The Patient-Centered Outcomes Research Institute (PCORI) is seeking to fund high-quality, comparative clinical effectiveness research (CER) projects that focus on optimizing physical and mental functioning for community-dwelling older adults and their caregivers.

Research Initiative Highlights

By 2060, the number of Americans over 65 is projected to reach around 95 million, making up almost a quarter of the U.S. population. The number of people of color among the older adult population is also projected to increase significantly. Many older adults live with multiple chronic conditions, with a disproportionately greater burden experienced by people of color. Most older adults, including those with multiple chronic conditions, prefer to stay in their homes and communities for as long as possible, a concept referred to as “aging in place.” Family members or close friends often serve as the primary caregiver to older adults and play a critical role in helping them age in place by directly addressing their care needs and helping them navigate a fragmented healthcare system. As the needs of older adults become more complex, the caregiving role also intensifies, often resulting in a detrimental impact on caregiver well-being. Currently, the healthcare system is not well-equipped to address these complex care needs of the rapidly growing and diverse older adult population in the United States.

The Healthy Aging Targeted PCORI Funding Announcement will solicit applications for CER studies that focus on different phases of the aging continuum and aim to achieve one or more of the following four goals:

• maintaining function and independence
• facilitating chronic disease management
• supporting individuals with significant functional impairment 
• reducing caregiving burden and improving quality of life

The different phases of the aging continuum include on one end the healthiest older adults who have no chronic conditions, followed by those who may have one or two well-managed conditions. Their main goal is to maintain function and independence. Next on the continuum are older adults with chronic or multiple chronic conditions whose primary health focus is to manage their conditions and slow or reverse progression, followed by those with significant functional impairment (physical and/or cognitive) who are at higher risk for adverse events, require more support, and are likely to have higher healthcare utilization and expenditures. Finally, at the other end of the continuum there are seriously ill older adults who may need end-of-life care.

Applications may focus on populations in different phases of the aging continuum except for those at the two extremes, i.e., the healthiest of older adults with no chronic health condition and those who require end-of-life care.

For this reissuance, we especially encourage applications examining interventions that emphasize caregiver needs and models of care that integrate the formal health care system with community-based services. We encourage all applicants to consider how their proposed research may impact health equity and/or address disparities, for example, by focusing on populations who are underserved, underrepresented, or historically excluded. Interventions may be delivered in primary and specialty care clinics and home and community-based settings (e.g., assisted living, senior housing, and retirement communities; adult day care programs).

Applications evaluating interventions delivered primarily in institutional settings such as hospitals and nursing homes will be considered non-responsive to the funding announcement. Additionally, applications primarily evaluating pharmacologic interventions will be considered non-responsive to this reissuance.

Applicants are strongly encouraged to propose individual, or cluster randomized controlled trials; however, well-specified natural experiments will also be considered. Applicants are required to pay special attention to issues of intervention implementation with an aim of facilitating widespread uptake of findings after completion of the study. Toward that end, mixed methods studies and/or hybrid type I/type II designs are encouraged. Applicants should propose well-justified outcomes that are clinically meaningful, considered important by patients and/or their caregivers, and can be impacted upon by interventions evaluated in CER studies ranging from three to five years in duration.

For questions regarding this funding announcement, please reach out to sciencequestions@pcori.org.