Clarifying the Relationship between Delirium and Alzheimers Disease and Related Dementias (R01) | PAR 17 038

Frequently Asked Questions (FAQs)

What is the title and identifier of this NIH funding opportunity?

The opportunity is titled "Clarifying the Relationship between Delirium and Alzheimers Disease and Related Dementias (R01)" and is identified as PAR-17-038.

What is the overall purpose of this grant?

This NIH R01 opportunity supports research that clarifies the two-way relationship between delirium and Alzheimers disease and related dementias (ADRD), with the goal of moving beyond simple associations to determine the biological and clinical reasons these conditions intersect and how that knowledge can be acted on.

What does the FOA mean by a "two-way connection" between delirium and ADRD?

The FOA highlights two directions: (1) people who already have ADRD are more likely to develop delirium and often have worse outcomes than people who develop delirium without pre-existing dementia, and (2) delirium may be a warning sign or contributing factor for later cognitive problems, with evidence linking delirium to higher risk of later mild cognitive impairment or ADRD and, in many cases, faster cognitive decline than in patients without delirium.

What types of research are encouraged (basic, clinical, translational)?

The emphasis is broadly mechanistic and translational. Applications may range from foundational biology to clinically grounded studies, as long as they clarify why delirium and ADRD are linked and how the findings could be translated into better risk assessment, diagnosis, patient stratification, prevention, or management.

Is the FOA focused only on showing an association between delirium and dementia?

No. A central goal is to move beyond simple association and identify the biological and clinical reasons the two conditions intersect, including shared or interacting pathways and mechanisms that explain risk, progression, and outcomes.

What kinds of mechanisms or pathways are of interest?

The FOA is explicitly interested in shared or interacting pathways that might underlie both disorders, including pathways that are common to both conditions, occur in sequence, are causative or contributory, or act synergistically to increase brain vulnerability.

Are animal models allowed or encouraged?

Yes. The FOA includes a specific callout for using appropriate animal models when they can illuminate mechanisms that are difficult to isolate in humans, particularly in the context of aging and neurodegeneration.

What are examples of biological processes that could be studied under this FOA?

Examples mentioned include neuroinflammation, synaptic dysfunction, blood-brain barrier changes, neurotransmitter disruptions, metabolic stress responses, and other processes that may make an aging or degenerating brain more prone to acute confusion and attention disturbance.

Does this opportunity support research on risk factors and prediction?

Yes. A major theme is identifying risk factors and improving prediction in both directions: risk factors for delirium onset and progression among people with ADRD, and risk factors for later cognitive impairment or dementia among people who have experienced delirium.

What categories of risk factors are within scope?

The FOA notes clinical, biological, environmental, and care-related factors as relevant categories that could help explain who is most vulnerable and why.

Does the FOA address challenges in diagnosing delirium in people with existing dementia?

Yes. The FOA recognizes that delirium can be hard to detect in someone with baseline cognitive impairment and supports efforts to improve diagnosis and assessment when one condition occurs in the presence of the other.

Does the FOA also address missed or mischaracterized dementia during or after delirium?

Yes. It acknowledges that underlying ADRD can be missed or mischaracterized during or after an acute delirium episode and encourages work that improves diagnostic and clinical assessment methods in these situations.

What does the FOA mean by "phenotypes" or "subtypes"?

The FOA encourages work to define meaningful phenotypes (subtypes) of patients who experience both delirium and ADRD. The intent is to support more precise prognosis and to help enable more targeted prevention or treatment strategies.

Are intervention studies allowed under this grant?

Yes. Intervention development and testing are within scope, including pharmacologic and non-pharmacologic approaches to prevent delirium, treat delirium, or reduce its impact among patients with ADRD.

Can projects focus on reducing longer-term cognitive harm after delirium?

Yes. The FOA supports strategies aimed at reducing downstream cognitive harm after delirium and potentially influencing longer-term dementia-related outcomes.

What outcomes or deliverables does NIH expect supported projects to produce?

The FOA describes an overarching expectation of mechanistic insight that can be translated into improved risk assessment, better diagnostic tools and clinical assessment methods, clearer patient stratification or phenotyping, and improved prevention and management for delirium and ADRD in real-world settings.

What funding mechanism is used for this opportunity?

This is an NIH discretionary grant using the R01 mechanism.

What is the CFDA number listed for this opportunity?

The opportunity is listed under CFDA 93.866.

Who is eligible to apply?

The eligible applicant pool is broad and includes many types of U.S. organizations, such as state, county, and local governments; public and private institutions of higher education; independent school districts; special district governments; Native American tribal governments (federally recognized) and tribal organizations (other than federally recognized governments); public housing authorities and Indian housing authorities; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and other entities.

Are specific institution types explicitly noted as eligible?

Yes. The FOA explicitly notes eligibility for groups such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving Institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), faith-based or community-based organizations, regional organizations, U.S. territories or possessions, eligible federal agencies, and non-U.S. entities (foreign organizations).

Are foreign organizations eligible to apply?

Yes. The FOA explicitly includes non-U.S. entities (foreign organizations) as eligible applicants.

When was this opportunity created and what deadline information is provided?

The opportunity was created on 2016-10-27. The original closing date listed is 2018-01-24, reflecting the initial submission deadline information provided in the notice.