognitive Impairment in Aging Partnership Initiative. The process for relevance review is fully described in each funding opportunity. Such reviews will take place prior to and in the absence of any knowledge about the outcome of peer review and will have no impact on the peer review process.

Cognitive Impairment in Aging Stakeholder Activities

Since the inception of the CIHR Institute of Aging in 2000, there has been an increasing level of interaction among stakeholders. The Alzheimer's Disease and related-Dementia (AD&D) research community and interested NGOs, industry, non-government organizations and some provinces have come together through various venues. The CIHR Institute of Aging has promoted such activities to further research and knowledge translation in the field through the sponsoring of workshops and by spearheading the establishment of the Cognitive Impairment in Aging Partnership. There is a general consensus and interest in catalyzing a Canada-wide coordinated and integrated approach to AD&D management through effective application of research-based evidence, best practices and technology to prevention, treatments and care for the benefit of every Canadian.

In October 2004, the National Advisory Council on Aging (NACA - an advisory body that advises the Minister of Health on issues related to aging and seniors) and the Alzheimer Society of Canada announced their partnership in calling for a National Strategy on Alzheimer Disease and Related Dementias. The goals of the strategy were outlined as follows:

  • decrease the prevalence of AD&D;
  • decrease the socio-economic burden of AD&D; and
  • develop evidence-based prevention strategies, improve early diagnostics of all dementias, and improve the access to and the quality of treatment and supportive care for all Canadians affected by AD&D (patients, families and caregivers).

In March 2006, the federal government convened an Alzheimer Disease and Related Dementias Stakeholder Workshop. In terms of discussion on research, the top recommendation was to a national research agenda for prevention, treatment and management of those affected by AD&D. Activities to support this would include the following:

  • Develop and fund a virtual network for researchers to dialogue, share data, tissue samples and other relevant information;
  • Develop and fund a virtual clearinghouse for research findings that includes knowledge translation to make information accessible to the general public, organizations and service providers — this clearinghouse would also include information on sector-appropriate strategies for implementation;
  • Develop opportunities for engaging with international researchers in AD&D through post-doctoral grants, awards and other mechanisms;
  • Increase federal government's level of research funding for basic and applied research to prevent and treat dementia.

Other social and economic aspects that were important discuss and breakout topics included:

  • Public Awareness;
  • Health Promotion/Disease Prevention program implementation;
  • Federal Support for Those Affected by AD&D (e.g. home care, national pharmacare, supportive housing, etc.);
  • Caregiver Support; and
  • Policy Leadership/Development.

Cognitive Impairment in Aging Partnership - related Events

Regular initiative updates will provide links to Cognitive Impairment in Aging-related conferences as well as IA-led consultations and think tanks.

Please visit the Institute of Aging Calendar of Events Web page for more information in relevant events. For additional information, please also see the Alzheimer Society of Canada Events Web page.

Contacts

For questions about the Cognitive Impairment in Aging Partnership Initiative, research objectives, and partnership opportunities contact:

Michelle Peel
Assistant Director-Ottawa
CIHR Corporate Headquarters
Telephone: 613-952-4537
Fax: 613-954-1800
Email: michelle.peel@cihr-irsc.gc.ca

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