>>WELCOME TO THE OPEN SESSION OF THE 144TH NATIONAL ADVISORY COUNCIL ON AGING. WE'RE GOING TO START OFF TODAY, HEARING FROM OUR DIRECTOR, Dr. RICHARD HODES AND HE WILL BE GIVING THE DIRECTOR'S STATUS REPORT. RICHARD? >> GOOD MORNING AND WELCOME. I WILL PROVIDE BACKGROUND INFORMATION TO OPEN OUR MORNING. SINCE WE LAST MET IN MAY, THE PRESENT BUDGET FOR FY2022 HAS BEEN RELEASED AS THE STARTING POINT IN THE LONG PROCESS THAT WILL EVENTUALLY LEAD TO A FY22 APPROPRIATION. THE PRESIDENT'S BUDGET CALLS FOR $51 BILLION FOR NIH, $9 BILLION INCREASE OVER THE FY2021 ENACTED AND THAT INCLUDED OF THE $9 BILLION INCREASE, $6.5 MILLION FOR THE ADVANCED RESEARCH PROJECTS AGENCY FOR HEALTH WHICH WOULD FOCUS ON CANCER AND OTHER DISEASES SUCH AS DIABETES AND ALZHEIMER'S. SUBSEQUENTLY IN JULY, THE HOUSE PASSED ITS APPROPRIATION BILL WHICH PROVIDED FOR $49.4 BILLION, INCREASE OF $7 BILLION AND OF THIS, $3 BILLION WAS APPROVED FOR ARPA-H. NOTABLY IT INCLUDED AN ADDITIONAL $200 MILLION FOR AD/ADRD RESEARCH, NOT RELEASED IN THE FIRST BUDGET. THE SENATE HAS NOT RELEASED ITS FY22 BUDGET YET SO WE WAIT. THE FEDERAL GOVERNMENT IS CURRENTLY FUNDED THROUGH SEPTEMBER 30, 2021 AND SO HOPEFULLY THERE WILL BE NO LAPSE AND HOPEFULLY THIS FUNDING WILL BECOME THE NORM. FOR FISCAL YEAR 2021, SOME GENERAL PAY LINES ARE SET. FOR THE MOST COMMON UNDER 500K GRANTS, THE PAY LINE WAS 10 PERCENTILE AND OF COURSE A LOT OF OUTSTANDING RESEARCH HAS NOT BEEN FUNDED. FOR NEW AND EARLY INVESTIGATION RESPECTIVELY, IT IS 13 PERCENTILE AND THEN A HIGHER BAR FOR THE GENERAL PAY LINE. AD/ADRD WITH 28 PERCENT AND 31 AND 33 PERCENT AND OF COURSE THIS PUTS US TO THE NEXT LEVEL OF FUNDING AND APPLICATIONS. NEXT SLIDE, PLEASE. THE PAY LINES FOR THE NONPERCENTILE, YOU CAN SEE HERE THE GENERAL PAY LINE, 15 FOR PROGRAM PROJECTS AND NIA-REVIEWED RESEARCH, 21 FOR CAREER DEVELOPMENT AWARDS AND 20 FOR FELLOW SHIPS AND YOU CAN SEE THE AD/ADRD PAY LINES RESPECTIVELY. NEXT SLIDE, PLEASE. I THINK EACH YEAR FOR THE PAST FEW YEARS WE HAVE TALKED ABOUT THIS LAW OR REQUEST OR REQUIREMENT THAT EACH YEAR NIH PREPARE AND SUBMIT A PRESIDENT'S BY PASS BUDGET WHICH GOES DIRECTLY TO THE PRESIDENT FOR REVIEW AND TRANSMITTAL TO CONGRESS WITHOUT COMMENT THAT COULD RESULT IN ANY CHANGE SO IT IS A BY PASS PROCESS AND THEN THE PRESIDENT SENDS IT TO CONGRESS FOR REVIEW FOR THE FUNDING NECESSARY TO CONTINUE TO SUPPORT ALZHEIMER'S AT THE OPTIMAL PACE NEEDED TO PURCHASE SEE THE GOALS AND FINDINGS INCLUDING THE CURE, PREVENTION AS WELL AS CARE FOR THOSE LIVING WITH AND CARING FOR THOSE WITH COGNITIVE DEMENTIA. SO WE WILL TALK A LITTLE BIT ABOUT 2023, NEXT SLIDE. THIS WILL BE RELEASED IN JULY AND BASED AS IN THE PAST ON THE GENERAL BROAD CATEGORIES, EIGHT CADRO CATEGORIES. NEXT SLIDE, PLEASE. AND AGAIN THIS BUDGET BASED ON THE CURRENT YEAR 2021, ACTIVE LEVEL. SINCE WE DON'T KNOW WHAT THE NEXT LEVEL WILL BE, THIS IS THE PROPOSAL FOR 2023 AND YOU SEE FOR EACH OF THE CATEGORIES LISTED, THE ADDITIONAL FUNDING NEEDED TO ACHIEVE MAX MAXIMAL PROGRESS FOR OUR GOALS. YOU CAN SEE AN ADDITIONAL AMOUNT NEEDED. AND FREEING UP PRIOR YEAR'S APPROPRIATIONS THAT CAN BE TAKEN FROM SUCCESSFULLY COMPLETED PROJECTS, THAT LEAVES ABOUT $226 MILLION REQUESTED IN THE BY PASS BUDGET. NEXT SLIDE, PLEASE. AND THIS IS JUST A POD DIAGRAM THAT ILLUSTRATES THE BREAKDOWN IN BROAD CATEGORIES, AGAIN THE TOTAL PROJECTED COST SOME $376 MILLION. NEXT SLIDE PLEASE. IF WE TRAPS LATE THIS INTO THE TOTAL RESOURCES NEEDED ACROSS AD/ADRD, IT WOULD BE $3.43 BILLION AND AGAIN WE WAIT TO SEE WHAT HAPPENS IN FY2022. IN THE MEANTIME THIS HAS BEEN SUBMITTED FOR CONGRESSIONAL APPROVAL TO CONGRESS. NEXT SLIDE, PLEASE. IN ADDITION, I WANT TO EMPHASIZE THERE IS AN IMPORTANT NARRATIVE AS A GREAT DEAL OF THOUGHT IS PUT INTO THIS SUMMARIZING THE NATURE OF PROGRESS, RESEARCH, GAPS AND PLANS AND I URGE ALL OF YOU TO PAY ATTENTION AND PROVIDE YOUR INPUT TO THIS. THE LINK IS GIVEN HERE TO THE FULL TEXT OF THE PROGRESS REPORT OR THE BY PASS BUDGET SUBMISSION. FOR TRACKING IMPLEMENTATION AS WE MOVE FORWARD WITH THESE MILESTONES, THERE ARE ONLINE TOOLS OPEN TO ALL OF YOU AS WE CONTINUE TO TRACK THE AWARDS UNDER THE CADRO CATEGORIES IN SUPPORT OF ALL OF OUR FUNDING EFFORTS AND CONSISTENCY TO BY PASS BUDGETS. NEXT SLIDE, PLEASE. COVID-19 HAS HAD A MAJOR IMPACT ON ALL OF US AND I WOULD NOTE HERE, CURRENTLY ACT NIA COVID-19 RELATED FUNDING OPPORTUNITIES AND DETAILS I WON'T GO INTO BEFORE, THE MANY INITIATIVES AROUND COVID WHICH NIH AND NIA STAFF HAVE PLAYED VERY IMPORTANT AND LEADING ROLES. NEXT SLIDE, PLEASE. NIH IS ISSUING A REQUEST FOR INFORMATIONAL RFI AROUND THE CONSENT LINE FOR FUTURE USE OF DATA AND URGE EACH OF YOU TO LOOK AT THIS IMPORTANT AREA TO MAXIMIZE THE COMFORT LEVEL OF THE POPULATIONS AND PROVIDE DATA TO ALLOW US TO TAKE ADVANTAGE OF INFORMATION AND BEST PLANNING TOWARDS THE HEALTH AND WELL-BEING OF OUR NATIONAL POPULATION. NEXT SLIDE, PLEASE. THE NIH FISCAL PLAN FOR FY2021-2025 IS NOW AVAILABLE. VERY BROADLY SPREAD AROUND THE MEDICAL SCIENCES, DEVELOPING MAINTAINING AND RENEWING SCIENTIFIC RESEARCH AND EXEMPLIFYING AND PROMOTING THE HIGHEST LEVEL OF SCIENTIFIC INTEGRITY. URGE YOU ALL TO LOOK AT THIS LINK. AND NEXT SLIDE. THE NIA HAS EXPANDED ITS ALZHEIMER'S CENTERS NETWORK AND HAS DONE SO AGREEING WITH WHICH WE HAVE CAPACITY FOR RESEARCH ACROSS THE COUNTRY. THE ADDITIONS IN BLUE HERE ARE FOUR NEW CENTERS IN NEVADA, NEW MEXICO, ALABAMA AND TENNESSEE ARE TARGETED TOWARDS, IN PARTICULAR, THE EXPLORATORY CENTERS IN AREAS OF THE COUNTRY THAT WERE LACKING IN REPRESENTATION AND WHERE MINORITY POPULATIONSRESIDE SO THE ATTEMPT HERE IN EXPLORATORY CENTERS TO PROVIDE THEM WITH THE BEGINNINGS AND PROVIDE IMPORTANT OUTREACH CAPACITIES. NEXT SLIDE, PLEASE. AN IMPORTANT ISSUE OF RECRUITING FOR CLINICAL TRIALS, ALL RESEARCH STUDIES FOCUSED HERE ON ALZHEIMER'S DEMENTIAS BUT IN ALL GENERAL CASES WE SUPPORT, TWO INITIATIVES PRESENTED HERE WITH LINKS, THE INFORMATION AVAILABLE TO YOU, THE ADORE PROGRAM, PLANNING RESOURCES FOR PARTICIPANTS IN THE AREAS OF AD AND ADRD AND OUTREACHPRO, ENABLING HEALTHCARE PROFESSIONALS TO GENERATE THEIR OWN TAILORED OUTREACH PROGRAM. NEXT SLIDE, PLEASE. WE DON'T HAVE THE LUXURY, IF YOU HAVE HAD THE ON-PERSON MEETINGS AND NEW STAFF THAT HAS COME ON BUT WE DO THIS HERE TO LIST THE PROFESSIONAL STAFF HIRED SINCE MAY, ALISON HERMAN, RESEARCH FELLOW, NATAN BASISTY, ALYSSA LIN, ANN MOORE AND CAMILLE POTTINGER. NEXT SLIDE, PLEASE. AND FOR THE OUTREACH ARM SINCE MAY, WE NOTE NIA HAS RELEASED27 RESEARCH HIGHLIGHTS, A NUMBER OF BLOGS AND ANNOUNCEMENTS AND PRESS REALIZES AND WE HAVE BEEN AS ACTIVE AS WE CAN BE IN THIS REMOTE TIME IN TERMS OF STAKEHOLDER GROUPS, CONGRESSIONAL HEARINGS AND BRIEFINGS THAT WE HAD THE OPPORTUNITY TO PARTICIPATE IN THIS SUMMER. NEXT SLIDE, PLEASE. AND WE END AS ALWAYS WITH A REMINDER TO PLEASE STAY INFORMED AND CONNECTED TO THESE SITES AND ANY AND ALL NEEDS TO HAVE THE CONTACTS STAY WITH US DURING OUR COUNCIL MEETINGS, I WILL END THERE AND TURN BACK TO ANY QUESTIONS AND COMMENTS FROM COUNCIL. >> THANK YOU, DOCTOR HODES. QUESTIONS? ALL RIGHT, NOT HEARING ANY, THANK YOU AGAIN, RICHARD, FOR THE UPDATE TO NIA AND OF COURSE IF ANY OTHER QUESTIONS BECOME APPARENT, PLEASE DON'T HESITATE TO ASK. SO THE NEXT PART OF OUR AGENDA, I JUST WANT TO REMIND YOU THAT -- OF FUTURE MEETINGS FOR OUR COUNCIL. WE HAVE MEETINGS NOW FOR -- ALL SCHEDULED FOR 2022 AND 2023 SO PLEASE MARK YOUR CALENDARS FOR THOSE MEETINGS COMING UP. YOU WILL NOTICE THAT SOME ARE ON -- INSTEAD OF TUESDAY-WEDNESDAY, IT IS WEDNESDAY-THURSDAY SO THERE IS A CHANGE IN OUR PROCEDURES BUT THAT IS DUE TO THE AVAILABLE ROOMS IN THE FUTURE. AND OUR JANUARY MEETING THIS COMING 2022, JANUARY 25TH AND 26TH WILL BE VIRTUAL SO THAT IS A CHANGE FROM THIS SLIDE HERE. ALL RIGHT, AND THE NEXT, WE HAVE A CONSIDERATION OF THE MINUTES FROM OUR LAST MEETING. I ASK COUNCIL MEMBERS WHERE AVAILABLE IN THE ELECTRONIC COUNCIL BOOK, I WOULD ASK IF THERE IS ANY CORRECTIONS OR COMMENTS ON THE MINUTES FROM THE LAST MEETING. ALL RIGHT, NOT HEARING ANY, COULD I HAVE A MOTION TO APPROVE THE MINUTES FROM THE LAST MEETING? >> SO MOVED. >> SO MOVED. >> SECOND? >> SECOND. >> ALL IN FAVOR? [ CHORUS OF AYES ] >> ANY OPPOSED? NOT HEARING ANY, THANK YOU, WE HAVE APPROVED MINUTES FROM THE LAST MEETING. NEXT, WE ARE GOING TO HEAR A REPORT FROM OUR TASK FORCE ON MINORITY AGING AND RESEARCH SO I WILL TURN THIS OVER TO DOCTORS WHITFIELD AND ROSEN. >> GREAT, THANK YOU VERY MUCH AND I WILL INTRODUCE KEITH WHO WILL TALK ABOUT THE FIRST SPEAKER. WE HAVE A VERY BUSY ONE AND A HALF HOUR SESSION WITH VARIOUS NEW PRESENTATIONS THAT WE WILL HIGHLIGHT. KEITH? >> THANK YOU, CLIFF, AND GOOD MORNING, EVERYONE. SO YESTERDAY AT OUR SESSION, WE HAD A EXTREMELY ROBUST SESSION ABOUT SOME OF THE BEHAVIORAL SOCIO-PSYCH LOGICAL AND BIOLOGICAL FACTORS THAT GO INTO UNDERSTANDING THE ROLE THAT HEALTH PLAYS IN LONGEVITY AND HEALTH BUT ALSO LOOKING AT HOW HEALTH DISPARITIES CHANGE WHAT WE SEE IN OUR POPULATION. SO THE FIRST PRESENTATION WE HAD WAS FROM KATHLEEN MULLAN-HARRIS WITH A HEALTH STUDY THAT WAS STARTED IN 2000, MAYBE BEFORE THEN AND AS THINGS DO, IT MATURED AND I THINK ONE OF THE THINGS THEY DID VERY WISELY WAS SET IT UP SO THAT IT CAN CONTINUE ON AND TAKE SOME OF THAT BASE OF WORK AND BE ABLE TO EXTEND IT INTO ADULTHOOD. SO THIS WAS A FASCINATING TALK ON MIDLIFE SOCIAL AND BEHAVIORAL FACTORS AND HOW THEY HAVE IMPORTANT APPLICATION FOR HEALTH STANDS. IT HIGHLIGHTS RISING MORTALITY RISKS AMONG WORKING PEOPLE, 25 TO 64-YEAR-OLDS AND AS WE KNOW, THAT NUMBER IN TERMS OF WORKING AGE, FOR MANY PEOPLE, THAT IS NOT LIMITED TO 25 TO 64-YEAR-OLDS. THE PRESENTATION ALSO POINTED OUT SOME OF THE FACTORS THAT CONTRIBUTE TO HEALTH DISPARITY. I THINK SOME IMPORTANT TAKEAWAYS WERE ONE, PREDRIVERS OF WORKING AGE MORTALITY THAT VARY WITH RACE AND GENDER INCLUDING DRUG POISONING, ALCOHOL INDUCED MORTALITY, SUICIDE AND CARDIO METABOLIC DISEASE. THE STUDY ALSO HIGHLIGHTED THE DIFFERENT ECONOMIC FACTORS AT WORK IN THE MACRO AND MICROLEVELS, ALL THE INDIVIDUAL LEVELS CREATING DIFFERENCES AND DISPARITIES AMONG OUR WORKING AGE ADULTS. DOCTOR HARRIS ALSO SUGGESTED THAT THE HEALTH DISPARITIES CAN SHOW UP IN MIDLIFE AND ARE AVAILABLE IN PSYCHOLOGICAL AND SOCIAL STAGES. SO WITH THAT I WILL HAND IT OVER TO KEITH FOR THE NEXT PRESENTATION. >> THANKS. SO THE NEXT SLIDE WAS FROM Dr. AMY KIND FROM THE UNIVERSITY OF WISCONSIN FOCUSING ON THAT GROUP AND THE MOST IMPORTANT INNOVATION AND NEIGHBORHOOD EFFORTS WHICH SHE IS REALLY THE INNOVATOR BEHIND. SO WHAT SHE TALKED ABOUT WAS LIVING IN DISADVANTAGED NEIGHBORHOODS CAN BE LINKED TO A NUMBER OF HEALTHCARE OUTCOMES INCLUDING THE HIGHER RATES OF DIABETES AND CARDIOVASCULAR DISEASE AS WELL AS HIGHER UTILIZATION OF HEALTH SERVICES AND, MOST IMPORTANT, EARLIER DEATHS. AND SHE MADE THE POINT THAT INTERVENTIONS AND POLICIES THAT DON'T ACCOUNT FOR NEIGHBORHOOD DISADVANTAGE MAY BE INEFFECTIVE. THIS WORK, SHE PIONEERED INITIALLY THROUGH THE ADI AND THEN DEVELOPED A FAIRLY UNIQUE TOOL, A NEIGHBORHOOD ATLAS, WHICH IN THE WEST SIDE WAS CREATED TO CLEARLY SHARE MEASURES OF NEIGHBORHOOD DISADVANTAGE WITH THE PUBLIC. AND SHE HAD HUNDREDS OF THOUSANDS OF HITS TO THAT WEBSITE AND UTILIZATION INCLUDING USE BY EDUCATIONAL INSTITUTES IN HEALTH SYSTEMS, NOT-FOR-PROFIT ORGANIZATIONS, GOVERNMENT AGENCIES. IN ORDER TO MAKE THOSE METRICS READILY AVAILABLE FOR USE IN RESEARCH IMPORTANTLY FOR PROGRAM PLANNING AND POLICY DEVELOPMENT. THE SITE WAS LAUNCHED IN 2018 AND HAS BEEN A WINDFALL FOR MANY OF US AS WE BEGIN TO PROCESS OUR NEIGHBORHOOD DISADVANTAGES PLAYING A MAJOR ROLE IN HEALTH DISPARITIES AND OVERALL HEALTH OUTCOMES. SO I THINK WHAT WE ALL TOOK FROM THIS WAS HOW IMPORTANT THE WEBSITE IS AND HOW WIDELY USED IT HAS BEEN TO GUIDE THE SCIENCE RELATED TO DISPARITIES AND INEQUITIES. AND IMPORTANTLY FOR NIA, HER WORK HAS ALSO BEEN APPLIED IN REVERSE, SOME OF IT, TO ADAR RESEARCH. THE NEIGHBORHOOD STUDIES WILL EXAMINE THE LIFE COURSE SOCIAL EXPOSOME -- [INDISCERNIBLE] THIS IS INCORPORATING 20 HEALTH CENTERS AND SPANS ACROSS THE NATION FOR INDIVIDUALS WHO HAVE DEMENTIA. IT IS ALSO TAKING A LOOK AT GENOME BIOLOGY. SO THIS GIVES US A WINDOW INTO THE SOCIAL BIOLOGICALLISM THAT UNDER LIE THE NEIGHBORHOOD DISADVANTAGE. WITH THAT, WE HAVE A FEW ANNOUNCEMENTS AND I WILL TURN IT BACK TO STEVE. >> THANKS, IS THERE ANY QUESTIONS REGARDING OUR SPEAKERS FOR THE TASK FORCE FOR Dr. WHITFIELD AND ROSEN? ALL RIGHT, THANK YOU AGAIN, CLIFF AND KEITH FOR YOUR PRESENTATION. SO NEXT WE ARE GOING TO MOVE ON TO OUR PROGRAM HIGHLIGHTS. AND THIS IS A REPORT OF OUR WORKING GROUP ON PROGRAM AND I WILL TURN IT OVER TO Dr. MONICA DRISCOLL. MONICA? MONICA, YOU ARE ON MUTE. >> MY APOLOGIES, GOOD MORNING, EVERYONE. WE'RE GOING TO BEGIN WITH A REPORT I WILL READ FOR YOU. SO CTA P IS A SUBCOMMITTEE OF THE NATIONAL ADVISORY COUNCIL ON AGING, NIA DIRECTOR REGARDING THE PRIORITY OF LARGE CLINICAL TRIALS. THE PANEL MET ON MARCH 20, 2021 BY ZOOM TO REVIEW AN AMENDED CONCEPT PROPOSAL FOR THE INVESTIGATOR INITIATED -- I'M SORRY, HRPEF CLINICAL TRIALS SUBMITTED BY DOCTOR KICHNER AT WAKE FOREST UNIVERSITY. IS IT IS A RANDOMIZED ATTENTION CONTROLLED TRIAL WHICH WILL BE PROMOTING THE EFFICACY OF OUTPATIENT TO HOME, PHYSICAL REHABILITATION IMPLEMENTATION IN ADULTS 80 YEARS AND OLDER WITH HEART FAILURE WITH PRESERVED HTEF PHENOTYPE. THE AMENDED CONCEPT PROPOSAL ADDRESSED THE COMMENTS MADE AT THE OCTOBER 2020 MEETING WHEN THE INITIAL CONCEPT WAS REVIEWED. CTA P WAS HIGHLY SUGGESTIVE THROUGHOUT THE STUDY BY A SCORE OF 17 SINCE THE PROPOSED STUDY ADDRESSES AN AREA OF GREAT IMPORTANCE ON THAT NEED AND OPPORTUNITY FOR INDIVIDUAL AND SYSTEM-WIDE IMPROVEMENTS. A MULTICOMPONENT REHABILITATION INTERVENTION IS IMPERATIVE FOCUSING ON GERIATRICS-TYPE PHYSICAL THERAPY AND AN APPROACH TO THE CONDITION THAT HAS THE WORDS HEART FAILURE IN ITS TITLE, YET REPRESENTS A MULTIFACTORAL SYNDROME WITH MULTIPLE MORBID TEASE FOR A GERIATRIC APPROACH. BY FOCUSING ON SUCH CRUCIAL OUTCOMES OF HOSPITALIZATION AND DEATH, IF SUCCESSFUL, THE STUDY RESULTS MAY PROVIDE EVIDENCE NEEDED TO COVER THE COSTS OF THIS APPROACH IN CLINICAL PRACTICE. IF IT PROVES ITS HYPOTHESIS, IT WILL OFFER A GREAT OPPORTUNITY TO PROMOTE GERIATRIC SCIENCE WITH MULTIENTER VEX ADDRESSING COMPLEX OLDER PATIENTS. IN OCTOBER 2021, WE WILL ACCEPT INVESTIGATOR APPLICATIONS FOR THE TRIAL FOR PEER REVIEW SO THAT IS THE CTA P REPORT. IF ANYONE HAS COMMENTS, I GUESS WE CAN ASK FOR THOSE NOW. IF NOT, WE WILL MOVE TO THE CONCEPT CLEARANCES WHICH, LET ME PULL UP. SO YESTERDAY, WE REVIEWED, WELL, I THINK 15 EXCITING NEW CONCEPT CLEARANCES AND SO WHAT WE WILL DO TODAY IS SUMMARIZE THE CONTENT OF THE CLEARINGS AND SUMMARIZE THE DISCUSSION AND THIS WILL BE DONE BY THE PRIMARY REVIEWERS. THE FIRST CONCEPT CLEARINGS IS ENTITLED DNA SEQUENCING AS AN INTEGRATING POINT OF THE AGING HALLMARKS. AND THE PRIMARY REVIEWER WAS ACTUALLY ME WITH A COREVIEWER. SO HERE WE GO. GIVE ME JUST A SECOND. SO THE ATTENUATION OF DNA HAS BEEN ASSOCIATED WITH AGING AND CELLULAR SYNAPSES AND IMPORTANTLY CONSIDERED TO BE A MAJOR DRIVER OF THE DECLINE IN PHYSIOLOGICAL FUNCTION. THE DNA CAN ACTUALLY ACTIVATE CERTAIN SIGNALING PATHWAYS IN THE CELL THAT HAVE BEEN KNOWN TO TRIGGER THE SECRETION PHENOTYPE AND HAS IMPORTANT WORKINGS OF THE AGENT. SO IN THE FIELD, THIS DNA IS SORT OF AN INTEGRATING POINT FOR DIFFERENT PATHWAYS COMING IN AND THEN THE CONSEQUENCES THAT RESULT IN DEBILITATIVE CONSEQUENCES IN THE AGING. THE PROBLEM IS A LOTTERY MAINS TO BE KNOWN ABOUT THE BASIC BIOLOGY OF THIS PROCESS AS WELL AS THE INTEGRATION WITH THE AGING FIELD, IN PARTICULAR WITH SOME OF THE MORE CLASSICALLY CONSIDERED HALLMARKS OF AGING. SO ESPECIALLY SINCE THIS DNA HAS BEEN SUGGESTED TO BE THE INTEGRATING POINT, IT IS REALLY IMPORTANT TO UNDERSTAND THE BACK BIOLOGY IN THE CONTEXT OF GREATER AGING PHENOTYPES AND THAT IS WHAT THIS CONCEPT IS ALL ABOUT. SO THE CONCEPT PROPOSES TO UNDERSTAND THESE GAPS AND PROVIDE AN UNDERSTANDING BY THE PROPOSAL ON INTEGRATIVE BIOLOGY AND BIOLOGY HALLMARKS AND REALLY NEW INSIGHTS AND INTEGRATIVE UNDERSTANDINGS CAN RESULT. SO IT IS A VERY TIMELY PLAN THAT ALSO I SHOULD ADD HAS AN ADDED BONUS THAT THE PROGRAM WILL KIND OF ORCHESTRATE COMMUNICATION AND REPORTING DATA EXCHANGE AND MEETINGS AND TECHNOLOGICAL EXCHANGE AMONG RECIPIENTS OF THESE GRANTS SO THERE IS AN ADDED BONUS OF KIND OF THE SYNERGY OF HAVING, REALLY, YOU KNOW SETTING UP A PLATFORM WHERE THEY WILL TALK WITH EACH OTHER AND THIS IS THE FIRST OF THE THREE CONCEPTS WE WILL REVIEW HERE. SO THE PROJECT IS DEFINITELY IN THE -- FALLS WITHIN THE SPECTRUM OF THE NIA GOALS OF UNDERSTANDING KIND OF FUNDAMENTAL MECHANISMS. THE PROGRAM ARGUES FOR A SETASIDE FOR FUNDING WHICH WILL BE GEARED TO ATTRACT EXPERIENCED INVESTIGATORS WHO ARE OF DIVERSE KIND OF EXPERTISE INTO THIS SOMEWHAT NEW FIELD AND WILL A SEPARATE REVIEW IS ENCOURAGED BECAUSE OF THIS INTERDISCIPLINARY NATURE AND BECAUSE SOME NEW FUNDAMENTAL DESCRIPTION IS GOING TO BE GENERATED AS A RESULT OF THE DISCUSSION. TO CLARIFY QUESTIONS ABOUT THE CONSORTIUM OF RESERVERS AND BROADENING OF THE DEFINITION OF WHAT AGING HALLMARKS MAY BE. I AM FULLY ENTHUSIASTIC ABOUT THIS CONCEPT THAT SHOULD ADVANCE RESEARCH IN A NOVEL HOT AIR THAT IS LIKELY TO KIND OF RECONFIGURE OUR BASIC BIOLOGY RELATED TO AGING AND THUS INSPIRE THOUGHTS ABOUT THERAPY. -- HOT AREA. OKAY, WE WILL MOVE TO THE SECOND -- THE SECOND CONCEPT IS ENTITLED MAPPING INTERCONNECTIVITY AMONG HALLMARKS OF AGING UNDER LIFESPAN MODIFICATIONS. THE PRIMARY REVIEWER IS Dr. ROSEN AND I WAS THE SECONDARY VIEWER. Dr. ROSEN? >> CLIFF, YOU ARE ON MUTE. >> SORRY ABOUT THAT, I APOLOGIZE. THIS IS AN UNDERTAKING TO TRY TO LINK THE CLASSIC HALLMARKS OF AGING, HOW THEY ARE INTERCONNECTED. IT IS CLEAR THAT WE HAVE ESTABLISHED AT LEAST NINE HALLMARKS THAT ARE RELATED TO AGING IN TERMS OF THE BIOLOGY AND THERE ARE MORE THAT ARE OUT THERE THAT ARE BEING DISCOVERED OR LINKED TO THE BASIC NINE HALLMARKS. WHAT WE WOULD LIKE TO DO IS TO KIND OF GET THE LINK GATHERING FROM HOW TO BE INTERFACED AND WHAT IS THE END RESULT, PARTICULARLY IN TERMS OF LIFESPAN MODIFICATION, THE MAJOR PRIORITY OF THE PROGRAM. SO THIS PLAN WOULD BE TO GENERATE A R01-TYPE MECHANISM WITH MULTIPLE PRINCIPLE INVESTIGATORS FOR A RESEARCH PROJECT THAT WOULD LOOK AT THE FOLLOWING AREAS. NORMAL LIFESPAN INTERACTIONS ACROSS THOSE NINE HALLMARKS AND HOW THEY ARE ADAPTIVE AND DO THE INTERACTIONS ACTUALLY CHANGE THE CONJECTURING. AND FURTHER, WHEN, DURING INTERVENTION, WOULD THIS OCCUR, MIDLIFE, LATE LIFE, EARLY LIFE AS THE EXPERIMENTAL MODEL AND THEN WE WOULD USE SINGLE CELL DYNAMICS AS AN APPROACH TO LOOK AT THAT. SO JUST A REMINDER THE CELLULAR AGING, STABILITY, STATIC CHANGES, REGULATING NUTRIENT SENSING, EXHAUSTION AND INTERCELLULAR COMMUNICATION SO OBVIOUSLY THESE ARE THEIR OWN DISCIPLINARY STUDIES BUT THIS WILL TRY TO MAKE THIS LINKA GE AMONG THE DIFFERENT COMPONENTS AND LOOK AT HOW THEY INTERACT. AND THIS IS A PRIORITY FOR NIA AND UAB AND PART OF A LONG-TERM STRATEGIC PLAN TO UNDERSTAND THE BIOLOGY OF AGING. SO IT WOULD BE A SETASIDE WITH AN RFA AND WOULD BE A COLLABORATIVE VENTURE AMONG INVESTIGATORS. SO THE IDEA WOULD BE TO BRING MULTIPLE PEOPLE IN TO THIS PROGRAM AS A CONSORTIUM, INFORMAL CONSORTIUM AND THEY WOULD ALSO SEEK COMPUTATIONAL EXPERTISE. SO WE SPENT A LOT OF TIME REVIEWING, DOCTOR DRISCOLL AND I, REVIEWING THE PROGRAM AND WERE ABLE TO FEEL VERY COMFORTABLE THAT THIS APPROACH WILL BRING TOGETHER A MULTIPLE DIFFERENT TYPES OF INVESTIGATORS IN THIS INTEREST -- INTER DISCIPLINARY TYPE APPROACH WITH THE RO1 MECHANISM. AND WE WERE COMFORTABLE ENOUGH TO SAY THAT EVEN THOUGH IT IS AMBITIOUS, THERE WILL BE ENOUGH THERE SO THAT THIS WILL BE A EARLY STEP IN TRYING TO DETERMINE THE INTEGRATION OF SOME OF THESE HALLMARKS OF AGING AND MOST IMPORTANTLY, THE READOUT WHICH WOULD SHOW THE TRAJECTORY. SO THERE WAS SOME DISCUSSION ON COUNCIL YESTERDAY BUT THIS IS SO IMPORTANT AND NEEDS TO MOVE FORWARD. >> OKAY, IF THERE IS NO FURTHER DISCUSSION ON THIS CONCEPT, H, WE WILL MOVE FORWARD TO THE NEXT ONE. HERE IS THE PRIMARY REVIEWER ON THIS -- [INDISCERNIBLE] DOCTOR WAGERS? >> THANK YOU, SO THIS IS THE THIRD IN THE TRIO OF THE STUDIES TO UNDERSTAND HOW AGING IS CONNECTED. THIS HAS CLEARLY BEEN IMPACTED BY THE CONCEPT OF THESE AGING HALLMARKS BUT IN LARGE PART HAVE BEEN STUDIES SEPARATE FROM ONE ANOTHER AND THIS IS A REALLY IMPORTANT MOVE TO EMPHASIZE THEIR INTER CONNECTEDNESS AND DEVELOP A BETTER UNDERSTANDING MECHANIC KISTICLY HOW THEY RELATE TO ONE ANOTHER. THIS IS A NEW EXCITING BIOLOGY THAT HAS RELEVANCE TO AGING MECHANISMS AND LIKELY SHAPES THE INTERACTIONS OF THESE AGING HALLMARKS AND THAT IS THE INTERCELL COMMUNICATION. IT HAS BEEN EMPHASIZED THAT COMMUNICATION OCCURS AT CONTACT SITES SERVING AS CRITICAL SIGNALING NODES FOR THE TRANSFER OF IONS, METABOLITES, LIPIDS AND PROTEINS AND CONTROL THE DYNAMICS OF THE ORGANELLES THEMSELVES, CRITICAL FOR MAINTAINING CELLULAR HOMEOSTASIS, KEEPING THEM IN A WORKING ORDER AND HOW THEY RESPOND TO STRESS. AND THESE PROPERTIES SHOW CELLS THAT BECOME LESS EFFICIENT AND LEAD TO DECREASES IN CELL AND ORGAN FUNCTION AND THE DECREASE WE SEE IN OLDER INDIVIDUALS SO THIS WILL CATEGORY ICE THE EXTENT TO WHICH THEY IMPACT AGING HALLMARKS, PARTICULARLY THE INTERACTIONS AMONG AGING HALLMARKS. TO DATE, MOST AREAS OF STUDIES HAVE FOCUSED ON THE IMPACTS ON CELLS INVOLVED AND THIS WILL BRING IMPORTANT INFORMATION TO THE AGING OF CELLS AND AS DISCUSSED, VEST KPWAEURTS FUNDED IN THIS MECHANISM WILL ENTER INTO MUTATIONS WITH OTHER INVESTIGATORS STUDYING AGING HALLMARKS WITH THE IDEA TO BRING TOGETHER A CONSORTIUM OF INVESTIGATORS TO SHARE KNOWLEDGE AND IDEAS AND REALLY PROPEL THIS AREA FORWARD. THERE WAS ROBUST ENTHUSIASM FOR THIS EMPHASIS BOTH IN TERMS OF BRINGING IN NEW AND IMPACTFUL CELL BIOLOGY, MORE TO THE FORE IN AGING BIOLOGY AND ALSO IN PIVOTING THE FIELD TO FOCUS ON THE INTERACTIONS AMONG HALLMARKS AS AN INTEGRATIVE WAY OF UNDERSTANDING MECHANISTICALLY HOW TO PROPEL THIS SCIENCE FORWARD SO WE'RE ALL VERY EXCITED TO SEE THIS CATALYZED. >> OKAY, THANK YOU VERY MUCH, IF THERE IS IN FURTHER DISCUSSION ON THIS CONCEPT, I THINK WE NOW MOVE TO THE DEVICE OF BEHAVIORAL AND SOCIAL RESEARCH CONCEPT. AND THE FIRST ONE REVIEWED THERE IS ENTITLED RESOURCES TO PROMOTE COORDINATION AND COLLABORATION ACROSS DEEPLY PHENO TIME LONGITUBINAL SOCIAL AREAS OF AGING. THE PRIMARY WAS Dr. WHITFIELD. >> YES, THANK YOU. SO THIS CONCEPT CLEARANCE AIMS TO CREATE THE INFRASTRUCTURE NEEDED TO PROMOTE, AND SUPPORT COORDINATION AND COLLABORATION OF LONGITUDINAL BEHAVIOR. WE UNDERSTOOD THE GOAL OF THIS WAS TO USE A COOPERATIVE AGREEMENT MECHANISM TO INVESTIGATE DIRECT FACTORS THAT IMPACT HEALTH AND WELL-BEING LATER IN LIFE. THE OBJECTIVE IS TO FIND COMMON GROUND ACROSS STUDIES SUPPORTED BY THE NIH TO SUPPORT HYPOTHESIS AND DO FINE GRAIN MAPPING ON AGING AND LIFESPAN DEVELOPMENT. THE STUDIES TO BE INCLUDED IN THIS INITIATIVE WOULD NOT BE WHAT ONE WOULD THINK OF, THESE LARGE POPULATION-BASED STUDIES THAT NIH SUPPORTS. RATHER, THESE WOULD BE THE SMALLER, DEEPLY PHENOTYPE STUDIES DEVELOPED BY INDIVIDUAL INVESTIGATORS AS STANDALONE PROJECTS. ESTABLISHING LINKS BETWEEN INDIVIDUAL STUDIES COULD PROVIDE REPLICATION OF TUNED TOINGS AND EXTEND RESULTS TO NEW CONTEXT AND PROVIDE INSIGHT ON IMPORTANT BEHAVIORAL, PSYCHOLOGICAL AND SOCIAL FACTORS THAT MODERATE HEALTH SPAN AND LIFESPAN. THE WORK TO BE DONE IF THIS IS WHAT IS APPROVED WOULD INCLUDE OUTREACH IN MEETING TO STIMULATE COLLABORATION. ENGAGEMENT OF METHOD LOGICAL STUDIES AVAILABLE ACROSS THE SERIES, THE STUDY OF THE -- [INDISCERNIBLE] AND BE ABLE TO SUPPORT MONIES AND MECHANISMS FOR SUPPORTIVE COLLABORATIVE THEMES THAT WORK TOGETHER. I NOTE ONE OF THE COMMENTS THAT Dr. WEIR SAID THAT MAY BE SOME OF THE MOST DIFFICULT WORK, IS TRYING TO CREATE THESE COLLABORATIVE THEMES. I DIDN'T SAY IT YESTERDAY BUT THOUGHT IT OVERNIGHT, YEAH, IT MIGHT BE LIKE HERDING CATS BUT YOU CAN MOVE THEIR FOOD. [LAUGHTER] >> SO I THINK THERE IS A LOT OF SUCCESS THAT CAN BE HAD HERE. SO THIS WORK WAS ACTUALLY DONE IN 2019 AND 2020 IN WORKSHOPS FOCUSING ON COLLABORATION AND COORDINATION ACROSS THE DIFFERENT STUDIES ALLOWING SCIENTISTS TO LEARN MORE ABOUT EACH OTHER' S WORK AND ACTUALLY TO ENCOURAGE THE COLLABORATION THAT CAME ABOUT AS A RESULT OF THAT. THIS PROMOTES THE RESOURCES NEEDED TO PROMOTE HIGH QUALITY RESEARCH. IN THE END, WE STRONGLY SUPPORT THIS PARTICULAR MEASUREMENT. THANK YOU. >> GREAT, THANK YOU VERY MUCH. IS THERE ANY FURTHER COMMENTS ON THIS PARTICULAR CONCEPT? OKAY, HEARING NONE, WE WILL MOVE TO THE NEXT ONE WHICH IS ENTITLED HEALTH EQUITY IN THE NOVEL TREATMENTS FOR ALZHEIMER'S DISEASES AND RELATED DEMENTIAS, THE PRIMARY WAS Dr. MANLY AND THE SECONDARY Dr. WHITFIELD. Dr. MANLY, WOULD YOU LIKE TO SPEAK TO THAT? >> SURE, THIS WAS AN RFA THAT WOULD REQUEST APPLICATIONS ACROSS R61 AND R33 GRANT, A BIOPHASIC MILESTONE DRIVEN MECHANISM THAT IN THE FIRST TWO-YEAR STAGE, WOULD DEFINE PARAMETERS FOR STIMULATION AND MODELS THAT WOULD SIMULATE THE COSTS AND HEALTH OUTCOMES OF NEW TREATMENTS FOR ALZHEIMER'S AND ADRD USING METHODS THAT ACCOUNT FOR KNOWN RACIAL AND ETHIC DISPARITIES IN THOSE CONDITIONS. AND ALSO DISPARITIES IN TREATMENT ENGAGEMENT AND ACCESS. SO THE PARAMETERS DURING THIS FIRST TWO-YEAR STAGE WOULD BE ESTABLISHED WITH STAKEHOLDERS, ALL OF US ARE STAKEHOLDERS, EVERYONE ON THIS CALL IS A STAKEHOLDER INCLUDING PEOPLE WHO ARE NOT ON AI COUNCIL. SO AND THIS ANALYSIS WILL GATHER ATTITUDES TOWARDS NEW DRUGS, INFORMATION ON WHAT OUTCOMES ARE MOST IMPORTANT TO MEMBERS OF A DIFFERENT RACIAL AND ETHIC GROUPS THAT HAVE BEEN TRADITIONALLY EXCLUDED FROM ADRD RESEARCH AND ALSO EXPERIENCE -- AND YET EXPERIENCED ADRD DISPARITIES AND THIS RESEARCH AFTER COLLABORATION WITH NIH STAFF, THOSE TEAMS CHOSEN TO MORE FORWARD WITH THE NEXT PHASE WOULD RUN THE MODELS AND DISSEMINATE FINDINGS. SO THE TIMELINESS OF THIS CONCEPT IS VERY CLEAR. WE HAVE ALL WITNESSED THE FDA APPROVAL RECENTLY AND WE KNOW GIVEN ITS PRICE, EVEN WITH 80 PERCENT MEDICARE COVERAGE, THE REMAINING 20 PERCENT OF THAT COST OF THAT DRUG IS EQUIVALENT TO 24 PERCENT OF THE MEDIAN HOUSEHOLD WEALTH OF BLACK OLDER ADULTS. AND WE HAVE ANALYSES NOW SHOWING THIS IMPACT OF EXPENDITURES ON MEDICARE AND THAT COST COULD BE POTENTIALLY DEVASTATING. WE ARE DISCUSSING A DRUG THAT HAS NO CLINICAL BENEFIT AND ONE THAT DID NOT INCLUDE SUFFICIENT NUMBERS OF ETHNIC MINORITIES. IN THE TRIAL ITSELF, WE HAVE NO IDEA WHAT THE SAFETY OF THAT PARTICULAR PROFILE IS IN PEOPLE, IN POPULATIONS WHO ARE MUCH MORE LIKELY TO BE HIT BY THE DISEASE UNDER STUDY, ALD HYPER'S DISEASE. SO THE TIMELINESS OF THE COST BENEFIT ANALYSIS IS QUITE CLEAR AND HIGHLIGHTED BY THE DISCUSSION OF THE DRUG APPROVAL AND THE CONCEPT CLEARANCE DOCUMENTS WAS VERY CLEAR ABOUT THE FACT THAT THERE IS REALLY NO INFORMATION IN THE LITERATURE ABOUT HOW TO MODEL COST AND HEALTH OUTCOMES OF THE POTENTIALLY NEW ALZHEIMER'S DISEASE DRUGS WITH THE RACIAL AND ETHNIC POPULATIONS WHO HAD NOT TRADITIONALLY BEEN INCLUDED IN RESEARCH. SO COUNCIL DID HAVE A DISCUSSION ABOUT THE POTENTIAL SIGNIFICANCE OF THESE METHODS. WE TALKED ABOUT, YOU KNOW, SORT OF THE TIMELINE, WHETHER INFORMATION ABOUT THESE GAME-CHANGING NEW APPROVALS WOULD BE AVAILABLE TO RESEARCHERS AND WHAT IT WILL BE. WE TALKED ABOUT SOME OF THE LIMITATIONS, POTENTIAL LIMITATIONS WITH THE CHAIRMAN BECAUSE SO FEW BLACKS AND HISPANICS OLDER ADULTS HAVE BEEN FORMALLY DIAGNOSED WITH DEMENTIA AND ALSO SORT OF, YOU KNOW, THE RELEVANCE OF THIS INFORMATION FOR TRIALS BETTER RUN BY, YOU KNOW, DRUG COMPANIES THAT -- WHERE THE DATA ABOUT THE COST AND BENEFITS AREN'T NECESSARILY -- WE'RE NOT NECESSARILY PRIVY TO. SO THAT WAS A REALLY INTERESTING DISCUSSION WE HAD BUT BECAUSE THE RFA WILL COVER MOST OF THE PRIORITIES FOR NIA WITHIN THE STRATEGIC DIRECTIONS FOR RESEARCH AND THE MILESTONES THAT HAVE BEEN SET FOR ADRD, WE WERE VERY ENTHUSIASTIC ABOUT MOVING THIS CONCEPT FORWARD, ESPECIALLY GIVEN THE TIMING WITH THE LACK OF INFORMATION, WE THOUGHT THAT ENGAGING IN NEW RESEARCH GROUPS AND QUESTION IN A SEVERE RELATED WAY TO SET ASIDE FUNDS AND HAVE A SPECIAL REVIEW FOR GROUPS THAT WOULD WANT TO PURSUE THIS TYPE OF WORK, AND SO WE WERE -- WE ENDED UP BEING VERY ENTHUSIASTIC ABOUT THE CONCEPT. >> THANK YOU VERY MUCH FOR YOUR SUMMARY. ARE THERE ANY COMMENTS ON THIS PARTICULAR CONCEPT? IF NOT, WE WILL MOVE ON TO THE NEXT ONE WHICH IS ENTITLED UNDERSTANDING AGE BASED ISSUES IN LATER LIFE, Dr. WEIR, CAN YOU SUMMARIZE FOR US? >> SURE, ACTUALLY KEITH WHITFIELD GAVE US A GOOD HEAD START IN HIS DISCUSSION OF THE PRESENTATION MAINLY ABOUT THE NATIONAL ACADEMIES REPORT THAT THE NIH -- [INDISCERNIBLE] SO A JOY TO WORK WITH AND LET ME JUST SAY I KNOW HE IS HERE BECAUSE OF HIS INSIGHT INTO HUMAN BEHAVIOR BUT HIS INSIGHT INTO CAT BEHAVIOR, I APPRECIATE THE OPPORTUNITY TO WORK WITH SUCH A MULTITALENTED INDIVIDUAL. [LAUGHTER] THE THRUST OF THAT IS THERE IS SOMETHING ELSE GOING ON AND REALLY TWO THINGS GOING ON. ONE HAS GOT TEN A LOT OF ATTENTION, SO-CALLED DEPTHS OF DESPARE, OPIOIDS AND VIOLENCE AND THOSE ARE OF SPECIFIC CONCERNS BUT WHEN YOU COMPARE U.S. TRENDS IN MORTALITY WITH OUR PARTNERS AROUND THE WORLD, WE SUFFER ALSO FROM MUCH MORE TRADITIONAL CAUSES OF DEATH -- [INDISCERNIBLE] SO IT IS NOT JUST ABOUT THE DRAMATIC SELF HARMS AND CAUSES, IT IS ABOUT NEO BIOLOGICAL SO THERE IS A LOT FOR US TO UNDERSTAND AND ONE OF THE THINGS IS THERE IS A LOT OF VARIATION BY RACE, HOW BAD THINGS ARE AND HOW BAD THINGS ARE GETTING AND THAT THAT MIGHT BE A PROMISING VENUE FOR GAINING INSIGHTS INTO THE UNDERLYING -- [INDISCERNIBLE] SO THIS CONS STEPPED ASKS FOR -- CONCEPT ASKS FOR RFA SET-ASIDE FUNDS FOR R01 TO HELP US UNDERSTAND WHAT IS GOING ON. WE ALL SUPPORTED THAT STRONGLY AS WE ALL BENEFIT FROM PUBLIC HEALTH --[INAUDIBLE]. >> THANK YOU VERY MUCH. ARE THERE COMMENTS ON THIS PARTICULAR CONCEPT? IF NOT, WE WILL MOVE TO THE NEXT ONE. SCREENING FOR COGNITIVE IMPAIRMENT, DECISION-MAKING SCREEN PID, ONCE AGAIN, DOCTOR WEIR IS THE PRIMARY REVIEWER. YOU CAN SUMMARIZE THIS ONE FOR US? >> SURE, THIS IS FOR A U24 WHICH IS A MODEST MECHANISM WITH A LOT OF NIA PROGRAMMING INVOLVEMENT TO DEVELOP BETTER MEASURES OF DECISION-MAKING, CAPACITY AND FUNCTIONING OF THE AGING POPULATION AND RATIONALE IS EXTREMELY STRO*PBG. STRONG. FIRST OF ALL, OUR COUNTRY DEMANDS EVEN GREATER CHOICE AND DECISION-MAKING ON THE PART OF OUR OLDER PEOPLE AROUND THEIR FINANCES AND INSURANCE AND MEDICAL TREATMENT AND THE IMPAIRMENT OF THOSE ABILITIES IS ONE OF THE CONSEQUENCES WITH COGNITIVE DECLINE AND DEMENTIA SO IT NEEDS TO BE STUDIED AND NEEDS TO BE -- WHILE IT IS REALLY RECOGNIZED WHEN IT HAPPENS IN THE REAL WORLD, IT IS NOT SOMETHING WE CAN TEST FOR ON A STANDARDIZED MEASURE. THE SECOND SIDE IS THAT THESE KINDS OF PROBLEMS, CREDIT PROBLEMS, FOR EXAMPLE, HAVE BEEN SHOWN -- [INAUDIBLE] -- SO WE WITH A VERY MODEST PROPOSAL SUPPORTED IT. >> THANK YOU VERY MUCH. IS THERE ANY FURTHER COMMENTS ON THIS PROPOSAL? IF NOT, WE ARE -- WE WILL MOVE TO THE DECISION OF GERIATRICS IN CLINICAL GERONTOLOGY WHERE WE HAVE THREE CONCEPTS, THE FIRST THE OLDER AMERICANS INDEPENDENCE CENTER. THE PRIMARY REVIEWER WAS Dr. ROSEN AND THE SECOND WAS Dr. RUBIN. IF YOU CAN SUMMARIZE THE DISCUSSION FOR US, Dr. ROSEN? >> THANK YOU, TO BE BRIEF, THE U2 1 MECHANISM TO SUPPORT AGAIN THE COORDINATING CENTER FOR THE CLAUDE PEPPER OLDER AMERICANS INDEPENDENCE CENTER. THIS IS ONE OF THE MOST CLINICAL PROFILE IN THE NIA AND WILL RENEW THE CENTER. IT HAS BEEN LOCATED AT WAKE FOREST UNIVERSITY SINCE 2005 AND HAS PERFORMED WELL ABOVE EXPECTATION TO WHAT HAD BEEN REQUIRED PREVIOUSLY. THE LAST RFA FOR THIS COORDINATING CENTER WAS IN 2018 AND RENEWAL UP IN 2023. WHAT THIS CENTER DOES IS ACTUALLY SUPPORT AND PROMOTE THE EFFORTS OF THE OLDER AMERICAN INDEPENDENCE CENTER, THE PEPPER CENTER. IT DOES SO BY DEVELOPING A WEBSITE TO PROVIDE SCIENTIFIC EXCHANGE ACROSS INVESTIGATORS, PROMOTE THE MISSION OF THE OAIC IN AGING RESEARCH COMMUNITY, REACHES OUT TO THE PUBLIC, SPONSORS INVESTIGATORS MEETINGS, SHARES RESOURCES, HAS DATABASES ONLINE WITH AGE BIOMARKERS AND IMAGINING AND PROMOTES REALLY CLEAR PATHWAY ACTIVITIES. SO THIS WOULD BE A SETASIDE FOR A SPECIAL REVIEW PANEL, A PRIORITY FOR NIA, A REALLY EXCITING PROGRAM THAT HAS COORDINATING CENTERS ABLE TO LINK THE CENTER IN SUCH A WAY THAT IT IS ALL INTERDIGITATED AND VERY SUCCESSFUL. WAKE FOREST HAS BEEN IF EXISTENCE SINCE 2005, IT WILL BE RENEWED WITH THE NEXT SUBMISSION AND WE WERE ALL ENTHUSIASTIC ABOUT RENEWING THIS IMPORTANT CENTER. >> THANK YOU VERY MUCH, ANY COMMENTS ON THIS PARTICULAR CONCEPT? NOT HEARING ANY, WE WILL MOVE TO THE NEXT ONE ENTITLED OPTIMIZATION OF PERSONALIZATION OF DIAGNOSTIC TESTS FOR AD/ADRD IN OLDER ADULTS WITH CHRONIC CONDITIONS. THE PRIMARY WAS Dr. RUBIN, THE SECONDARY Dr. MANLY, DOCTOR RUBIN, COULD YOU COMMENT, PLEASE? >> YES, THIS IS TO PROVIDE RESEARCH INFRASTRUCTURE FOR DIAGNOSTIC STUDIES ON MCC AND AD/ADRD. IT ENVISIONED A CONSORTIUM TO CONDUCT DISCIPLINARY AGING DIAGNOSTIC BIOMARKER AND IMAGINING PROJECTS FOCUSED ON ADRD AND CHRONIC CONDITIONS. IT WOULD ASSEMBLE EXISTING DATA TO INSURE A LARGE SAMPLE AND ADEQUATE EXAMPLE AND REPRESENTATION OF AN OLDER ADULT, GIVE SUBGROUP ANALYSIS, PROVIDE BETTER RESULTS ON OUTCOMES ON HEALTH IN OLDER PATIENTS AND DEVELOP TOOLS AND METHODS TO INTEGRATE COGNITIVE FUNCTION, LITERACY, CULTURAL FACTORS. THE-- LET ME SWITCH HERE. SO IN REVIEWING THIS, THERE WAS A LOT TO LIKE AND THEN SOME CONCERNS THAT CAME UP. THE CONCEPT CLEARANCE BACKGROUND CLEARLY STATED THE CASE FOR THE IMPORTANCE OF MCC BUT PRETTY MUCH AFTER MAKING THE DIAGNOSIS, THE RATIONALE FOR THE RESEARCH ON DIAGNOSTIC TESTING AND MTP AT THE DIAGNOSTIC STAGE WAS LESS CONVINCING. THE DIAGNOSIS OF DEMENTIA CURRENTLY RELIES ON NIA CRITERIA ON COGNITIVE TESTING AND FUNCTIONAL IMPAIRMENT. CLEARLY OTHER CONDITIONS COULD AFFECT THE DIAGNOSIS OF DEMENTIA, THOSE WHO ARE FRAIL OR HAVE OTHER IMPAIRMENT FROM OTHER CONDITIONS BUT THAT DOESN'T SEEM TO BE THE FOCUS ON THE CONCEPT, IT SEEMS TO BE FOCUSING MORE ON BIOMARKERS. SO ONE OF THE CONCERNS WE HAVE HAD WAS IT WAS A BIT BROAD AND MIGHT BENEFIT FROM BETTER FOCUS. FOR EXAMPLE, RESEARCH ON PSYCHO METRICS AND THE ACCURACY OF BIOMARKERS INCLUDING BLOOD, CSF AND IMAGINING COULD BE A SONAR 24. AND FOLLOWING A POSITIVE SCREEN COULD BE ANOTHER ARCH 24. AND SOME OF THESE COULD BE JUST AS RELEVANT TO PERSONS WHO DIDN'T HAVE MCC AS WELL AS THOSE WHO HAD MCC. IT WOULD FOCUS ON DEVELOPING TOOLS FOR PATIENT EDUCATION ABOUT BENEFITS AND PREFERENCES. ANOTHER ONE COULD BE A RELATIONSHIP BETWEEN BIOMARKERS AND CLINICAL SYNDROME SUCH AS DEMENTIA MCI. SO UPON THE WHOLE, WE FELT THAT THIS CONCEPT COULD BE BETTER FOCUSED AND WOULD GAIN MORE FROM SOME ADDITIONAL WORK ON IT. THE CONCLUSION WE CAME UP WITH IS FOR STAFF TO REVISE AND THEN WE WOULD HAVE A LOOK AT IT AGAIN BEFORE IT WAS FINALIZED. >> OKAY, THANK YOU. ARE THERE OTHER COMMENTS ON THIS PARTICULAR CONCEPT? IF NOT, WE WILL MOVE TO THE NEXT ONE. -- SORRY, IF NOT, WE WILL MOVE TO THE NEXT ONE WHICH IS FARM CO-- PHARMACOKINETIC FACTORS ON INNING MEDICATIONS. THE SECONDARY VIEWER WAS Dr. WONG AND THE PRIMARY REVIEWER WAS -- [INDISCERNIBLE] [INAUDIBLE] >> THE STUDY OF PHARMACOKIN NET ETIC RESULTS ON CONDITIONS. SEVERAL FORMULATIONS AND ANALOGS HAVE BEEN APPROVED IN HUMANS BUT MOST ALL OF THESE APPROVED TRIALS ARE APPROVED FOR CANCER INDICATIONS AND A FEW FOR ORGAN TRANSPLANTATION. HOWEVER, A VERY LIMITED AMOUNT OF INFORMATION IS AVAILABLE ON STUDIES FOR -- [INDISCERNIBLE] [ AUDIO GARBLED ] -- TO ENCOURAGE STUDIES OF THESE INHIBITORS IN AGE-RELATED CONDITIONS. AND IT WAS MET WITH ENTHUSIASM AND AGREEMENT THAT THESE STUDIES OF THESE AGENTS WITH PATIENTS IN THESE CONDITIONS WAS NECESSARY AND THE DATA IS NECESSARY AND MOVES FORWARD RATIONALE FOR MORE ADVANCED TRIALS. THERE WAS A LOT OF DISCUSSION AROUND HOW NARROW THIS SHOULD BE AND THE STAFF EXPLAINED THAT THE PROGRAM HAD LARGER PLANS TO INCLUDE PROPOSALS IN SEVERAL DIFFERENT CATEGORIES OF CANDIDATE MOLECULES -- [INDISCERNIBLE] -- IS JUSTIFIED. THERE WERE TWO OR THREE SUGGESTIONS, ONE TO INCLUDE MILESTONES IN THE FOA RELATED TO MONITORING THE PROGRESS OF THESE STUDIES AND, SECOND, TO CONSIDER THE RESULTING INFORMATION OF -- [INDISCERNIBLE] AND THERE WAS STRONG SUPPORT FOR SUCH DISCUSSION. >> THANK YOU VERY MUCH. ANY OTHER COMMENTS ON THIS? OKAY, HEARING NONE, WE WILL MOVE TO THE DIVISION OF NEUROSCIENCE CONCEPTS. THE FIRST ONE IS ENTITLED NONCODING RNAS IN ALZHEIMER'S DISEASE AND RELATED DIMENTIA. THE PRIMARY REVIEWER IS ALISON DOTE, THE SECONDARY IS Dr. WONG. Dr. DOTE, IF YOU COULD SUMMARIZE THE DISCUSSION FOR US? -- GOATE. >> SORRY, I WAS ON MUTE. THE GOAL OF THIS STUDY IS TO INCREASE THE FUNCTION IN THE CODING OF RNA IN ALSZ HYPER'S DISEASE AND DEMENTIA AND INCLUDING THOSE WHO WORK ON RNA TO ENTER THE STUDY DETAILS. SO THE MECHANISM OF ACTION OF RNAS AND INVESTIGATE THE POTENTIAL AS THERAPEUTIC BIOMARKERS AND TO FOCUS PARTICULAR RFA ON UNDER STUDIES CLASSES OF ENCODING RNA. THESE GOALS SPECIFICALLY ADDRESS GOALS RELEVANT TO AD/ADRD RESEARCH IMPLEMENTATION AND NIA STRATEGIC DIRECTION GOAL. TWO MECHANISMS ARE PROPOSED IN THIS RFA, RO1 AND R21. THE R01S WOULD CONSIDER PILOT DATA WHERE THE R21S WOULD ENCOURAGE APPLICATIONS WITHOUT PILOT DATA RELEVANT SPECIFICALLY TO AD/ADRT AND THIS WOULD BE THE MECHANISM OF ENCOURAGING EXPERTS ON ENCODING R NA FROM OUTSIDE FIELDS. CONSIDERABLE EVIDENCE SUPPORTS THE ROLE OF THIS CLASS OF SCIENCE OF AGING DISEASE. SPECIFIC LINKS TO THE MODULATION OF APP, COULD BE USEFUL POTENTIALLY AS THERAPEUTIC TARGETS. HOWEVER, THIS HAS BEEN VERY LITTLE FOCUS ON OTHER CLASSES OF NONCODING RNAS, SUCH AS LINK RNAS AND SEARCH RNAs AND THIS IS PARTICULARLY IMPORTANT BECAUSE THERE HAS BEEN RECENT EVIDENCE TO SHOW THAT THERE IS A LINK TWO CEREBROSPINAL FLUIDS IN RNA AND DEMENTIA SEVERITY AND THAT THESE MAY BE USED AS BIO MARKERS FOR ADRD. AND LINKED RNAS HAVE BEEN LINKED TO THE PROTEIN TAU AND MIGHT SUGGEST POSSIBLE ROADS FOR THERAPEUTICS. BUT DESPITE THESE INTERESTING OBSERVATIONS, THERE IS REALLY A TESTING NEED FOR A BETTER MECHANISTIC UNDERSTANDING OF THE ROLE OF THESE DIFFERENT CLASSES OF CODING RNAS OF DEMENTIA AND USING UTILITIES AS A FEATURE OF THE BIOMARKER. SO WE WERE VERY ENTHUSIASTIC ABOUT THE GOALS OF THIS PARTICULAR CONCEPT. ALSO A COMPARISON OF FUNDING FOR THESE ENCODING RNA STUDIES ACROSS THE INSTITUTE SHOWS THE NIA SPENDS LESS THAN OTHER INSTITUTES IN THIS AREA. SO THIS OBSERVATION TOGETHER WITH THE NOVEL AND EXCITING DATA LINKING THE OTHER CLASSES OF NONCODING RNA TO ADRD STRONGLY SUPPORTS THE RATIONALE FOR THOSE CONCEPTS. THE SCIENTIFIC AREA IS IMPORTANT AND HAS STRONG IMPLICATIONS FOR BOTH THE MECHANICKISTIC UNDERSTANDING AND TREATMENT OF THE DISEASE. SO THE PROPOSED FUNDING MECHANISM SHOULD INCREASE SUPPORT OF HIGH-QUALITY SCIENCE IN THIS AREA. AND GIVEN THE LOW PERCENTAGE OF FUNDS AT NIH CURRENTLY SUPPORTING NONCODING RNA RESEARCH COMPARED TO OTHER INSTITUTES, THIS PROVIDE FOR SETTING ASIDE FUNDS FOR REVIEW IN THIS AREA AND THE PANEL WILL INSURE THE -- [INDISCERNIBLE] WHICH IS LACKING IN THE STANDARD STUDIES SECTION. SO WITH ALL THESE BENEFITS AND SORT OF INCREASING SCIENTIFIC INTEREST IN NONCODING RNAS, WE WERE EXTREMELY ENTHUSIASTIC ABOUT THIS CONCEPT AND STRONGLY SUPPORT IT. >> THANK YOU VERY MUCH. ARE THERE ANY QUESTIONS OR COMMENTS ON THIS CONCEPT? IF NOT, WE WILL MOVE TO THE SECOND UNION ENTITLED SELF IMPACT OF AGING AND DISEASE. THE PRIMARY REVIEWER WAS ME AND THE SECONDARY VIEWER WAS Dr. WONG SO I WILL SUMMARIZE THE NATURE OF THE CONCEPT AND THE DISCUSSION. SO IN RECENT YEARS, IT HAS BECOME CLEAR THAT DIFFERENT PARTS OF THE CELL CAN ACTUALLY EXIST IN DIFFERENT PHASES, MUCH AS YOU MIGHT SEE OIL AND WILL WATER IN A LIQUID PHASE SEPARATION. AND IT HAS ALSO BECOME CLEAR THAT PROTEINS GO TO THESE SPOTS DIFFERENTIALLY AND THEIR ENTRY AND EXIT AND FUNCTION CAN BE REGULATED BY THE ASSOCIATION OF THESE SUBCELLULAR DOMAINS. MOREOVER, IT IS SUPER-INTERESTING THAT SEVERAL GENES -- OVERALL PROTEINS, EXCUSE ME, THAT ARE IMPLICATED IN NEUROGENERATIVE DISEASE INCLUDING TAU, ARE PARTICULARLY AMENABLE TO THESE PHASE CHANGES IN THE FORMATION OF THESE BIOMOLECULAR CONDENSATES. SO THE QUESTION EMERGES AND IS NOT REALLY VERY WELL UNDERSTOOD HOW THIS PARTICULAR BIOLOGY OF PHASE SEPARATION INKHRAOUPBSZ OF ACTIVITY AND TOXICITY OF PROTEINS AND HOW THAT CHANGES WITH AGING. SO THERE HAS BEEN A LOT OF ATTENTION SORT OF AT THE BIOPHYSICAL LEVEL BUT NOT SO MUCH IN AGE AND OBVIOUSLY IT IS CLEARLY UNDERSTANDING TO UNDERSTAND THE FUNDAMENTAL BIOLOGY FOR NEUROGENERATION. SO THAT IS WHAT THIS CONCEPT IS ABOUT, THE MECHANISM PROPOSED IS R21 AND THE IDEA IS TO BRING IN EXPERTS IN THESE AREAS THAT -- KIND OF FROM OUTSIDE TO THINK ABOUT AGING AND NEUROREDEGENERATION AND THE IMPACT ESSENTIALLY ON NEURO BIOLOGY. THIS IS CLEAR FOR THE NIA UNDERSTANDING THE FUNDAMENTAL BIOLOGY HOW THESE CHANGE WITH AGE AND OF COURSE, YOU KNOW, THERE IS ALWAYS THE POTENTIAL FOR NOVEL UNDERSTANDING ON NEW IDEAS FOR THERAPEUTICS AND PREVENTION. THE MECHANISM MAKES SENSE BECAUSE WE ARE KIND OF AT AN EARLY PHASE STAGE, EXPLORATORY DEVELOPMENT, I THINK HAVING THE REQUESTED SETASIDE WILL ENCOURAGE THIS MULTIDISCIPLINARY COLLABORATION ATTRACTING INVESTIGATORS INTO THE AREA AND SPECIAL REVIEW IS PROBABLY NEEDED TO KIND OF KICK-START THIS AS A CORE MOVING SOURCE, BECAUSE IT IS SCATTERED IN DIFFERENT STUDIES AND MORE ATTENTION IS NEEDED TO EXPLORE THIS ANCHORING CONCEPT. SO EXPLORATORY WORK HAS BEEN SUPPORTED BY THE NIA IN TERMS OF DEVELOPMENT AND TO SUMMARIZE I WOULD SAY WE -- BOTH Dr. WONG AND I, WERE ENTHUSIASTIC ABOUT SUPPORTING THIS CONCEPT TO BRING INNOVATIVE INVESTIGATION INTO AN UNDERINVESTIGATED AREA OF THESE CON DENSATES AND HOW THIS CRACKING IMPACTS AGING IN AD AND ADRD. SO I WILL STOP THERE AND ASK IF THERE ARE ANY QUESTIONS OR COMMENTS ON THIS CONCEPT. NOT HEARING ANY, WE WILL MOVE TO THE NEXT ONE WHICH IS ENTITLED LIPIDS IN BRAINING AND ADRD. THE PRIMARY WAS Dr. WONG AND SECONDARY WAS Dr. GOATE. Dr. WONG, IF YOU COULD SUMMARIZE THAT? >> YES, SO THIS LOOKS AT LIPIDS WHEN IT COMES TO AGING AND THE ACTIVITY FOCUSING ON NEW APPROACH WITH THE STUDY OF LIPIDS IN AGING AND ALZHEIMER'S DISEASE AND RELATED DEMENTIA. [INDISCERNIBLE] AND ADDITIONALLY, SOME STRONG GENETIC FACTORS FOR AD AND METABOLITES TRANSFER BUT THE ROLES FOR THE LIPID PROFILES IN AGING AND ADRD HAS BEEN ADVANCING FOR DECADES. HOWEVER RECENT TECHNOLOGY HAS RENEWED INTEREST IN THIS UNDERSTUDIES AREA ABOUT LIPIDS AND THEIR CONTRIBUTIONS OF PROFILE CHANGE AND ADRD. HISTORICALLY THERE HAVE BEEN REPORTS IN LIPID AUTOLOGY SHOWING THERE CAN BE AN ACCUMULATION OF LIPID DROPLETS AND THESE LIPID DROPLESS ARE NOW GETTING LONG OVERDUE ATTENTION AND MANY SUGGESTING THE LIPID DROPLETS CREATE A CALL FOR THE DISEASE PATHOGENESIS AND ASSOCIATION AND INTERESTINGLY, LIPID DROPLETS ALSO OCCUR DURING THE NORMAL AGING PROCESS IN THE BRAIN WITH MENTAL CHANGES AND STRESS. SO THERE IS AN ASSOCIATION OF THE LIPID PROFILE DURING AGING AND RAISES MANY QUESTIONS THAT CLINICALLY NEED TO BE ADDRESSED. THIS FOA AIMS TO ADDRESS MANY OF THESE QUESTIONS -- [INDISCERNIBLE] SO THE REVIEWERS IN PANEL HAVE HAD A DISCUSSION ABOUT THIS FOA AND THE PANEL FEELS STRONGLY AND IT IS VERY CLEAR THAT THIS FOA IS DIRECTLY RELEVANT TO ADRD RESEARCH AND CLINICAL MILESTONES A AND 2B AND ALSO ADDRESSED TO NIH STRATEGIC DIRECTIONS AND GOALS. AND THE PANEL ALSO FEELS THIS FOA IS TIMELY IMPORTANT WITH A HIGH PRIORITY WITH AD AND ADRD RESEARCH, TOO. AND WE ALSO FEEL IT IS PERFECT TO HAVE A -- IT IS IMPORTANT TO HAVE A SPECIAL REVIEW PANEL BECAUSE IT REQUIRES SPECIAL EXPERTISE TO REVIEW THE LIPID PANELS -- [INDISCERNIBLE] AND ALSO NEED TO SUPPORT THIS AREA FOR ADRD RESEARCH. SO IN SUMMARY, BOTH REVIEWERS AND PANELS HIGHLY SUPPORT THIS CONCEPT. >> THANK YOU VERY MUCH. ANY FURTHER DISCUSSION ON THIS PARTICULAR CONCEPT? IF NOT, WE WILL MOVE ON TO THE NEXT ONE WHICH IS THE MECHANISMS OF THE BRAIN HYPER FUNCTION IN ADRD. THE PRIMARY REVIEWER WAS Dr. SNYDER, THE SECONDARY WAS Dr. REIMAN. Dr. SNYDER, COULD YOU SUMMARIZE THIS, PLEASE? >> THANK YOU. SO OVERALL THIS FOCUSES ON -- [INAUDIBLE] -- WHILE THE PROFUSION MAY BE THE RESULT OF METABOLISM, THERE IS ALSO EVIDENCE THAT IT MAY CONTRIBUTE DIRECTLY TO NEUROREDEGENERATION. SO THE FOA PROPOSES A BETTER UNDERSTANDING NEEDED FOR THE MECHANISMS AND CONSEQUENCE OF NEURODEGENERATION. WITH THE PROGRAM, WE FOUND IT IS INTENDED TO SOLICIT A WIDE PATH OF STUDIES TO INCLUDE BUT NOT LIMITED TO -- [INDISCERNIBLE] IT ALSO IS INTENDED TO LOOK AT CELLULAR STUDIES, FOR EXAMPLE, COULD REVIEW THE NEURORECELLS AS WELL AS INTERVASCULAR AFFECTING THE FLOW. ALSO IN DISCUSSION OF THE PROGRAM WE FOUND IT FOCUSED NOT ONLY ON ANGELOID TANGLES WITH THE RD MODELS, WE FOUND IT WAS RELATED IN THE INTERACTIONS OF PATHOLOGY. SO WE REVIEWED THIS CONCEPT TOGETHER AND WITH THOSE CLARIFICATIONS ON THE INTENDED LARGE GRASP AND SPECTRUM OF BOTH STUDIES, ESPECIALLY SINCE IT WOULD INCLUDE NOT ONLY ANIMAL MODELS BUT ALSO HUMAN STUDIES, AFTER THESE CLARIFICATIONS, Dr. REIMAN AND I GOT IT TO MOVE FORWARD WERE THIS INTENTION CLARIFIED. THEY PROPOSED AND AGREED WITH OUR RO1 PROPOSAL AND THAT IT WOULD BE IMPORTANT TO PROVIDE NEW INCENTIVE FOR NFL RESEARCH MOVING THIS FIELD FORWARD, ATTRACT NEW INVESTIGATORS AND NEW IDEAS. THANK YOU. >> THANK YOU. ANY COMMENTS OR QUESTIONS ON THIS CONCEPT? HEARING NONE, WE WILL MOVE ON TO OUR LAST SUMMARY WHICH IS UNDERSTANDING THE ROLE OF BILINGUAL WALLISM IN COGNITIVE RESERVE RESILIENCE IN AGING AND AD/ADRD. THE PRIMARY REVIEWER WAS Dr. REIMAN, THE SECOND WAS Dr. MANLEY. IF YOU COULD SUMMARIZE THIS, Dr. REIMAN AN NO ONE? >> THANK YOU, MONICA. THIS IS NOT YET PROVEN -- [INDISCERNIBLE] STUDIES ARE STILL NEEDED TO CLARIFY THE PILING BIOLOGICAL AND COGNITIVE IMPACTS ON BILINGUAL WALLISM ON AD AND ADRD DISEASES IN WAYS THAT MEASURE FOR THE POTENTIALLY CONFOUNDING AND INTERACTIVE CONTRIBUTIONS OF FACTORS LIKE HEALTH EQUITY, IMMIGRATION HISTORY, SOCIOECONOMIC STATUS, EDUCATION, DIFFERENT ASPECTS OF SECONDARY LANGUAGE HISTORY AND PROFICIENCY AND DO SO IN WAYS THAT BETTER ADDRESS THESE QUESTIONS. THE 2021 NIA WORKSHOP ON THIS FINDING NOTICED THE STATE OF THE ARRESTED FINDINGS AND NEED TO ADDRESS THE NOTED COMPLEXITIES AND CLARIFY THE IMPACT ON BILINGUAL WALL AND AGE RELATED DISEASES. IT HAS BEEN THIS CAN INFORM COGNITIVE RESISTANCE AND HEALTH PROMOTING INTERVENTION DEPENDING ON THE FINDINGS. THIS CONCEPT WOULD CAPITALIZE ON A NEW FUNDING OPPORTUNITY ANNOUNCEMENT, THE RO1 GRANT MECHANISM, SET ASIDE FUNDS TO PROMOTE RESEARCH INTERESTS AND APPLICATIONS RELATED TO THIS IMPORTANT TOPIC AND A SPECIAL EMPHASIS PANEL TO CONSIDER RELEVANT NEUROBIOLOGICAL PSYCHOSOCIAL AND LINGUISTIC FACTORS NEEDED TO ASSESS THESE GRANTS IN WAYS THAT ARE -- COULD CLARIFY THEIR LIKELIHOOD OF HAVING THE RIGHT IMPACT. Dr. MANLEY AND I ROW -- REVIEWED THE CONCEPT AND DISCUSSED IT WITH OTHER COUNCIL MEMBERS AND WERE HIGHLY SUPPORTIVE OF THE CONCEPT. WE BELIEVE THE PROBLEM IS IMPORTANT. WE BELIEF THAT NEW METHODS, METRICS AND APPROACHES ARE NEEDED TO BE DEVELOPED AND INCORPORATED TO ADDRESS THIS QUESTION AND CLARIFY THE ISSUES IN A BETTER WAY. WE BELIEVE THAT SET-ASIDE FUNDS WOULD HELP IN THAT REGARD. WE BELIEVE THE SPECIAL EMPHASIS FAMILIAR WOULD CONSIDER MULTIDISCIPLINARY COMPLEXITIES IN WAYS THAT COULD DETERMINE THE LIKELIHOOD THAT THE PROPOSED GRANT WOULD HAVE THEIR INTENTED IMPACT AND THEREFORE HIGHLY SUPPORT IT. >> OKAY THANK YOU VERY MUCH. ANY COMMENCE COMMENTS OR QUESTIONS ON THIS? HEARING NONE, I THINK WHAT WE DO NOW, IF WE MOVE TO CON ACCORDANCE ON THIS GROUP OF REVIEWS, KEN? >> EXACTLY. SO COULD I GET THEN A MOTION TO APPROVE THE 14 OUT OF THE 15 CONCEPTS AND THE DEALER -- DEFERRAL OF ONE CONCEPT -- [INDISCERNIBLE] -- IN MULTIPLE ADULTS WITH CONDITIONS. >> SO MOVED >> A SECOND? >> SECOND >> SECOND. >> ALL IN FAVOR? >> [ CHORUS OF AYES ] >> ANY OPPOSED? NOTE HEARING -- NOT HEARING ANY, WE HAVE THE CONCURRENCE OF THE 14 CONCEPTS AND DEFERRAL OF 1 AND THANK YOU VERY MUCH FOR YOUR AS FAR AS OF THE CONCEPTS THIS ROUND. >> THANK YOU AND I MIGHT JUST ADD THANKS TO THE NIA PROGRAM FOR THE HARD WORK IN PUTTING TOGETHER THESE REALLY EXCITING CONCEPTS. I THINK WE'RE ALL SUPER-ENTHUSIASTIC ABOUT WHAT THE FUTURE NIA IS GOING TO BE BRINGING AS A CONSEQUENCE FOR YOUR REALLY HARD WORK. AND THANKS TO COUNCIL FOR YOUR HARD WORK AND COUNSELING. >> THANKS VERY MUCH, MONICA. ALL RIGHT SO LET'S SEE, NEXT WE HAVE ACTUALLY SOMETHING THAT IS SOMEWHAT SAD FOR US BUT WE HAVE SEVERAL RETIRING MEMBERS OF OUR COUNCIL COMING UP AND PERHAPS I WILL TURN IT OVER TO RICHARD TO INTRODUCE OUR RETIRING MEMBERS AND IF THEY WOULD LIKE TO SAY A FEW WORDS. >> THANK YOU, KEN. THIS IS AS YOU SAY QUITE A BITTERSWEET TIME. I THINK YOU HAVE SEEN TODAY AND IN DAYS PAST AND BETWEEN SESSIONS, THE ENORMOUSLY PRODUCTIVE PARTNERSHIP THAT NIA APPRECIATES WITH THE ADVISORY COUNCIL AND I THINK WE ASK A LOT OF COUNCIL FROM THE REVIEW OF INDIVIDUAL GRANTS, CONCEPT CLEARANCES, REVIEWS OF OVERALL PROGRAMS AND STILL LARGER ISSUES OF GLOBAL IMPORTANCE THAT ARE RAISET BY COUNCIL, BY US, BUT WE ALWAYS HAVE SUCH A WONDERFUL ONGOING PARTNERSHIP. NORMALLY AT THIS POINT WE WOULD HAVE A FAREWELL DIFFERENT AND HAD A CHANCE TO SOCIALIZE AND EXPRESSION OUR MULE -- MUTUAL APPRECIATIONS. BUT NO DINNER, WE WOULD NORMALLY CELEBRATE THIS WITH A HANDSHAKE AND HUG BUT NONE OF THAT RIGHT NOW SO WITH SEVEN MEMBERS RETIRING FROM COUNCIL, YOUR RELATIONSHIP WITH US IS NOT OVER NOR IS OUR REQUESTING FOR FURTHER HELP FROM YOU BUT WE WOULD LIKE TO GIVE EACH OF YOU A CHANCE TO REFLECT ON YOUR TIME WITH COUNCIL, ADVISE OR SHARE YOUR THOUGHTS WITH US. SEVEN, WE HAVE ENJOYED WORKING WITH EACH AND EVERY ONE OF YOU SO PLEASE EXPRESS IF YOU FEEL COMFORTABLE AND REFLECT YOUR OWN THOUGHTS. >> I WOULD LIKE TO EXPRESS MY GRATITUDE TO ALL RETIRING MEMBERS FOR ALL OF YOUR HARD WORK AND EXCEPTIONAL ADVICE THAT YOU HAVE BEEN GIVING TO OUR INSTITUTE. WE REALLY CAN'T FUNCTION WITHOUT YOU AND, AGAIN, OUR GREATEST APPRECIATION TO ALL YOUR WORK. SO IF ANY OF OUR MEMBERS, SO WE HAVE AGAIN SEVEN MEMBERS, DOCTORS APPLEBY, COMER, GOATE, GOODELL, REIMAN AN , ROSEN AND WAGERS WILL BE ROTATING FROM THIS ROUND AND ANYONE WOULD LIKE TO SAY ANY WORDS BEFORE WE MOVE ON TO THE NEXT AGENDA ITEM. >> Dr., IF I MAY, THIS IS PATRICIA JONES AND I WOULD LIKE TO EXPRESS MY PROFOUND GRATITUDE FOR Dr. ROSEN IN HIS CO-CHAIR DUTIES AND WILL MISS HIS COMMITTED FOCUS ON IMPORTANT TOPICS AS WE WERE PLANNING TO ADDRESS PRESSING ISSUES WITH DIVERSITY, EQUITY AND INCLUSION AND CLIFF HAS ALWAYS BEEN A WONDERFUL RESOURCE TO RELY ON SO WE WILL CERTAINLY MISS HIS CONTRIBUTIONS AND VERY THANKFUL FOR EVERYTHING HE HAS CONTRIBUTED IN HIS TERM ON THE COUNCIL. I ALSO WANT TO ACKNOWLEDGE FOR DOCTOR APPLEBY, GSA HAS BEEN AN IMPORTANT SUPPORT FOR THE PROGRAM AND VERY THANKFUL FOR THEIR INTERESTS IN PROMOTING EARLY YEAR IN SIFTS AND HELPING THEM MAKE THEIR WAY TO AGING SCIENTISTS SO WE LOOK FORWARD TO THAT PARTNERSHIP BEYOND COUNCIL'S ROLE. >> THANK YOU, PATRICIA. ANY OTHER COMMENTS? >> AS A LONG TIME RESEARCHER, I WOULD LIKE TO THANK YOU FOR ALLOWING ME TO SERVE ON THE COUNCIL AND MY FELLOW SCIENTISTS FOR A REAL WORLD POINT OF VIEW. I THINK THE COUNCIL SEAT OFFERS A UNIQUE LENSINTO HOW THE NIA WORKS AND THREE THINGS IMPRESSED ME THE MOST, FIRST, INTEGRITY AND DISCIPLINED AND COMPLEX DELIBERATIONS IN THE NIA GRANT PROPOSALS AND THE ADMINISTRATION OF THOSE GRANTS TO RESPECT THE PUBLIC INVESTMENT. SECONDLY, NIA'S LONG STANDING COMMITMENT AND ATTENTION TO ISSUES OF DISPARITY, MENTORING THE NEXT GENERATION OF INVESTIGATORS AND YOUR MANAGEMENT OF INPUT FROM PEOPLE LIKE ME FROM THE PATIENT AND THE COMMUNITY. AND THE THIRD THAT NEVER GETS TALKED ABOUT IS HUMILITY AND I THINK THAT IS A BIG LESSON IN SCIENCE, THE OPENNESS TO DIFFERENT PERSPECTIVES BUT THE ONLY THOUGHTFUL BUT PASSIONATE AND INTENSE COMMITMENT OF THE NIA INVESTIGATORS WE HAVE HEARD FROM DURING OUR MEETINGS, TO IMPROVE THE HEALTH AND QUALITY OF AGING FOR US ALL AND I THINK IT IS VERY CLEAR IT IS ALSO THE REASON THAT SCIENCE NEEDS TO BE LEFT TO THE SCIENTISTS. SO THANK YOU VERY MUCH FOR THIS OPPORTUNITY. >> THANK YOU. THIS IS ERIC REIMAN. I WANTED TO EXPRESS MY DEEP APPRECIATION TO EVERYBODY ON THE NIA TEAM. I SAID A FEW OF THESE THINGS YESTERDAY TO MY NEURO SCIENCE COLLEAGUES BUT YOU ARE EXTRAORDINARY IN THE CONSEQUENTIAL WAY YOU HAVE ALLOWED ALZHEIMER'S AND AGING DISEASES RESEARCH. IT CANNOT BE EASY TO MANAGE THIS THROUGH THE RESEARCH AND PORTFOLIO STUDIES BUT YOU HAVE BEEN HIGHLY IMPACTFUL, COLLABORATIVE, ROW -- REVIEWING STUDIES IN INCLUSIVE WAYS AND SHARING SCIENCE THAT HAS HAD A DRAMATIC IMPACT ON THE FIELD. YOU HAVE TAKEN OPPORTUNITIES TO BE BOLD AND INCUR RISK WHEN WARRANTED AND YOU HAVE DONE THIS IN AN EXTREME LEAP SUPPORTIVE, EVEN GENTLE, TRANSPARENT AND ACCOUNTABLE WAY AND I COULD NOT BE MORE GRATEFUL. IT HAS BEEN A TRUE PRIVILEGE L AND JOY TO SERVE ON THE COUNCIL TO GET TO KNOW AND LEARN FROM SUCH DISTINGUISHED COLLEAGUES FROM DIFFERENT DISCIPLINES AND BACK GROUNDS INCLUDING OUR STAKEHOLDER ADVOCATES, ALL OF WHOM HAD THE SAME SHARED GOALS. SO I WANTED TO EXPRESS MY GRATITUDE FOR ALL OF YOU. >> THANK YOU. >> CAN I -- >> YEAH, AMY, SURE. AND THEN ALISON. >> I ALSO JUST WANTED TO ADD MY DEEP GRATITUDE TO EVERYONE AT THE NIA AND ALL MY FELLOW COUNCIL MEMBERS. THIS HAS BEEN JUST AN INCREDIBLE EXPERIENCE FOR ME AND I FEEL LIKE I HAVE MARKED TIME IN THE YEAR WITH OUR MEETINGS AND I KNOW THAT, YOU KNOW, FOUR MONDAYS HAVE PASSED AND WHAT HAVE I GOT TEN DONE, IT IS TIME FOR ANOTHER COUNCIL MEETING. EVERY TIME IT HOLDS ME ACCOUNTABLE. IT IS REMARKABLE TO ME HOW QUICKLY THE NIA HAS ADAPTED TO CHANGES IN THE FIELD, TO CHANGES IN THE WORLD, TO CHANGES IN ALL THE WAYS THAT BUSINESS IS DONE AND CAN SEE THE INCREDIBLE DEDICATION OF EVERY PERSON ON THE COUNCIL AND AT THE NIA TO THE CAUSES OF ADVANCING AGING, IT IS JUST INSPIRATIONAL. I AM REALLY -- THIS IS A TIME IN MY PROFESSIONAL CAREER THAT I WILL, YOU KNOW, FREQUENTLY LOOK BACK ON AND APPRECIATE EVEN MORE AND I AM THRILLED TO KNOW THAT YOU WILL CALL ON ME AGAIN AND I LOOK FORWARD TO MORE INTERACTIONS IN THE FUTURE. SO THANK YOU ALL SO MUCH. [LAUGHTER] >> THANK YOU. >> YES, I REITERATE EVERYTHING THAT EVERYONE HAS SAID. IT HAS BEEN AN HONOR AND A PRIVILEGE TO SERVE ON THE COUNCIL THE LAST FEW YEARS. I REALLY LEARNED SO MUCH ABOUT THE PROCESS AND ALSO LEARNED A LOT OF SCIENCE FROM HEARING ABOUT THIS DIVERSION AREA OF SCIENCE COVERED UNDER THE NATIONAL INSTITUTE OF AGING. I THINK I FOCUSED MY OWN RESEARCH AROUND ALZHEIMER'S DISEASE BUT REALLY LEARNED A LOT FROM OTHER PEOPLE ABOUT THE RESEARCH ON AGING. I REALLY WANT TO THANK THIS DEDICATION, THE DEDICATED PROGRAMS AND ALL OF MY COLLEAGUES AND THAT IT WAS REALLY A PRESSURE WORKING WITH EVERYONE ON THIS. AND REFLECTING OVER THE LAST FEW YEARS, I THINK WE HAVE BEEN VERY LUCKY TO BE ON COUNCIL AT A TIME WHEN THE BUDGET HAS BEEN EXPANDING AND TO BE PART OF THE PROCESS OF BEING ABLE TO FUND SO MUCH MORE RESEARCH AND SEE THE FRUITS OF THAT RESEARCH WITH THE RECENT AAPPROVAL OF COMIARTY -- COMINARTY BY THE FDA. AND THE INSIGHT OF HUGE NUMBERS OF APPLICATIONS, A MASSIVE EXPANSION OF THE DIVISION AND KUDOS TO ALL OF YOU. I KNOW YOU HAVE WORKED REALLY, REALLY HARD WITH THE HUGE NUMBER OF APPLICATIONS THAT HAVE COME IN SO WELL DONE, EVERYONE IN LIASONING THAT. AND ANOTHER THING THAT INSPIRED ME WAS THE ATTENTION TO DIVERSITY AND BEING VERY CURIOUS ABOUT THAT THIS IS A PROBLEM WE REALLY NEED TO ADDRESS, HEALTH DISPARITIES AND THAT THIS IS SOMETHING THE COMMITTEE AND THE INSTITUTE TAKES VERY SERIOUSLY. AND I THINK WE, UNFORTUNATELY, WITH COVID, HAVE SEEN HOW PADLY THIS REALLY AFFECTS LARGE PARTS OF THE COMMUNITY IN THE U.S. AND WE, YOU KNOW, AS A RICH NATION, WE -- ALL MEMBERS OF OUR POPULATIONS DESERVE TO HAVE GOOD HEALTHCARE AND I THINK IT IS IMPORTANT WE FOCUS ON THAT. ANOTHER AREA I THINK, WE HEARD ABOUT THE BUT LETTER PROGRAM AND OTHER ASPECTS OF TRAINING, I REALLY THINK THE NIA IS IT A FANTASTIC JOB IN SUPPORTING TRAINING OF THE NEXT GENERATION OF SCIENTISTS. AND THEN OVERALL I WOULD JUST COMMENT I WAS IMPRESSED BY THE THOUGHTFUL AND DELIBERATIVE PROCESS THAT IT HAS UNDERTAKEN IN REVIEWING BOTH LARGE AND SMALL ASPECTS AND I THINK THAT SHOULD GIVE THE PUBLIC GREAT CONFIDENCE THAT EVERYONE TAKES VERY SERIOUSLY THEIR ROLE IN -- IN DISPERSING FUNDS, ESSENTIALLY, MAKING SURE OUR TAX DOLLARS ARE SPENT IN APPROPRIATE WAYS THAT WILL BENEFIT THE ENTIRE COMMUNITY. SO I WOULD JUST LIKE TO THANK EVERYBODY ON COUNCIL AND ALSO BEN STAR FOR THE PRIVILEGE OF WORKING WITH YOU FOR THE LAST FEW YEARS. >> CLIFF? >> GREAT, THANK YOU, AS EVERYONE KNOWS I AM REALLY ENTHUSIASTIC ABOUT COUNCIL AND I LOVED MY TIME AND I WANT TO REENLIST IF I CAN BUT OBVIOUSLY I CAN'T. [LAUGHTER] BUT I WANT TO THANK RICHARD FOR GREAT LEADERSHIP AND I HAVE BEEN ON OTHER COUNCIL AND I CAN TELL YOU THIS COUNCIL IS SO EMBRACING IN COLLABORATION AND COLLEGIALITY AND FOR ME BEING ABLE TO HAVE A MUCH BROADER VISION OF NOT JUST MY BIOLOGY AND NOT JUST THE BIOLOGY OF HUMANS BUT ABOUT THE SCIENCE IN PARTICULAR AND PSYCHOSOCIAL ASPECTS OF AGING THAT ENLIGHTEN ME SO TREMENDOUSLY. AND I THINK WE GET CORNERED INTO OUR, YOU KNOW, SORT OF INTEREST AND FORGET ABOUT THE BROADER BASIS OF SOCIETY. AND THIS HAS BEEN REMARKABLY FANTASTIC. AND I THINK THE INSTITUTE HAS TAKEN THE LEAD IN THE TASK FORCE FOR MINORITY AGING RESOURCES AND PATRICIA AND OTHERS, THIS HAS BEEN A HUGE MOVEMENT FORWARD AND I THINK IT HAS BEEN MORE NIA AND RIGHTLY SO AND I AM JUST DISAPPOINTED THAT I CAN'T CONTINUE TO DO THESE EFFORTS AT THIS LEVEL. BUT IT IS SO EXCITING TO ME TO HAVE SPENT THE TIME AND WORKING WITH SO MANY OF YOU THAT I THINK I AM JUST CREST FALLEN. I THOUGHT I HAD ANOTHER YEAR OR SO AND I GOT THE CORRESPONDENCE AND I WAS SHOCKED LIKE AH, I AM DONE. SO THANK YOU EVERYBODY, IT HAS BEEN A GREAT EXPERIENCE FOR ME. >> THANKS, CLIFF. >> THANK YOU, CLIFF. >> AND THANKS FOR PRE-VOLUNTEERING FOR ALL OUR SPECIAL PROJECTS. APPRECIATE THAT. [LAUGHTER] >> IF I COULD JUST SAY WHAT AN HONOR I FOUND IT TO SERVE ON THE NATIONAL ADVISORY COUNCIL ON AGING. IT HAS BEEN REWARDING, IT HAS BEEN REWARDING WORKING WITH SUCH PASSIONATE AND COMMITTED COUNCIL MEMBERS AND REWARDING SEEING UP CLOSE AND PERSONAL, THE AMAZING WORK OF THE NIA TEAM AS YOU HAVE BEEN MAKING SO MUCH POSSIBLE. REFLECTING ON THE PAST FOUR YEARS, I RECALL THAT ONE OF THE MANY ITEMS PROVIDED TO COUNCIL MEMBERS DURING AN EXTENSIVE ORIENTATION PROCESS IS A DOCUMENT ENTITLED ADVICE TO COUNCIL MEMBERS AND I AM SURE MY FELLOW COUNCIL MEMBERS REMEMBER THAT. THE SUBTITLE IS GUIDANCE FOR MEMBERS OF THE NATIONAL ADVISORY COUNCIL ON AGING FROM THEIR PEERS AND IT TALKS ABOUT THE ROLE OF COUNCIL AND HOW COUNCIL WORKS AND ET CETERA. AND I FOUND THAT VERY VALUABLE AND I WOULD JUST ENCOURAGE CONTINUING COUNCIL MEMBERS TO NOT ONLY REFER TO THAT BUT CONTINUALLY REVISE AND UPDATE THAT AS NEEDED, AS TIMES CHANGE, AS POLICIES CHANGE, AS WE OPERATE DIFFERENTLY GOING FORWARD, JUST TO KEEP THAT IN MIND, HAVING THAT DOCUMENT JUST GIVES IMPORTANT INSIGHTS FROM COLLEAGUES WHO SERVED ON COUNCIL IN THE PAST THAT CAN HELP CARRY US FORWARD AND GUIDE US. AND LASTLY, I WOULD JUST LIKE TO SAY THE ENORMOUS GREAT TAUGHT I FEEL FOR THE WORK AT NIA STAFF, PROGRAM OFFICERS, EVERYONE INVOLVED AND ON BEHALF OF GSA'S5000-PLUS MEMBERS, I WANT TO EXPRESS OUR COLLECTIVE GRATITUDE FOR WHAT YOU DO DAY IN AND DAY OUT. THE NIA TEAM IS REALLY THE BACKBONE OF THE AGING RESEARCH INFRASTRUCTURE NOT ONLY IN THE UNITED STATES BUT EXTENDING GLOBALLY. WHAT YOU DO IS IMPORTANT, MEANINGFUL AND MAKES A DIFFERENCE DAY IN AND DAY OUT IN THE LIVES OF CITIZENS IN THE U.S. AND AGAIN GLOBALLY. SO THANK YOU FOR WHAT YOU DO AND GSA STANDS READY TO SUPPORT NIH WORK GOING FORWARD ANY WAY THAT IT CAN. AND I PERSONALLY WOULD BE VERY HONORED TO CONTINUE WORKING ON PROJECTS AS NEEDED WHERE I COULD MAKE A CONTRIBUTION INDIVIDUALLY OR ON BEHALF OF THE SOCIETY. SO THANK YOU AND Dr. HOTES, A SPECIAL THANKS TO YOU FOR CONTINUING YOUR STEADY LEADERSHIP OF THE NIA. IT MAKES ALL THE DIFFERENCE IN THE WORLD. >> WELL, THANK YOU. AND PEGGY? DO WE HAVE PEGGY WITH US? >> I BELIEVE SO. SHE HAS BEEN HAVING SOME TROUBLE -- >> SHE'S BACK. >> THERE SHE IS. BUT I THINK -- IS THE HURRICANE DOWN IN HER AREA RIGHT NOW? SHE MAY BE HAVING TROUBLE. >> WE HEARD RE ASSURANCE FROM HER LAST NIGHT THAT THEY HAD SURVIVED THE STORM. LET ME SAY AS A WAY TO OFFICIATE THESE COMMENTS, YOUR REFERENCE TO A BRIEFING DOCUMENT AND PERHAPS AN INVITATION WE CAN MAKE TO ALL OF YOU TO AMEND THAT AS TIME GOES ON, I ACTUALLY WILL FIND THAT USEFUL AND KEN YOU WANT TO TALK A BIT ABOUT EXTENDING COUNCIL MEMBERS FOR ANOTHER ROUND? [LAUGHTER] >> YES. HERE IS THE SHOE DROP. >> ESPECIALLY SINCE YOU ARE WILLING TO DO SO. [LAUGHTER] >> WELL, IT WILL CERTAINLY DEPEND ON THE CURRENT ADMINISTRATION IN APPROVING OUR NEXT SLATE OF COUNCIL MEMBERS AND AS YOU PROBABLY HAVE BEEN INVOLVED IN THIS YOURSELVES, IT TAKES A LONG TIME AND THERE IS MANY DIFFERENT HURDLES THAT WE HAVE TO GO THROUGH IN ORDER TO GET FINAL SIGNOFF. SO I DON'T KNOW AT THE PRESENT BUT I MAY CALL UPON SOME OF OUR RETIRING MEMBERS TO EXTEND THEIR TIME JUST IN CASE WE NEED TO HAVE SOME OVERLAP BEFORE OUR NEXT CADRE OF COUNCIL MEMBERS IS BEING ONBOARDED. SO YOU KNOW AS OF RIGHT NOW I AM NOT SURE BUT I WILL BE IN TOUCH WITH YOU IN THE FUTURE IN CASE WE -- YOU ARE WILLING TO SERVE AN ADDITIONAL ROUND FOR OUR COUNCIL. SO I DO APPRECIATE THAT CONSIDERATION IN THE FUTURE. >> AND THAT REALLY WASN'T FAIR TO GET YOU TO VOLUNTEER BEFORE YOU KNEW BUT THERE YOU GO. >> BUT WE HAVE IT ON TAPE NOW. >> WE CAN GET MAYBE BACK TO PEGGY LATER IF SHE CONNECTS AND MOVE TO OUR NEXT GUEST? >> YES. SO NEXT WE HAVE TWO OF OUR COUNCIL SPEAKERS. FIRST, I WOULD LIKE TO GET Dr. EVAN HADLEY TO INTRODUCE OUR FIRST SPEAKER. >> ALL RIGHT, THANKS. SO A REAL PLEASURE TO INTRO INTRODUCE -- [INAUDIBLE]. AND IN ADDITION TO THAT, THE IMPACT OF -- [INAUDIBLE] AND INCLUSION OF THE DANISH SITE REALLY ADDS A LOT TO THAT PARTICULARLY BECAUSE WE CAN GET EXTENSIVE INFORMATION TO HELP AND GOING BACK WITH A VERY LONG LENS -- [INDISCERNIBLE] >> THANK YOU VERY MUCH, EVAN FOR THIS KIND INTRODUCTION AND IT IS A PLEASURE FOR ME TO BE ON THE COUNCIL AND TALK ABOUT ROBUST AND RESILIENT CONSIDERATION IN THE DANISH COMPONENT OF LONG LIFE FAMILIES. I KNOW A COUPLE OF YEARS AGO, MY PROVINCE -- NEXT SLIDE, PLEASE, THE PI OF THE PROJECT WAS THERE TO TELL YOU ABOUT IT BUT I ALSO KNOW THERE HAS BEEN NEW MEMBERS ON THE COUNCIL AND SO I WILL JUST SHORTLY OUTLINE THE LONG LIFE FAMILY STUDY. IT STARTED OUT AS THE UO1 AND HERE IN THE LAST ROUND, IT BECAME A U19 AND WE ARE IN THE THIRD YEAR OF THAT. AND THEN IF YOU WILL JUST FLIP THROUGH THE NEXT FOUR SLIDES RATHER QUICKLY, IT HAS DATA MANAGEMENT, COORDINATING CENTER AT WASH-U, THEN THE FOUR CENTERS, BOSTON, PITTSBURGH, COLUMBIA AND DENMARK AND THEN OTHER CENTER AT DUKE. NEXT SLIDE, PLEASE. THE STUDY DESIGN IS PED GREASE WITH EXTREME FAMILIAR Y'ALL LONGEVITY, WE HAVE BEEN STUDYING THIS A LONG TIME AND IN THE SCORE IT ALLOWS US TO SCORE FAMILIES WITH A FLOSS SCORE WHICH IS BASED ON THE EXCEPTIONALITY OF AGES AT DEATH, OF EXPECTED AGES AT DEATH AND BONUS FOR LIVING SIBLINGS. SO TO GIVE YOU AN IDEA WHAT WE ARE TALKING ABOUT, THE MINUTE NUMB CRITERIA WOULD BE TWO SIBLINGS IN THEIR 90s BUT MOST OF THE FAMILY IS MUCH MORE EXCEPTIONAL. NEXT SLIDE, PLEASE. LIKE FOR INSTANCE, THESE SIX DANISH SISTERS AT THEIR 100TH YEAR BIRTHDAY, EVENTUALLY THE SIX OF THEM NEARLY REACHED 6060 YEARS, JUST SHY OF 600 YEARS TOGETHER AND THESE ARE SOME OF OUR SHOWCASE FAMILIES BUT GENERALLY IT IS IN FAMILIES. NEXT SLIDE, PLEASE. BEFORE THE U9, WE HAD ABOUT 5000 SECRETARIES DIVIDED BETWEEN THE FOUR SITES THAT WERE DATA COLLECTING AND IT IS ABOUT 500 FAMILIES AND ALL OF THEM HAVE AT LEAST A LIVING SIB PAIR IN THE OPERATION AND LESS THAN 1 PERCENT OF FRAMINGHAM HEART STUDY FAMILIES WOULD QUALIFY TO ENTER AND WOULD BE IN THE VERY LOW END OF THE DISTRIBUTION OF OUR EXCEPTIONALITY. AS PART OF THE UA1, WE LOOKED AT EIGHT TO TEN YEARS AND THE HEALTH PROFILES BETWEEN THESE GENERATIONS, ALTHOUGH THERE IS CONSIDERABLE PHENOTYPIC AND FAMILIAR Y'ALL HETEROGENEITY AMONG THEM. YOU CAN LOOK AT THE BOTTOM OF THE SLIDE AND SEE THE FIRST PART IS RATHER BIG AND THE SECOND PART THEY HAVE TWO IN THE NEXT GENERATION. NEXT SLIDE, PLEASE. IN THE U19, WE ARE INCLUDING ALSO GRANDCHILDREN. SO YOU SEE THE DESIGN OF THE STUDY, THE DOT BLUE GENERATION 1, THE SIBLINGS, THEN THERE IS THE OFFSPRING GENERATION BORN IN THE MIDDLE OF THE 20TH CENTURY AND THEN THE RED ONES ARE SPOUSES, WE INCLUDE SPOUSE CONTROLS AS WELL AND NOW WE HAVE INCLUDED SOME OF THE GRANDCHILDREN, PARTLY BECAUSE OF SOME OF THE RESULTS I AM GOING TO TELL YOU ABOUT TODAY. NEXT SLIDE, PLEASE. BUT JUST TO GIVE YOU AN IMPRESSION OF THE ONGOING DATA COLLECTION IN THE U19, IT IS ONGOING BUT OF COURSE HAS ITS CHALLENGES. WE ACTUALLY HAD THE KICKOFF MEETING THE FIRST WEEK OF MARCH 2020, SO IT WAS A ROUGH START AND BUT WE EXPECT TO INCLUDE ABOUT 400 FROM THE PRO BAND GENERATION. THERE HAS BEEN NATURALLY QUITE SOME MORTALITY IN THIS UPPER GENERATION SINCE THEY WERE FIRST INCLUDED IN 2006. ABOUT 2000 OFFSPRING AND THEN ABOUT 800 GRANDCHILDREN FROM THOSE FAMILIES THAT HAVE SHOWN TO BE MOST GENUINE NET CALLIE INFORMATIVE BASED ON THE GENETIC FUNCTIONALITY. NEXT SLIDE, PLEASE. BUT WHAT I AM REALLY GOING TO TELL YOU ABOUT TODAY IS JUST THE SPINOFF ON THE WORK WE DID IN IDENTIFYING AT THE BEGINNING OF THE PROJECT, THE STATISTICS IN DENMARK. BECAUSE THE WAY WE DID IT WAS TO COMBINE OUR CIVIL REGISTRATION SYSTEM WITH OUR CHURCH TO BASICALLY FIND SYSTEMATICALLY THE SHIFTS THAT WERE EXCEPTIONALLY LONG LIVED AND PICKED TO INCLUDE IN THE LONG LIVED FAMILIES STUDY. AND JUST TO TELL A LITTLE BIT ABOUT DENMARK, YOU SEE THERE ON THE TOP OF GERMANY IN SCANDINAVIA. WE LIKE TO SEE OURSELVES AS THE SOUTHERN CALIFORNIA OF SCANDINAVIA ALTHOUGH WE CAN'T COMPETE WITH THE CLIMATE, I CAN TELL YOU. AND WE HAVE ABOUT 6 MILLION PEOPLE AND HAVE SOME LONG TRADITIONS FOR RECORDING AND LINK CAGE AG -- LINGAGE AND EVERYBODY HAS A UNIQUE IDENTIFIER AND THERE IS STILL IN SOCIETY HIGH LEVEL OF TRUST IN AUTHORITY AND RESEARCH SO THE CORRELATION IS VERY POSITIVE, ALSO REFLECTED CURRENTLY. THE PARTICIPATION RATE IS 95 PERCENT FOR THESE FAMILIES THAT HAVE PARTICIPATED FOR MANY YEARS. SO IT'S -- I MEAN IT IS A SMALL, GRAPHIC DISTANCE SO IT IS A VERY CONVENIENT PLACE TO DO RESEARCH. I USUALLY SAY THAT YOU DON'T HAVE TO BE VERY SMART TO BE A GOOD RESEARCHER. IN DENMARK, IT IS LIKE STREET FOOTBALL, YOU ARE INVITED TO PLAY MAYBE NOT BECAUSE YOU ARE ANY GOOD BUT BECAUSE YOU HAVE THE FOOTBALL. NEXT SLIDE, PLEASE. WHAT WE DID SYSTEMATICALLY WAS THERE WERE ABOUT 65 FAMILIES THAT HAD EXCEPTIONAL LONGEVITY AND IN ORDER TO GET TO 1200 PARTICIPANTS, WE USED 12 PERCENT OF THESE FAMILIES TO DO THE IN-PERSON PART OF THE LONG LIFE FAMILY STUDIES. SO WE WERE THINKING WHAT ABOUT THE 90 REMAINING PERCENT WE IDENTIFIED? WHY NOT COMBINE ALL THIS AND USE OUR REGISTER SYSTEM? THE RED ONES ARE THE LONG LIVED SIBLINGS THAT WE IDENTIFIED IN THE CHURCH BOOK WHILE THE GREEN ONES ARE THE OFFSPRING REPORTED FROM THESE FAMILIES. SO WE TALKED WITH ALL THESE 659 FAMILIES. AND THEN FROM THE BLUE ONE, THE GRANDCHILDREN, THAT WAS OBTAINED THROUGH REGISTER LINKS IN PLACE FOR INDIVIDUALS BORN FROM 1953 ONWARD, SO THAT WAS THE EASY PART. NEXT SLIDE, PLEASE. AND WHAT WE TAKE ADVANTAGE OF IS THIS TRADITION FOR REGISTER. SOME OF THEM GO BACK QUITE SOMETIME. THE DANISH REGISTER STARRED IN THE 19 HOSS. THE CIVIL AND SOCIAL REGISTRATION SYSTEM IN '68, OF COURSE CAUSE OF DEATH REGISTER IN THE 70s AND NATIONAL PATIENT REGISTER STARTED IN 1977 AND WE HAVE NATIONAL HEALTHCARE WITH NO OUT OF POCKET COST. THEN WE HAVE THE EDUCATION REGISTER AND THE NATIONAL PRESCRIPTION REGISTER WHICH IS THE LATEST ADDITION. AND THESE ARE BASICALLY THE RESOURCES THAT ARE BEE NEAT THAT I WILL ALSO TELL YOU ABOUT IN A FEW MINUTES. AND THE GOOD THING IS THAT WE NOT ONLY HAVE THE PEOPLE IN OUR FAMILY, WE ALSO HAVE A 5 PERCENT RAPID COME TO SAMPLE OF THE CHOSEN POPULATION INCLUDED IN THESE LADIES -- IN THESE LINKAGES WHICH MEANS WE HAVE THE BIRTH CONTROLS, SOCIAL FACTORS AND OTHER STUFF AND THERE IS VIRTUALLY NO LOSS TO FOLLOW UP. NEXT SLIDE. BUT BACK TO THE LONG-LIVED SIBLINGS, IF WE LOOK AT THE SIX SISTERS, HOW THEIR FAMILY LOOKED IN 1920, THIS IS THE PICTURE. AND OF COURSE ONE THING THAT COMES MAYBE -- WE LIKE TO STUDY LONG-LIVED FAMILIES AND LONG-LIVED SIBLINGS BECAUSE WE THINK THEY ARE EVEN MORE EXCEPTIONA L INDIVIDUALS WHO SPORADICALLY LIVE A LONG TIME, THAT ONE PERSON LIVES A LONG TIME, THERE IS MORE LIKELIHOOD THERE IS A SYSTEMATIC DIFFERENCE BETWEEN LONG-LIVED SIBLINGS COMPARED TO SPORE RAD -- SPORADIC LONG-LIVED SIBLINGS. AND IT IS PRETTY SIGNIFICANT IN A CHILDHOOD BECAUSE IT TAKES YEARS TO PRODUCE A GROUP LIKE THIS ONE. SO WE WERE THINKING MAYBE A BIG PART WHAT WAS DRIVING THESE FAMILIES IS THIS REALLY SOCIOECONOMIC CONDITION, WHICH IS STUDYING PRIVILEGED FAMILIES AND THAT IS WHAT OUR STUDY IS ABOUT. AND WE THOUGHT THAT WAS IMPORTANT TO SHED LIGHT ON FROM THE VERY BEGINNING, WAS IT JUST BECAUSE THEY HAD A VERY GOOD START TO LIFE IN THEIR CHILDHOOD. NEXT SLIDE, PLEASE. AND THEREFORE, AGAIN, THIS IS THE SIGN OF THE STUDIES WHERE WE HAVE THE BLUE GENERATION 1, THE LONG-LIVED SIBLINGS. SO BASICALLY THE GREEN ONES ARE THE PARENTS IN THE PICTURE WE JUST SAW AND WHO THEN TO COMPARE THEM WITH IF WE WANTED TO KNOW WHETHER THEY WERE PRIVILEGED? THEN WE USED THE OFFSPRING'S SPOUSES, GRANDPARENTS TO COMPARE WITH AS ONE. AND THE OTHER ONE WAS BACKGROUND POPULATION. NEXT SLIDE, PLEASE. AND OF COURSE THE CONTROL FAMILIES WERE SOMETIMES DIFFERENT. YOU COULD HAVE A LONE MOTHER WITH ONE CHILD. THAT IS NOT GOING TO HAPPEN IN THE LONG-LIVED SIBLING FAMILY AND YOU COULD HAVE A DAD THAT WENT TO FIRST WORLD WAR AND THEREFORE THERE >> MODEST DIFFERENCE IN THE TOTAL NUMBER OF CHILDREN IN THE CONTROL FAMILIES AND THE LONG LIFE. IT WAS 6.6 IN THE CONTROL FAMILIES AND IT WAS 7.4 IN THE LONG LIVED FAMILIES. THEN WE WERE LUCKY THERE WAS 1916 WHEN THE TYPICAL LONG LIFE FAMILY WERE CHILDREN AND THERE WAS A CENSUS AT THAT TIME THERE WAS ONLY 3 MILLION PEOPLE IN DENMARK. AND THIS WAS AN EXCEPTION BECAUSE IT INCLUDED INFORMATION ON INCOME AND ASSETS AND TAXES. THAT'S USUALLY ON OCCUPATION BUT NOT ECONOMIC VARIABLES. SO WE WERE ABLE TO GO BACK AND FIND MORE THAN 90% OF THE FAMILIES AND FIND FIND MODEST DIFFERENCES BETWEEN THE LONG LIVED FAMILIES AND THE CONTROL FAMILIES AS WELL AS THE BACKGROUND POPULATION. IT DIDN'T SEEM TO HAVE A SLIGHT ADVANTAGE BUT MODEST AND SEEMS UNLIKELY TO BE WHAT IS DRIVING THE LARGE DIFFERENCES LATE IN LIFE. WITH ONE THING MIGHT IMMEDIATELY THINK STUDYING LONG LIVE FAMILIES MUST HAVE GOOD HEALTH. THAT'S HOW YOU SELECT THEM. IT'S NOT A SURPRISE. BUT WHAT WE TRIED TO LOOK AT NOR LONG LIVED SIBLING TO COMPARE THEM WITH OTHER PEOPLE THE SAME AGE THAT DIDN'T COME FROM LONG LIVED FAMILIES. THAT IS THE POPULATION BACKGROUND CONTROL FOR INSTANCE TAKING 95-YEAR-OLD MAN AND CON PAIR HIM WITH ANOTHER 95-YEAR-OLD MAN AND THEN LOOK BACK AT HOW MUCH THEY WERE HOSPITALIZED AND HOW MUCH MEDICINE THEY USED AND FROM 95 YEARS ONWARD HOW IS THEIR SURVIVAL. HERE IT'S CLEAR THE LONG LIVED SIBLING HAD A SIGNIFICANT LOWER RISK IN TERM OF HYPER TENSIVE DISEASES, CNS DISEASES AND DEPRESSION AND HAD A SIGNIFICANT BETTER SURVIVAL IN FEMALE SIBLINGS. I'M SHOWING HERE THE RESULT FOR FEMALES ONLY BECAUSE ACTUALLY WE ONLY HAVE 5% OF THE POPULATION FOR BACKGROUND CONTROLS AND THAT MEANT THAT THE RESULT FROM THE MALES ARE SOMEWHAT UNSTABLE. THERE'S TOO MUCH STATISTICAL UNCERTAINTY. NOW WE'RE WORKING ON AN UPDATE WITH MORE FOLLOW-UP AND A WHOLE POPULATION TO SELECT CONTROLS FROM. SO THIS SHOWED THE LONG-LIVED SIBLING HAD LESS DISEASES AND BETTER SURVIVAL THAN OTHERS THEIR AGE. THEY HAVE ROBUST AND RESILIENT. THEN WE MOVED ON TO THE GREEN ONE, SO TO SPEAK, THE OFFSPRING AND LOOKED AT HOW IS THEIR HEALTH AND PLEASE NOTICE THEY ARE NOT SELECTED ON ANY SURVIVAL. THEY ARE JUST SELECTED ON HAVING A PARENT WHO LIVED A LONG TIME AND THIS PARENT HAD A SIBLING ALSO LIVING A LONG TIME. SO THEY CAN DIE EARLIER. THEY CAN HAVE ALL KINDS OF DISEASES. SO THEIR HEALTH IS NOT THE TICKET INTO THE LONG LIVED FAMILY. AND THE FIRST THING WE WERE LOOKING AFTER IN THE OFFSPRING WAS THE NUMBER OF CANCERS AND HERE WE USED THE OBSERVATION TIME AND THEN COMPARED WHAT WE SHOULD EXPECT BASED ON THE POPULATION NUMBER. AND WITH OBSERVATION TIME WE HAD FROM THE START OF THE STUDY, WE WOULD HAVE EXPECTED 545 CANCERS BUT WE ONLY SAW 423 SO THERE WAS ABOUT A 22% REDUCED CANCER INCIDENT IN THE OFFSPRING. THEN WE WERE INTERESTED IN OKAY, IS THERE A PARTICULAR KIND OF CANCER MISSING? HERE IF YOU SEE THE RED ONES, THOSE ARE THOSE WHO PAY MOST ATTENTION TO THESE SIGNIFICANT RESULTS. THERE'S THIS ADVANTAGE AMONG THE OFFSPRING BUT WHAT REALLY STICKS IS OUT IS IN THE LONG CANCER GROUP WITH OBSERVATION TIME WE WOULD HAVE EXPECTED 71 CANCERS AND WE ONLY OBSERVED 24. SO THAT'S ONLY A THIRD OF THE EXPECTED LONG CANCER CASES. AND TOBACCO RELATED CANCERS, GENERALLY WE SAW TWO-THIRDS OF WHAT WE EXPECTED. THAT CAN MEAN TWO THINGS. EITHER THESE OFFSPRING SMOKED LESS OR MORE RESILIENT TOWARDS THE AFFECT OF SMOKING. ONE GOOD THING IS WE CAN OFTEN COMBINE THE REGISTERED STUDIES OF THE LONG-LIVED FAMILIES WITH THE IN PERSON LONG LIFE PART BECAUSE WE TALK WITH PEOPLE AND THEY REPORT SMOKING AND CAN COMPARE THIS TO OTHER SURVEYS AND THEN WE CAN SEE THEY HAVE A LOWER SMOKING FREQUENCY. THEY CAN OF COURSE ON TOP OF THAT HAVE MORE RESILIENCE. THEN THE NEXT THING WE WERE LOOKING AT WAS SURVIVAL. THE OFFSPRING, HOW IS THEIR SURVIVAL? DURING A 45-YEAR FOLLOW-UP PERIOD FOR THE GREEN SECTION OF THE GRAPH BEFORE, THAT IS FROM AGES 20 TO 70 WE HAVE OUR STATISTICAL POWER. WE OBSERVED ABOUT 400 DEATH IN OFFSPRING AND 500 IN SPOUSES COMPARED TO THE BACKGROUND POPULATION THAT'S AN AMAZING AFFECT OF BEING IN THESE FAMILIES BECAUSE THEY ONLY HAVE ABOUT HALF THE EXPECTED MORTALITY IN THE AGE RANGE 20 TO 70. IT IS LARGELY AN AGE RANGE WHERE THE MORTALITY IS LOW BUT STILL OF A CERTAIN MAGNITUDE ESPECIALLY IN THE 60s. THIS IS A MARK REDUCTION CUTTING THE MORTALITY RATE IN HALF JUST BY HAVING A PARENT LIVING A LONG TIME AND THIS PARENT HAS A LONG-LIVED SIBLING AS WELL. THEN WE ALSO LOOKED AT THE SPOUSES AND IT TURNED OUT THE SPOUSES ALSO HAD A SUBSTANTIALLY BETTER SURVIVAL THAN THE BACKGROUND POPULATION. THEIR MORTALITY HAD A REDUCTION OF THE THIRD. SO TWO-THIRDS OF THE EXPECTED MORTALITY COMPARED TO POPULATION CONTROLS. AND THEN OF COURSE MADE US THINK, OKAY, THIS IS QUITE SOME AFFECT IN THE OFFSPRING GENERATION. IT CAN BE SEEN IN THE GRANDSON GENERATION AND BECAUSE OF THE VARIANCE YOU CAN HAVE BIG PEDIGREES WOULD BE HELPFUL. WE STARTED OUT SAYING OKAY, IS THERE ANY SIGN THAT THE GRANDCHILDREN ARE ALSO DOING BETTER? THEN WE STARTED WITH INFANT MORTALITY AND HERE WE HAVE TO PAY NOTICE TO THE Y AXIS THAT IT'S VERY SMALL NUMBERS. IT'S .998, .996 AND SO ON BECAUSE INFANT AND CHILD MORTALITY IS VERY LOW BUT THE SUMMIT LINE IS THE LONG LIFE FAMILY GRANDCHILDREN SURVIVAL WHILE THE DOTTED LINES ARE CONTROL GROUPS AND SELECTED AND THEN MULTIPLE BIRTH AND ALL KINDS BUT IT'S VERY ROBUST FINDING. ALREADY FROM BIRTH TO GRANDCHILDREN IN THESE LONGEVITY ENRICHED FAMILIES HAVE A HEALTH ADVANTAGE. THIS MOTIVATED US TO SAY IS THIS VISIBLE IN TIME TO FIRST HOSPITALIZATION AND IT WAS AND THEN WE SAY, OKAY, NOW WE SHOULD SEE FOR THE GREEN AND BLUE AND THE GRANDCHILDREN TRIED TO SEE WHAT DISEASES ARE MISSING IN THESE FAMILIES DO THEY AVOID SPECIFIC DISEASES OR IS IT ACROSS THE BOARD AND HOW BIG IS THIS AFFECT IN THE VARIOUS TIME PERIOD. THE OFFSPRING WE CAN FOLLOW FROM 20 TO 70 WHILE THE GRANDCHILDREN WE CAN FOLLOW FROM BIRTH TO 50 DUE TO THE TRUNCATION OF THESE REGISTERS. I WE WERE IMPRESSED WITH THE ADVANTAGE THE OFFSPRING HAVE COMPARED TO THE BACKGROUND POPULATION. THIS GEOGRAPHY HAS 22 GROUPS OF DISEASES AND THE DOTTED LINE IS IF THE OFFSPRING WERE SIMILAR TO THE BACKGROUND POPULATION. THE BLACK LINE IS TO THE RAW DATA AND RED LINE IS IF WE CONTROL FOR ATTAINMENT AT AGE 30. THIS IS BASED ON MORE THAN 5,000 OFFSPRING AND THEN TRIED TO MATCH 10 CONTROL TO EACH. IT'S NOT ALWAYS POSSIBLE BECAUSE WE MATCH ON OTHER VARIABLES BUT IT'S CLOSER TO 10 AND THAT MEANS THAT WE HAVE SEVERAL 100,000 OBSERVATION YEARS FOR THE OFFSPRING AND MORE THAN A MILLION. THAT GIVES US GREAT STATISTICAL POWER TO LOOK AT THE DIFFERENCES. WHAT IS STRIKING IS IT'S BASICALLY ACROSS THE BOARD THE OFFSPRING HAVE AN ADVANTAGE AND THEN THEY'RE RANKED DEPENDING ON THE AFFECT SIZE. YOU CAN SEE THE MOST DOMINANT IS MENTAL DISORDERS IS WHAT HALF SHOULD BE EXPECT FROM THE BACKGROUND POPULATION AND THEN NEUROLOGICALLY AND ENDOCRINE INFECTIONS AND ALL THE WAY DO YOU BUT MARKED AFFECT BASED ON HOSPITAL RECORD. THIS IS HOSPITALIZED DISEASES. THEN WE LOOKED AT CAUSE OF DEATH TO SEE WHETHER THEY DIED FROM SPECIAL CAUSES AND OUT TO THE FAR RIGHT YOU CAN SEE THE ESTIMATE OF ABOUT HALF THE MORTALITY FOR ALL CAUSES TOGETHER BUT AGAIN YOU CAN SEE IT'S ACROSS THE BOARD THE CAUSES OF DEATH THE OFFSPRING HAD AN ADVANTAGE. THEN WE DID THE SAME ANALYSIS FOR GRANDCHILDREN WHICH WERE TWICE AS MANY AND THEREFORE WE CAN ALSO DO IT TWICE AS PRECISE BUT LUCKILY ALSO FOR ALL OF US, THE DISEASE INCIDENTS IS MUCH LESS FROM BIRTH TO 49 COMPARED TO 20 TO 70. THE NUMBER OF EVENTS ARE FEWER BUT AGAIN WE SEE THE SAME PATTERN. BUT NOW THE AFFECT SIZE IS ABOUT HALF WHAT WE SAW IN THE OFFSPRING. YOU SEE AGAIN MENTAL AND BEHAVIORAL DISORDERS IS THE ONE WITH THE BIGGEST EFFECT AND HERE IT'S ABOUT A 20%, 25% REDUCTION INSTEAD OF CUTTING IT INTO HALF. SIMILARLY WITH THE CAUSE MORTALITY ON THE FAR RIGHT YOU SEE IT IS ABOUT A QUARTER REDUCTION AND AGAIN CROSS THE BOARD OF ALL THE CAUSES OF DEATH. SO WE CAN SEE THE INCIDENTS OF DISEASES IS LOWER BOTH IN THE OFFSPRING AND GRANDCHILDREN WHAT WE CALL ROBUSTNESS. IT'S NOT LIKE THEY ALL VACCINATED ARE IMMUNE AND WHAT HAPPENS TO THOSE WHO GET THE DISEASE AT THE SAME TIME WITH THE SAME AGE. WE CAN STUDY LINKING THE REGISTERS. HERE WE LOOK AT THE SURVIVAL IN THE 15 YEARS FOLLOWING CANCER DIAGNOSIS. AS YOU CAN SEE WE HAD 465 OFFSPRING AND HERE WE COULDN'T GET 10 CONTROLS BECAUSE IT SHOULD THE SAME AGE AND SO ON SO WE MANAGED TO HAVE TWO CONTROLS FOR EACH OFFSPRING. BUT AGAIN YOU CAN SEE NOT ONLY DO THEY GET DISEASES MORE RARELY, ONCE THEY GET THEM, THEY HAVE BETTER SURVIVAL. NOW, WE'RE TRYING TO LOOK BECAUSE OF BEHAVIORAL THING THEY GET DIAGNOSED EARLIER OR IS IT SIMPLY BECAUSE THE OTHER DISEASES ARE FEWER SO THERE'S FEWER COMPETING RISK OF DEATH OR IS IT SOME RESILIENCE THAT WE ARE NOT ABLE TO MEASURE THROUGH REGISTERS. OF COURSE, MOST OF YOU PROBABLY THINK IN REGISTERS YOU ONLY HAVE THESE EVENTS THAT IS REGISTERED IN THE ADMINISTRATIVE SYSTEM AND THAT'S TOTALLY CORRECT AND OFTEN WE ARE MISSING THE IN PERSON INTERVIEW DATA BUT HERE IT COMPLEMENTS THE IN PERSON DATA VERY WELL BECAUSE THEN WE CAN TAKE THAT FOR THE SMALLER. AND SOME TIME IDIRECTLY WE CAN GET INFORMATION ABOUT BEHAVIOR FOR PROXIES FOR BEHAVIORS TRUE DEMOGRAPHIC EVENTS. SO ONE OF THE THINGS WE WERE THINKING ABOUT, WHAT COULD INDICATE STABLE FAMILIES AND BEHAVIOR AND SO ON? THAT IS TEEN AGE PARENTHOOD AND ALSO HOW IS YOUR WELL BEING AND SO ON. THE DIVORCE RISK. BOTH IN THE OFFSPRING AND GRANDCHILDREN GENERATION THERE'S A LOW OCCURRENCE OF TEEN AGE PARENTHOOD AND DIVORCE RISK. SO TO SUMMARIZE, BOTH THE OFFSPRING AND GRANDCHILDREN HAVE BETTER SURVIVAL THAN THE BACKGROUND POPULATION. THEY HAVE LOWER ALL DISEASE GROUPS AND MORE ROBUST AND RESILIENT AND THE ONLY ADVANTAGE THEY HAVE ARE HAVING LONG LIVED GRANDPARENTS WHO HAD SIBLINGS ALSO LIVING A LONG TIME. SO HOW DID THEY DO IT? WE SAW LARGE AND STABLE FAMILIES. IT'S NOT SOCIAL ECONOMIC STATUS ASSOCIATED. THE SPOUSES ARE DOING AS WELL AND REBUSTNESS AND FAMILIAL FACTORS ARE IMPORTANT. THAT'S WHERE THE IN PERSON LONG LIFE FAMILY COMES INTO PLAY WITH THE DATA AND THE GENETIC ANALYSIS MADE BECAUSE COULD IT BE RARE MULTIPLE PROTECTIVE VARIANTS OR EPIGENETIC MECHANISMS? A LOT OF THE STUFF I'VE SHOWED YOU TOWARDS POINTS GOOD BEHAVIOR BUT THIS CAN BE BOTH ENVIRONMENTALLY AND GENETICALLY INFLUENCED. HERE'S TO SAY LITTLE ABOUT THE ONGOING REGISTER RESEARCH PART OF THE LONG LIFE FAMILY STUDY. RIGHT NOW WE'RE UPDATING THE REGISTER LINKAGE TO 2021 AND GIVEN A LOT OF EVENTS ESPECIALLY IN THE OLD GENERATION WILL ENABLE US TO START STUDYING END OF LIFE AND CAUSE OF DEATH IN LONG LIVED SIBLINGS COMPARED TO SPORADIC LONG LIVERS AND ESPECIALLY A FOCUS ON DEMENTIA WHERE NOT ONLY DO THEY LIVE LONGER AND BETTER, BUT THEY ALSO LEAVE THIS PLANET IN BETTER SHAPE THAN SPORADIC LONG LIVED INDIVIDUALS. ONE OF THE THINGS THAT WE FOUND VERY INTRIGUING IS WHAT IS THE MECHANISM OF THE LOWER INFANT MORTALITY IN THE GRAND CHILDREN GENERATION. WE'RE PUTTING A LOT OF EFFORT INTO THIS AND FINALLY, THE TESTING AND TREATMENT OF THE COVID-19 IS ALSO HAVING A REGISTER BEING BUILT NOW AND WE WANT TO INCLUDE THAT IN THE LINKAGE TO SEE WHETHER ALL THE THREE GENERATIONS HAVE BEEN LESS AFFECTED WITH COVID-19 THAN THE POPULATION CONTROL AND ALSO TO LOOK AT THE TESTING AND VACCINATION PATTERNS AGAIN TO GET A PROXY FOR THE BEHAVIORAL ASPECT OF THIS ADVANTAGE. AND FINALLY, IT'S THE NATIONAL INSTITUTE ON AGING THAT HAS BEEN THE MAIN SUPPORTER OF THIS RESEARCH THROUGH THE UL1, AND CURRENT UL19 AND ACKNOWLEDGE THE EUROPEAN FUNDING FOR THE INFRASTRUCTURE THAT WE ARE BUILDING THIS RESEARCH ON. THANK YOU VERY MUCH. >> THANK YOU, DR. CHRISTENSEN. QUESTIONS? >> IN TERMS OF THE RELATIONSHIP TO S.E.S., IN TERMS OF THE RANGE OF S.E.S. VARIABILITY IN DENMARK SAY VERSUS THE UNITED STATES, IS IN IN TERMS OF WHETHER THERE'S GREATER IN S.E.S. AND WHETHER THERE'S A STRONGER FACTOR IN DENMARK VERSUS THE UNITED STATES? THE GRADIENT IS LARGER IN THE U.S. POPULATION, THAT'S FOR SURE BUT IT'S STILL SUBSTANTIAL IN DENMARK. IF YOU TAKE PEOPLE TODAY WITH ONLY SEVEN YEAR OF SCHOOLING IT'S A DIFFERENCE OF SEVEN YEARS IF YOU TAKE THE REAL TALES AND THE 25% IT'S ABOUT THREE YEARS OR SO. IT'S THERE AND WE SEE A LITTLE AFFECT WITH THE RED AND BLACK LINE WHEN WE CONTROLLED FOR SOCIO ECONOMIC FACTORS AND CAN SEE ESPECIALLY AMONG MALES THAT'S WHERE THE AFFECT IS BIGGEST. >> KEITH WHITFIELD HERE, HOW ARE YOU? >> GOOD, HOW ARE YOU? >> I'VE BEEN TAKING FURIOUS NOTES AND HAVE A STUDY OF AFRICAN AMERICAN FAMILIES THAT IN SOME WAYS TRIES TO REPLICATE WHAT YOU'VE DONE BUT NOT AS IMPRESSIVE. IT'S BEEN INCREDIBLE. I HAVE A QUESTION FOR YOU. WE HAVE BOTH DONE TWIN WORK BEFORE AND IN TWIN STUDIES WE TYPICALLY ONLY INCLUDE TWIN FAMILIES WHERE BOTH MEMBERS ARE STILL ALIVE AND GIVES A SLIGHT BIAS. WE HAD A PAPER THAT DEMONSTRATED THAT. IS THERE ANY DOWNSIDE TO NOT HAVING THE ENTIRE FAMILY WITH THESE? IS THERE SOME WAY YOU'RE CONTROLLING FOR MISSING DATA OR DO YOU MAKE ANY OTHER ASSUMPTIONS ABOUT THOSE MISSING? THE OTHER PART OF THE QUESTION IS THAT THROUGH YOUR DATA DO YOU KNOW THEY'RE MISSING RANDOMLY? JUST TRYING TO FIGURE OUT IF YOU HAVE INFORMATION ON THOSE WHO YOU DIDN'T INTERVIEW VERSUS THE CORE PIECES OF THE FAMILY WHERE YOU DID? >> WE DO CONTROL FOR THIS BECAUSE THERE'S DEAD SIPS AND LIVING SIPS AND WHEN THEY INFORM ABOUT THE CHILDREN AND SIBLINGS CHILDREN THE SIBLING'S CHILDREN MIGHT HAVE DIED EARLIER AND EVERYBODY FORGOT ABOUT IT AND INCLUDE AN ANALYSIS WHERE WE ONLY LOOKED AT INTERVIEWED SIBLINGS AND THEIR OFFSPRING AND GRANDCHILDREN BECAUSE IT'S UNLIKELY YOU HAVE A CHILD THAT YOU FORGOT AFTER AGE 40 AND YOU REPORT THAT AND DOESN'T CHANGE THE RESULTS. BUT IT'S FOR SURE SOMETHING WE TEST EVERY TIME WHETHER THE INTERVIEWED SIBLINGS DELIVERED FROM THE NON-INTERVIEWED SIBLINGS. >> THAT'S FASCINATING AS YOU LOOK AT THE PATTERNS OF TRUE LONGEVITY WITHIN FAMILIES. I LOVED YOUR POINT I THINK YOU CALLED THEM THE SPORADIC ONES LOOK FOR PATTERNS OF SPORADIC WHETHER IT BE A CONTROL GROUP OR SOME SPORADIC DEATHS YOU MAY FIND WITHIN YOUR STUDY GROUP I WAS FASCINATING. I'VE ALREADY SENT YOU A NOTE AND I'LL BE REACHING OUT BUT THANK YOU FOR YOUR PRESENTATION. IT WAS ABSOLUTELY WONDERFUL. >> THANK YOU, PLEASE DO. >> DR. GOATE DID YOU HAVE A QUESTION? >> I DO. THANK YOU FOR THE NICE PRESENTATION. ALLUDED TO THE GENETICS. -- YOU ALLUDED TO THE GENETICS AND WONDERED WHAT RESULTS COME OUT OF GENETICS AND WHETHER YOU DO FIND THERE'S EVIDENCE FOR GENETIC BASIS TO THE RE SSIL SISILIENCY GENETICALLY. >> WE FIND A GENETIC COMPONENT TO LONGEVITY AND MAY INCREASE WITH AGE BUT IF YOU'RE ASKING TO SPECIFIC GENETIC FACTORS, THAT'S WHERE WE'RE LOOKING. EVERYBODY WAS SO OPTIMISTIC WITH F.O.E. THERE'S BEEN MANY SMALL FISH BUT WHAT IS REALLY EXCITING IN THE LONG-LIFE FAMILY STUDY NOW IS TO LOOK AT BOTH GWAS AND SEQUENCING DATA AND THE LINKAGE DATA BECAUSE TRYING TO ALONG AT THE LINKAGE PEAKS AND GWAS HITS AND LINKAGE PEAK IN FAMILIES WHERE THERE'S NO GWAS. THAT'S INDICATING POTENTIAL RARE PRIVATE MUTATION OF BIG EFFECTS AND THERE'S A NUMBER THESE STUDIES GOING ON AT THE VARIOUS SITE AND COORDINATING CENTER WITH DIFFERENT HEALTHY AGING PHENOTYPES WHERE THERE'S SOME HITS AND THE GRANDCHILDREN ARE SUPPORTING THE STUDIES AND TO PROVIDE MORE POWER. AND THIS IS A VERY SUBSTANTIAL PART OF THE U-19 IS DEVOTED TO THIS. WHAT I TOLD ABOUT TODAY WAS A SMALL SPINOFF OF THE BIG PROJECT. >> THAT WAS THE SECOND QUESTION TO YOU, ARE YOU GUYS COLLECTING BIOLOGICAL SAMPLES FROM ALL THE FAMILIES AS WELL SO YOU'LL BE ABLE TO DO VARIOUS LEVELS OF OMICS IN BIOLOGICAL FLUIDS? > > >>YEAH FOR THE 10% OF THE LONG LIFE FAMILY THAT'S WHERE NUMEROUS IOMICS ARE DONE CURRENTLY AND BACK TO THE SOURCE POPULATION WE ARE NOW USING IN THE REGISTERED SYSTEM AS AN ADD-ON TO THE MOTHER STUDY. >> AND THREE AMERICAN SITES ARE ALSO DOING EXTENSIVE OMICS IN COORDINATION WITH THE DANISH. >> DO YOU HAVE A QUESTION? >> YES, THANK YOU. ENJOYED YOUR TALK VERY MUCH. I WANTED TO ASK A QUESTION ABOUT THE SELECTION OF GROUP FOR COMPARISON. AND THE QUESTION RELATES TO THE SELECTION OF MULTI-GENERATIONAL COHORT AND THE PREFERENTIAL IMPROVEMENT OF PEOPLE WHO ARE FERTILE AND EXCLUSION OF PEOPLE INFERTILE. AND STUDIES HAVE SHOWN INFERTILITY TRACK THERE'S A DIFFERENCE IN COHORT OF COUPLES INFERTILE AND THE PERCENT WHO HAVE SUBSTANTIAL CLUSTERING OF COMORBID CONDITIONS. HAVE YOU CONSIDERED OR DONE COMPARISON WITH ONLY THE INDIVIDUALS OF KNOWN FERTILITY? >> I'M NOT SURE I FULLY UNDER UNDERSTAND. THE LONG LIFE FAMILY WAS INCLUDING A HUGE SHIP/SHIP AND HAVE SURVIVING TO 90. IF YOU HAVE 12 CHILDREN YOU HAVE HIGHER CHANCE TWOS MAY GET TO HIGHER AGES COMPARED TO ONLY HAVING TWO CHILDREN. WAS THIS SIZE OF THE SHIP DRIVEN? WE FIND ONLY THE 6.6 AND 7.4 DIFFERENCE IN SIZE BETWEEN THE CONTROL FAMILIES AND THESE ONES BUT I'M NOT SURE HOW WE COULD COMPARE TO PEOPLE NOT ABLE TO HAVE CHILDREN BECAUSE WE CANNOT STUDY THEIR OFFSPRING OR GRANDCHILDREN IF THEY DON'T GET ANY. >> THAT'S THE DIFFICULT ISSUE THAT PEOPLE WHO ARE INFERTILE ARE BEING REMOVED FROM THE GENETIC POOL. WHEN YOU LOOK AT THE ENTIRE POPULATION AND INFERTILE AND THE COMORBIDITIES AND IT'S PROBABLY A BI-DIRECTIONAL RELATIONSHIP. WHEN YOU'RE STUDYING IN ONE GROUP YOU HAVE PEOPLE WHO WHERE YOU HAVE MULTI-GENERATIONS AND LESS REPRESENTATION COMPARED TO THE GENERAL POPULATION INCLUDES A HIGHER POPULATION OF THOSE WITH FERTILITY AND LIKELY CLUSTERING OF COMORBIDITIES. >> I'M NOT SURE I ANSWERED YOUR QUESTION BUT IT GAVE ME THE IDEA THAT IF THIS COULD BE AN ISSUE, WE COULD LOOK AT THE NUMBER OF OFFSPRING AND INFERTILITY TREATMENT IN LONGEVITY RICH FAMILIES IF THIS IS LINKED TO THE FERTILITY PATTERN. BUT I'D BE HAPPY TO LEARN MORE HOW YOU THINK WE COULD APPROACH IT IN THE REGISTER STUDIES IN THE FUTURE TO AVOID A POTENTIAL BIAS. >> YEAH, I'D LIKE TO TALK TO YOU OFFLINE ABOUT THIS. >> ALL RIGHT. THANK YOU, VERY MUCH, DR. CHRISTENSEN. WE'LL HAVE TO MOVE ON TO OUR NEXT SPEAKER BUT IF THERE ARE OTHER FURTHER QUESTIONS, PLEASE PUT THEM IN THE CHAT BOX AND WE'LL RELY THEM TO DR. CHRISTENSEN. THANK YOU AGAIN. DR. HODIS WOULD YOU LIKE TO INTRODUCE OUR NEXT SPEAKER. >> I'D LIKE TO INTRODUCE JAMES ANDERSON. HE CAME TO NIH IN 2010 AS AN NIH DEPUTY DIRECTOR AND HEAD OF THE VISION OF PROGRAM COORDINATION AND INITIATIVES AND AMONG THE MANY RESPONSIBILITIES IS THE MANAGEMENT OF THE COMMON FUND ACROSS NIH AND NIA HAS BEEN PARTICULARLY INTERESTED IN BEING PARTICIPATORY AND WE ARE INTERESTED IN HEARING FROM YOU AND LETTING OUR COUNCIL AND STAFF HEAR MORE ABOUT THE MAKE S OF THE COMMON FUND. >> IT'S AN HONOR AND FUN TO TALK ABOUT THE COMMON FUND. I'LL GIVE YOU HISTORY WHERE IT CAME FROM AND IF YOU UNDERSTAND THE HISTORY IT MAKES MORE SENSE. SOMETHING ABOUT OUR MANAGEMENT OF THE COMMON FUND AND CHOOSING PROGRAMS AND MANAGING THEM. WE HAVE LEARNED WHAT CREATES IMPACTFUL PROGRAMS AND WE FOLLOW SOME CRITERIA FROM PROGRAM TO PROGRAM THEN GOOD GIVE AN EXAMPLE OF SEVERAL PROGRAMS SO YOU CAN SEE WHAT THE COMMON FUND IS AND DOES AND ALONG THE WAY I'M GOING HIGHLIGHT PROGRAMS THAT NIA HAS BEEN INVOLVED IN AND I'D SAY RICHARD HAS BEEN ONE OF OUR KEY INSTITUTE DIRECTORS AND HAS BEEN THE CO-CHAIR OF MULTIPLE AND I'M GOING HAVE HELP WITH THE SLIDES SO GO TO THE NEXT. SO FIRST A LITTLE BIT OF HISTORY AND THEN I'LL SPEED UP AFTER THIS. WHAT'S THE ORIGIN OF THE COMMON FUND? IT GOES BACK TO THE DIRECTOR OF THE EARLY 2000s WHO HAD AN OPINION THERE NEEDED TO BE OPPORTUNITY FOR INSTITUTE TO WORK TOGETHER AND COORDINATE RESEARCH. THERE'S INSTITUTE WHERE'S THEY WORKED TOGETHER ONLY PROGRAMS BUT THOUGHT THERE NEEDED TO BE A MORE FORMAL WAY TO DO THIS AND INTRODUCED WHAT MANY REMEMBER AS THE NIH ROAD MAP. HE HAD SEVERAL SCIENTIFIC GOALS. ONE WAS TO CREATE PROGRAMS THAT HE CALLED PATHWAYS TO DISCOVERY. THESE WERE PROGRAMS LIKE THE EPIGENOMICS PROGRAM WHICH SET A TONE FOR THE COMMON FUND IN TERMS OF BEING BOLD. EPIGENOMICS WERE DONE A GENE AT A TIME AND PROTEINS AND ELEMENTS AROUND MOSTLY CANCER GENES. THIS PROGRAM, SAID, WELL, THAT'S NOT ENOUGH. WE CAN'T SEE THE BIG PICTURE, LET'S DO THE ENTIRE GENOME IN MULTIPLE CELLS AND THIS WILL CREATE THE INFORMATION TO CREATE A NEW PATHWAY TO UNDERSTANDING SCIENCE. ALSO IN MANY DISEASES, ANOTHER THEME. AND HAD A BIG EMPHASIS ON RESEARCH TEAMS AND REENGINEERING THE CLINIC PATHWAY. YOU REMEMBER HE STARTED THE CTSAs BACK THEN. HE DID THIS BY TAPPING THE BUDGETS OF ALL THE INSTITUTES AND PUTTING IN THE COMMON SOURCE TO PUT IN THE ACTIVITIES. CONGRESS WATCHED THIS. THEY THOUGHT IT WAS A GREAT IDEA AND IN 2006 CALLED IT THE COMMON AND GAVE SOURCES AND COLLECTED MULTIPLE OFFICES THAT WERE HELPING COORDINATE LIKE THE OFFICE OF RESEARCH ON WOMEN'S HEALTH, DISEASE PREVENTION, BEHAVIORAL, SOCIAL SCIENCE RESEARCH AND PUT US ALL IN ONE GROUP SO WE CAN BETTER HELP THE INSTITUTES WHEN IT'S APPROPRIATE TO COORDINATE AND CURRENTLY HAVE 14 OFFICES FROM DIETARY SUPPLEMENTS TO TRIBAL HEALTH RESEARCH. THAT'S THE ORIGIN FROM THE COMMON FUND FROM THE ROAD MAP AND WE MAINTAIN SOME OF THE THEMES. WHAT IS IT TODAY? WELL, IN FISCAL YEAR 21 IT'S $649 MILLION AND AS IT AN APPROPRIATION TO THE OFFICE OF THE DIRECTOR SO IT WORKS THROUGH AND IS DISTRIBUTED THROUGH OUR DIVISION AND THE MONEY IS SPENT IN THE INSTITUTES AFTER WE AGREE WHO IS GOING TO DO WHAT AND HOW A PROGRAM'S DESIGNED. CONGRESS GAVE US SEVERAL CRITERIA NFOR THE FUNDS AND ONE IS THE PROGRAMS NEED A GOAL AND IT'S NOT DISCOVERY SCIENCE OR SET OF RO1s. IT'S AN AGREEMENT IF WE DID THIS IN X PERIOD OF TIME IT WOULD CHANGE THE WAY RESEARCHERS DO THEIR RESEARCH. SO THIS HAS LED TO A DIFFERENT KIND OF SCIENCE THAN MUCH OF WHAT THE PORTFOLIO. IT'S JUST DIFFERENT. IT'S NOT BETTER IT SPECIFICALLY HAS TO HAS GOALS AND WE HAVE TO DEMONSTRATE MILESTONES, YEAR TO YEAR AND PRODUCT TO PRODUCT AS WE GO ALONG. CONGRESS -- I AM VERY GRATEFUL, GAVE A 10 YEAR LIMIT ON ANY PROGRAM. SO WHEN WE START, WE SAY OKAY, HOW ARE WE GOING GET THIS DONE IN THIS PERIOD OF TIME AND CHANGE SCIENCE IN FIVE YEARS, SIX YEARS, WHATEVER IT TAKES. ALSO A REQUIREMENT THAT AT LEAST TWO INSTITUTES WORK TOGETHER ON A PROJECT. THE PROGRAMS ARE NOT CATEGORICAL. THEY TAKE ON SOME OBSTACLE THAT'S VERY BROAD AND IS HOLDING BACK MULTIPLE INSTITUTES. YOU'LL SEE THAT FROM SOME OF THE EXAMPLES. SO GIVEN THE SIZE WE TEND TO GRAVITATE TOWARDS THERE'S TYPICALLY 25 SIMULTANEOUSLY PROGRAMS BEING MONITORED SO THERE'S A LITTLE UNDER $30 MILLION A YEAR PER PROGRAM. SOME HAVE BEEN A FEW MILLION. THE LARGEST MOLECULAR LIBRARIES WAS $110 MILLION A SINGLE YEAR AND ASKED WHAT NEEDS TO BE HAPPEN AND THEN ASK HOW WE'LL PAY FOR IT AND WHAT IT WILL COST. THERE'S NO SPECIFIC PORTFOLIO. WE'RE NOT TRYING TO CURE CANCER OR PULMONARY FIBROSIS BUT WHAT WE AGREE AS A GROUP IS HOLDING BACK PEOPLE. THEY'RE DISEASE AGNOSTIC GOALS, GENERALLY, WITH AN EYE IF WE DID THIS IT WILL ACCELERATE BROADLY WHAT RESEARCH IS. WE THINK, OR AT LEAST I DO, IN TERMS OF WITH THOSE CRITERIAS, WE HAVE TO DELIVER SOMETHING IN A CERTAIN PERIOD OF TIME AND HAS TO HAVE A CERTAIN DEFINED IMPACT WE THINK OF AS A TRANSFORMATIVE DELIVERABLE. IF WE DID THIS, WE'D HAVE THIS IMPACT. THEY TEND TO FALL IN DIFFERENT CATEGORIES. THEY GENERATE DATA WE DIDN'T HAVE THAT ACCELERATES SCIENCE OR TECHNOLOGY WE DIDN'T HAVE OR A NEW PARADIGM FOR RESEARCH FOR WORKFORCE DEVELOPMENT. I SHOULD STEP BACK AND SAY, WHAT I HAVE SAID LEADS TO YOU CONCLUDE THESE PROGRAMS ARE VERY LARGE, THEY'RE CONSORTIA AND HAVE MULTIPLE COMPONENTS DELIVERING SOMETHING THAT WORKS TOGETHER TO ACHIEVE THE GOAL WHETHER DATA OR TECHNOLOGY OR TOOLS. A THIRD OF THE COMMON FUND IS ACTUALLY DEVOTED TO HIGH RISK-HIGH REWARD AND ARE INTERESTING. THEY'RE NOT YOUR TYPICAL RESEARCH APPLICATION AND CRITERIA. WE CALL THEM HIGH RISK-HIGH REWARD AND THE PIONEER IS THE FIRST PROGRAM STARTED BACK EVEN BEFORE THE COMMON FUND WAS CREATED. THERE'S NO PRELIMINARY DATA ALLOWED. IT'S NOT A TYPICAL APPLICATION. IT'S A SHORT ESSAY OF WHAT YOU'RE TRYING TO ACCOMPLISH. A PIONEER IN THE SENSE THAT THE PERSON CAN'T HAVE TRIED IT BEFORE AND NO ONE ELSE HAS TRIED IT BEFORE AND THE MONEY IS LARGER THAN AN RO1 AND DE RISKING THE ABILITY TO DO RISKY RESEARCH AND WE'VE HAD SOME HOME RUNS FROM OPTO GENETICS AND THE NEXT IS THE NEW INNOVATORS. THIS IS THE PIONEERS FOR EARLY STAGE INVESTIGATORS. SAME THING IT'S MORE MONEY THAN TYPICAL AND SHORT APPLICATION, NO PRELIMINARY DATA AND THIS IS ALSO -- WE'VE REVIEWED BOTH OF THESE AND IN TERMS OF THEIR IMPACT AND COMMUNITY'S AGREEMENT ON WHAT THEY PRODUCE AND THESE ARE ALL SIGNIFICANTLY MORE IMPACTFUL THAN OUR STANDARD RESEARCH AWARD TYPES LIKE RO1s. TRANSFORMATIVE TEAM SCIENCE AND TELLING US WHAT YOU NEED TO DO. IT'S INTERESTING, THERE'S NO BUDGET CAP ON THE TRANSFORMATIVE RESEARCH AWARDS BUT FOLKS GENERALLY GIVE THEMSELVES A CAP. IF SOMEONE WANTED $30 MILLION WE'D SAY THAT'S FINE, WHAT DO YOU WANT TO DO BUT THEY'RE MUCH SMALLER THAN THAT. THE FINAL ONE IS THE EARLY INVESTIGATOR AWARD. AGAIN, THESE ARE ALL EXPERIMENTS IN HOW TO STIMULATE SCIENCE. THIS IS TESTING THE IDEA THAT FOLKS CAN SKIP THE POST-DOC. IT'S BEEN QUITE SUCCESSFUL. IN FACT TO THE POINT THAT WE ARE EXPANDING THE NUMBER OF SLOTS THIS YEAR TO TEST WHAT THE POOL SIZE PEOPLE WHO DON'T NEED POST-DOCTORAL TRAINING BUT CAN JUMP INTO A FACULTY POSITION. THAT'S A THIRD AND THE REST ARE TIME LIMITED PROJECT. IT'S CHALLENGING TO GENERATE A CONCEPT THAT FITS THE CRITERIA. MOST PEOPLE DON'T THINK THAT WAY. SO WE GET OUR IDEAS FROM OUTSIDE MEETINGS. A VERY GOOD SOURCE IS THE INSTITUTES AND THE PROGRAM STAFF WHO HAVE A VERY GOOD SENSE OF WHAT'S GOING ON BROADLY IN SCIENCE. WE AGREE ON THAT AND HAVE A COMMITTEE AND WE HAVE MECHANISMS WHERE WE ASK THE COMMUNITY WHAT'S HOLDING US BACK AND WHAT NEEDS TO HAPPEN? IN TERM OF HOW DO WE SELECT THEM, IT'S IMPORTANT THE INSTITUTE DIRECTORS AGREE ON A CONCEPT AND PROGRAM BECAUSE THEY'LL BECOME THE SCIENTIFIC DIRECTORS OF THE PROGRAM. THAT'S THROUGH THE COUNCIL. IT HAS COUNCILS FROM ALL THE INSTITUTES. AND THE FINAL DECISION IS THE NIH DIRECTORS BECAUSE IT'S AN APPROPRIATION TO THE OFFICE OF THE DIRECTOR. THESE FALL INTO DIFFERENT CATEGORIES AND TO COME UP WITH DIFFERENT EXAMPLES. WE DON'T CONSTRAIN THEM BUT WE FIND THEY CAN BE BANDED TO CATEGORIES. ONE IS STIMULATING TRANSFORMATIONAL DISCOVERIES AND TOOLS AND THE H.R. PROGRAM IS THERE. ANOTHER EXAMPLE WOULD BE LIKE 40 NULEOME AND THERE'S NOT TOOLS TO STUDY THAT. THIS HAS A BIG TOOL DEVELOPMENT COMPONENT TO IT. DATA IS ALSO ANOTHER GOAL. THE MICROBIOME FUNDED SHOWING ME A CORE MICROBIOME AND THEY DID IT AND OTHER EXAMPLES WHERE WHAT'S HOLDING BACK A FIELD IS A BROAD INFORMATION OF THE DATA IN THE FIELD BECAUSE PEOPLE DO IT ONE THING AT A TIME NOT THE WHOLE THING. THAT'S SOME OF OUR PROGRAMS ARE SPECIFICALLY DESIGNED TO DELIVER THAT. S ANOTHER IS HOW CAN WE RE-ENGINEER THE CLINICAL AND TRANSLATIONAL RESEARCH PROCESS AND GIVE AN EXAMPLE LATER RICHARD'S INVOLVED IN THERE. THEN BACK TO THE ROAD MAP. THERE'S A NEED TO PUSH THE WORKFORCE DEVELOPMENT IN SOME AREAS OF THE BOTTOM RIGHT. WE'VE HAD PROGRAMS THAT INTRODUCE GRADUATE STUDENTS TO ALTERNATIVE CAREERS. DIVERSITY HAS BEEN THE STRONGEST THEME IN OUR WORKFORCE DEVELOPMENT AND KICKING OFF THIS YEAR IS A PROGRAM WE CALL FIRST WHICH IS A DIVERSITY COHORT HIRING MODEL AT UNIVERSITIES WHERE THE UNIVERSITY WITH OUR SUPPORT WILL HIRE A COHORT OF FACULTY THAT BECOME UNITEAS IN THEIR SCHOOL FOR SIMULATING DIVERSITY. A LOT OF OUR WORKFORCE PROGRAMS HAVE BEEN ENHANCING DIVERSITY. SO THESE LISTED HERE AND I'LL GO THROUGH SOME OF THESE ARE THE PROGRAMS AND RICHARD HAS BEEN A CO-LEAD AND ONE IS HEALTH ECONOMICS I WON'T DESCRIBE IN MORE DETAIL BUT TO SAY FROM 2011 TO 2017. THIS ADDRESSED THE ISSUE THAT NIH CAN PRODUCE WONDERFUL THERAPEUTICS BUT NOT WIDELY ADOPTED SO WHAT ARE ECONOMIC INCENTIVE TO THAT AND CAN WE OVERCOME THEM. THAT'S THE HEALTH ECONOMICS PROGRAM AND SCIENCE AND BEHAVIOR CHANGE RICHARD ALSO CO-CHAIRED THIS PROGRAM WHICH BASICALLY ATTEMPTED TO USE A MEDICAL MECHANISTIC BEHAVIOR MODEL FOR BEHAVIOR CHANGE AND TEST THAT IN TERM OF MODIFYING BEHAVIORS FOR THERAPEUTICS. I'LL COME BACK TO SOME OTHERS LATER. WHAT MAKES A PROGRAM SUCCESSFUL? WE THINK IT'S IF WE CHANGE THE WAY WE CHANGE HUMAN BIOLOGY OR PREVENT DISEASE. THESE ARE THE PARADIGM SHIFTS IN HOW WE DO SCIENCE. WE'RE LOOKING TO SUSTAIN CHANGE IN THE WAY RESEARCH IS CONDUCTED FOR EXAMPLE BY CREATING THE DATA SET NO ONE HAD BEFORE. AND THEN ALSO WITH CATALYTIC TOOLS AND DATA THAT WASN'T THERE BEFORE. SO WE PUT A LOT OF THOUGHT INTO WHAT'S HOLDING THIS BACK AND WHAT CAN WE DO TO CHANGE THE WAY WE DO THE SCIENCE. SO HERE'S AN EXAMPLE OF RE-ENGINEERING THE HEALTH RESEARCH OR TRANSLATIONAL/CLINICAL ARENA. THE HEALTH CARE SYSTEMS RESEARCH COLLABORATORY AND THIS TOOK ON THE CHALLENGE THAT HEALTH DELIVERY IN THIS COUNTRY IS DONE AN DISTRIBUTED WAY AND IT'S DIFFICULT FOR INVESTIGATORS TO TAP THE INFORMATION THAT'S IN MULTIPLE HEALTH CARE SYSTEMS OR SITES. SO HOW CAN WE -- WHAT IS THE PROBLEM WITH THAT? HOW DO WE OVERCOME IT? THAT WAS THE GOAL OF THIS PROGRAM. WE LEARNED SOME THINGS ALONG THE WAY WE NEEDED TO FOCUS ON THE TYPES OF PROJECTS THAT INFORM THE CLINICAL PRACTICE AND HAD TO DO THE RESEARCH WITHIN THE ROUTINE CLINICAL CARE ENVIRONMENT RATHER THAN PULLING PATIENTS OUT OR ASKING PHYSICIANS OR SURGEONS TO DO SOMETHING SPECIAL ALONG THE WAY. WE ACCOMPLISH THIS BY SETTING UP A COORDINATING CENTER THAT HELPED GAIN ACCESS TO DISTRIBUTED INFORMATION FOR INVESTIGATORS. ONE STRONG REALIZATION WAS THAT IT WAS EASIEST TO DO THIS TYPE OF WORK DOING PRAGMATIC CLINICAL TRIALS. TESTING AN IDEA WITHIN THE ROUTINE CARE WITHIN THE SYSTEM. I WANT TO MAKE THE POINT WHEN WE START A PROJECT WE KNOW IT'S TIME LIMITED AS CONGRESS TOLD US AND PUT AN EMPHASIS UP FRONT ON HOW WE'LL SUSTAIN THIS? WHO ARE WHERE HE HANDING OFF TO AND WHO WILL PAY FOR THIS AND WHAT WILL HAPPEN TO THE INFORMATION AND DATA. THIS IS NOW THE LAST YEAR AND THERE ARE NINE INSTITUTES AND CENTERS AND OFFICES PAYING AGREED TO PAY FOR THE COLLABORATIVE CENTER AND EIGHT IN OFFICES THAT ARE ALREADY GOING TO FUND THIS YEAR PRAGMATIC CLINICAL TRIALS WITHIN THE SYSTEM. THIS IS LEARNING HOW TO DO SOMETHING AND LEARNING HOW TO HAND IT OFF TO THOSE WHO CAN SUSTAIN IT AND CONTINUE TO USE IT. THIS IS ONE OF MY FAVORITES AND I THINK ONE OF RICHARD'S TOO. THESE A CO-CHAIR ON A PROGRAM CALLED MOLECULAR TRANSDUCERS OF PHYSICAL ACTIVITY IN A CONSORTIUM. THE CHALLENGE BEING TAKEN ON HERE IS THAT WHAT HAPPENS IN THE BODY WHEN YOU EXERCISE? DOES IT CHANGE WITH AGE OR CHANGE IN AN ATHLETE VERSUS SOMEONE WHO IS SEDENTARY? WHAT ARE THE SIGNALS IN THE BODY STIMULATED BY THE EXERCISED OR MAINTAINED AND IT WAS OFTEN ONE AT A TIME LOOKING AT A PROTEIN CHANGE OR ENZYME AND THIS SAYS LOOK AT IT ALL IN AN ENTIRE SYSTEMATIC APPROACH AND MAKE THE DATA AVAILABLE TO THOSE WHO WANT TO USE IT. THERE'S A RAT DATA AND THE DATA THERE IS DONE AND THIS IS EXERCISING RATS IN DIFFERENT WAYS AND LOOKING AT WHAT WE CAN MEASURE IN TISSUES AND MOLECULAR DATA AND THIS IS AVAILABLE TO THOSE WHO WANT TO MINE THEM AND TEST THE HYPOTHESIS AND PURSUE IN A LIMITED WAY. THE OTHER BOLD THING IS THE LARGE PROGRAM WITH OVER 200 HUMAN PARTICIPANTS WHO AGREED TO UNDER GO REGIMENTS OF EXERCISES AND AT LEAST IN THE ADULTS TO HAVE MUSCLE BIOPSIES AND FAT BIOPSIES AND IN THE CHILDREN URINE AND BLOOD SAMPLES TO LOOK AT GENOME, TRANSCRIPT OEME -- TRANSCRIPTOMICS AND MAKE IT PUBLICLY AVAILABLE TO ANYONE WHO WANTS TO USE IT AND IT WILL BE TREMENDOUS FOR A.I. USE AND IT CONTINUES TO ROLL OUT. A LITTLE BIT OF A SETBACK WITH THE PANDEMIC BUT THINGS ARE ROLLING AGAIN. AGAIN, RICHARD IS CO-LEADING THIS AND THERE'S ALSO AN AGING COMPONENT TO THE RAT POPULATIONS. THAT GIVES A SENSE -- THIS SAY HUGE PROGRAM AND IT'S THE KIND OF THING YOU HAVE TO DO COMPREHENSIVELY AND WON'T BE DONE AGAIN EASILY OR BY A SINGLE INSTITUTE. AS IT AN NIH-WIDE PROGRAM. THIS SAY PROGRAM KICKING OFF THIS YEAR CELLULAR SENESCENCE NETWORK AND NOT SURPRISINGLY, RICHARD IS CO-CHAIR OF THIS AND THERE'S OTHER INTEREST AND CO-LEADS THIS IS TRYING TO OVERCOME THE BLOCKS IN GENERALLY APPROACHING WHAT HAPPENS IN THE BODY IN SENESCENCE IN THE NORMAL DEVELOPMENT AND WOUND HEALING AND ALSO DISEASE. IT'S DEVELOPING TOOLS, TECHNOLOGIES, BIOMARKERS FOR COMPREHENSIVELY STUDYING SENESCENCE. WE HAD A PAPER RECENTLY THAT DESCRIBES THE PURPOSE AND THE BREADTH OF THE PROGRAM. THIS IS A NICE REVIEW ARTICLE. I DON'T USUALLY TALK ABOUT PROGRAMS THAT DIDN'T WORK AS WELL. WE LIKE TO HAVE A LITTLE RISK HERE. ONE THAT HAS PRODUCED BUT NOT DELIVERED WHAT WE HOPED IS THE PROTEIN CAPTURE REAGENT PROGRAM. THIS TOOK ON THE CHALLENGE THAT PEOPLE NEED TO RECOGNIZE PROTEINS FOR IMMUNOASSAYS AND HISTOCHEMISTRY. ANTIBODIES ARE EXTREMELY UNRELIABLE. A HUGE AMOUNT OF MONEY IS SPENT EVERY YEAR ON UNREUSABLE REAGENTS. THE PROGRAM INTENDED TO PRODUCE A PROTEIN FOR ALL 20,000 PRODUCTS OF THE GENOME. IT STARTED WITH ROUTINE MONOCLONALS AND AN INVESTMENT IN OTHERS WAYS OR CHEMICAL APPROACHES TO RECOGNIZE PROTEINS. IT VERY QUICKLY HAS SLOWED PROTEIN CHEMISTRY IS COMPLICATE SOD THE ANTIGENS WERE INSOLUBLE WHEN THEY WERE PRODUCED. THE ANTIBODIES WERE UNSTABLE AND EVERY STEP IN THE PRODUCTION LINE WE HAD A LOSS. IF I WAS AT FORD MOTOR COMPANY I'D BE SHAKING MY HEAD AND THINKING WHY DID YOU DESIGN A PRODUCTION PATHWAY WITH FAILURE POINTS SO HIGH AT EVERY STEP? SO WE BACKED UP AND TRIED TO LEARN THE LESSON ON VALIDATION AND PRODUCED ANTIBODIES TO HUNDREDS OF TRANSCRIPTION FACTORS AND THEY'RE PUBLICLY AVAILABLE AND WE PUT A LOT OF EFFORT INTO VALIDATING THEIR USE ON THE NEXT SLIDE. FOR EXAMPLE, TAKING EACH ONE OF THEM AND PERFORMING A KNOCKOUT IN A CELL LINE TO DEMONSTRATE THE PROTEIN YOU THOUGHT IT RECOGNIZED DISAPPEARED. THAT'S A VALIDATION AND AN IMMUNOPRECIPITATE THE PROTEIN YOU THOUGHT IT DID. IT BROUGHT DOWN THE TRANSCRIPTION REGION IN THE CHIP ASSAY YOU THOUGHT IT WOULD. THERE'S MULTIPLE STEPS WE TRIED TO VALIDATE THE PRODUCTS. AND THE BOTTOM LINE IS IT'S JUST ERROR PRONE. AND ASK APPLICANT TO VALIDATE IN THE CONTEXT OF THEIR PERSONAL USE FOR THE ANTIBODY. THAT'S ABOUT AS GOOD AS WE CAN DO. YOU CAN GO TO THE WEBSITE AND FIND OUR VALIDATION ASSAYS BUT ONLY SOME OF THEM WORK. THIS IS A PROGRAM THAT PRODUCED AGENTS FOR TRANSCRIPTION FACTORS BUT DID NOT PRODUCE A RECAPTURE REAGENT FOR 20 PRODUCTS. THE LESSON IS ONE SOLUTION FOR 20,000 OPPOSED TO 20,000 PRODUCT ALL HAVE THEIR OWN PROBLEMS. WE LEARNED WHAT IS FEASIBLE WITH A PROGRAM LIKE THIS. I'M GOING TO WRAP UP WITH THAT AND RICHARD I'M AFRAID THERE'S NOT MUCH TIME FOR QUESTIONS BUT I'M HAPPY TO TAKE IT. >> WE'LL TAKE SOME TIME FOR QUESTIONS. WAS LUCKY ENOUGH TO RECRUIT JIM KANE FROM UNC AND HAS A BACKGROUND IN MANY AREAS. NONE OF US CAN BE EXPERTS IN THE FULL AREAS. QUESTIONS, PLEASE. YOU CAN SEE FROM THE LIST THIS IS GERMANE TO MANY NIA PROGRAMS. >> RICHARD, CAN I GO AHEAD? THIS IS JEN. >> PLEASE DO. >> THANK YOU VERY MUCH, DR. ANDERSON FOR THAT UPDATE AND OVERVIEW OF THE IMPORTANT WORK IN THE COMMON FUND. I HAVE TWO SORT OF DISTINCT QUESTIONS. ONE IS OF THE HIGH-RISK, HIGH-REWARD RESEARCH PROGRAM, WHAT PROPORTION OF THOSE FUNDED GRANTS AND MAYBE YOU CAN SAY SOMETHING ABOUT THE APPLICANTS VERSUS THE FUNDED GRANTS ARE AGING-FOCUSSED GRANTS? AND THEN JUST TO FOLLOW-UP, A COUPLE YEARS AGO EVERYTHING SORT OF BLEND TOGETHER WITH THE PANDEMIC BUT THERE WAS AN RFI THAT SOUGHT OUTSIDE THOUGHTS AND RECOMMENDATIONS FOR INCREASING THE DIVERSITY OF THE APPLICANTS TO THE COMMON FUND AND THE TWO MAIN THINGS THAT WERE POINTED OUT WERE THE APPLICANT POOLS FOR EACH OF THE INITIATIVES YOU WENT OVER HAD LOW PROPORTIONS OF UNDER REPRESENTED GROUPS AND THAT BEHAVIORAL AND SOCIAL SCIENCE RESEARCH WAS UNDER REPRESENTED IN THE APPLICANT POOL. >> OKAY. THANK YOU FOR THE QUESTION. IT'S SOMETHING WE THINK ABOUT CONSTANTLY AND TRY TO THINK ABOUT HOW TO ADDRESS. FIRST, I DON'T KNOW WHAT THE FRACTION IS IN AGING BUT I'LL GET BACK TO RICHARD WITH AN ANSWER ON THAT AND HE CAN LET YOU KNOW. THE OTHER IS THE DIVERSITY ISSUE. THIS IS VERY TROUBLING. IT GOES BACK TO THE PIONEER. THE FIRST YEAR OF THE PIONEER WAS ONLY MEN AWARDED 10. THERE WAS A RESET. THIS IS NOT WHAT WE WERE LOOKING FOR, THERE HAVE BEEN FEWER WOMEN APPLYING BUT THE AWARD RATE IS THE SAME AS IS THE APPLICANT POOL RATIO. IN FACT IT'S BETTER. THIS IS THE SAME WITH THE OTHER AWARDS. OUR CHALLENGE IS WOMEN DON'T APPLY AT THE SAME RATE. THEY TYPICALLY RECEIVE THE AWARDS AT A HIGHER RATE THAN THEIR APPLICANT RATIO. SO WE PUT EFFORTS IN TO MAKING IT CLEAR TO THE COMMUNITY WE DON'T INTEND THIS TO BE AN ELITIST AWARD, A HIGH-RISK, HIGH-REWARD COVERS THE PORTFOLIO OF DISEASE. IT WAS THWARTED A BIT BY THE PANDEMIC BUT HAVE GONE OUT TO MANY SOMETHING TO PROMOTE TALKS ABOUT THE COMMON FUND. IT'S A CHALLENGE WITH THE INSTITUTIONS AND THERE'S A BIAS ON THE COASTS AND WE RECOGNIZE IT AND ADMIT AND MUST BE PART OF THE PROBLEM AND TRYING TO DEAL WITH IT. STRONG OUTREACH IN THE LAST TWO YEA YEARS. THINK WE'LL SEE NEXT YEAR IF IT PAID OFF. THE PANDEMIC SET IT BACK. >> IT SEEMS THE SOLUTION TO THIS POINT HAS PRIMARILY BEEN TO INCREASE OUTREACH AND TRYING TO BROADEN KNOWLEDGE ABOUT THE PROGRAM. >> THAT'S BEEN THE STRONGEST APPROACH SO FAR. WE HAVE TRACKED THIS FOR YEARS AND WOMEN DO BETTER IF THEY APPLY. THEN IN TERMS OF MINORITY APPLICATIONS, I HAVE NO EXCUSE. WHEN YOU GIVE OUT 10 PIONEERS A YEAR -- OH, LET ME BACK UP. THIS LAST YEAR WE TRIED SOMETHING. WE DID AN ANONYMIZED REVIEW AND THE REVIEWERS DIDN'T KNOW WHO PEOPLE WERE AND GOT COMMENTS AND INTERVIEWED THE APPLICANTS. WE GOT COMMENTS AND I WILL TELL YOU THE APPLICANT POOL IS MORE DIVERSE WHEN WE ANONYMIZED THE REVIEW AND ASKED APPLICANTS WHY AND SEVERAL RESPONSES WERE I THOUGHT I'D GET A FAIRER REVIEW FIT WAS ANONYMIZED AND THAT'S ONE OF THE ISSUES. PEOPLE HAVE TO FEEL THEY'LL GET A FAIR SHAKE OR THEY WON'T APPLY. >> CAN I FOLLOWUP. YOU SAID THE FIRST YEAR WAS ONLY MEN AND IN 2016 IT WAS ALMOST EXCLUSIVELY MEN THOUGH IT HAD GONE UP AND DOWN. I'M WONDERING AND THINK THE PIONEER IS A TWO-PHASED REVIEW, A WRITTEN REVIEW AND INTERVIEW AND MANY FACULTY RECRUITMENT GROUPS ARE ARE TRYING TO INCREASE THE POOL. >> WE'VE TRACKED WHERE THE DIFFERENCE ARISES. AGAIN, IT'S NOT WITH WOMEN THE AWARDS ARE THE SAME. WE CAN'T FIND A STEP THAT'S BIASSED. >> YOU ALSO REFERRED TO AN EXTREME DIFFERENCE AMONG THE COASTS AND WONDER IF YOU TRACKED THAT. DO PEOPLE IN THE MIDDLE OF THE COUNTRY DROPPING OUT OR SIMPLY NOT APPLYING OR DROPPING OUT AT THE FIRST ROUND OF REVIEW AND SO FORTH? THEY'RE NOT APPLYING. THAT'S BEEN OUR EFFORT THE LAST TWO YEARS. IS TO GO TO MEETINGS AND INSTITUTIONS AND MAKE IT CLEAR AND WE'RE NOT LOOKING TO FUND SO PEOPLE ALL ON THE COAST THAT STUDY GENOMICS. I'LL BE HARSH THERE. THE INTENT IS AND WE THOUGHT THERE SHOULD BE SET-ASIDE FOR SOCIAL SCIENCE AND THIS OR THAT? IT'S SUCH A SMALL POOL IN THE FIRST PLACE WE TRY TO ENCOURAGE THE TOPICS AND SCHOOLS AND APPLICANTS. >> THANK YOU FOR VISITING WITH US. IT'S A CHANGE OF TOPIC. I RECOGNIZE IN THE BREADTH OF THE THINGS YOU SHOWED US, THERE'S A LOT OF RESEARCH AT NIH THAT DOES NOT INVOLVE HUMAN SUBJECTS BUT THERE IS A LOT THAT DOES, CLINICAL TRIALS CERTAINLY AND BEHAVIORAL RESEARCH. AND IT'S BEEN INCREASINGLY DIFFICULT TO ENGAGE PEOPLE TO PARTICIPATE IN HUMAN SUBJECTS RESEARCH. THE LAST YEAR AND A HALF OF POLITICIZATION OF SCIENCE HAS PROBABLY MADE THAT WORSE OR MADE THE PROBLEM OF GETTING FULLY REPRESENTATIVE PARTICIPATION EVEN WORSE. SO IN THINKING ABOUT WHAT COULD BENEFIT A NUMBER OF I.C.s, IN THE AREAS I WORRY ABOUT, SOMETHING ABOUT HOW TO RESTORE FAITH IN THE IMPORTANCE OF SCIENTIFIC RESEARCH AND THE IMPORTANCE OF PARTICIPATING IN SCIENTIFIC RESEARCH SEEMS LIKE IT COULD BE A REAL BENEFITO AT AT LEAST UNDERSTANDING BETTER THE MENTALITY BEHIND THE DECLINE IN PARTICIPATION. >> YES, ACTUALLY. ONE OF THE IDEAS THAT'S COME UP FROM SEVERAL GROUPS THIS YEAR IS HOW CAN WE BETTER COMMUNICATE THE VALUE OF SCIENCE? I THINK THIS COMES OUT OF OUR COUNTRY'S EXPERIENCE IN THE LAST SEVERAL YEARS AND WE WOULDN'T TAKE IT OFF THE TABLE AS A PROGRAM IS HOW CAN WE BETTER COMMUNICATE THE VALUE OF SCIENCE. >> ANY FINALLY COMMENTS? QUESTIONS? I KNOW WORE OVER TIME BUT IF THERE'S ANY OTHER COMMENTS STILL? >> JIM I WANT TO THANK YOU FOR SPEAKING WITH US AND BEING WILLING TO STAY ON LONGER. THERE'S A LOT OF INTEREST IN WHAT WE'RE DOING AND JIM AND I ARE OPEN TO INPUT SO IF I WANT TO FOLLOW-UP THE PROCESS IS ONE IN WHICH THERE'S A CONSTANT SOLICITATION OF INPUT FROM NIH AND INSIDERS AND FACTOR VERY MUCH IN DECISIONS ON NEW PROGRAMS AND MODIFYING OTHERS. WE'LL CONTINUE THIS DIALOGUE BEYOND THIS COUNCIL MEETING. >> THANK YOU. IT'S A PRIVILEGE TO TALK WITH YOU AND WE RELY ON RICHARD AS ONE OF OUR CENTRAL INSTITUTE DIRECTORS WHO'S PUT A SHOULDER TO THE STONE AND HELPED WITH A LOT OF THESE BIG PROGRAMS. THANK YOU. >> ALWAYS A PLEASURE. >> THANK YOU, DR. ANDERSON. >> THANK YOU. ALL RIGHT. THIS THEN CONCLUDES OUR OPEN SESSION OF COUNCIL. RICHARD, ANY FINAL WORDS? >> MAYBE JUST FOLLOWING UP AGAIN, SINCERELY INVITE FOLLOW-UP IN THE PRESENTATION BY JIM ANDERSON BUT MAYBE WAS NOTED NOT IN THE LONG LIST OF OUR INCLUDING MY INVOLVEMENT THIS SAY NET AS YOU MAY SURMISE QUITE A LEVERAGING OF NIH RESOURCES FROM THE COMMON FUND FOR AREAS THAT ARE OF INTERESTS TO NIH RANGING FROM SCIENCE AND BEHAVIORAL CHANGE AND HEALTH ECONOMICS THROUGH MOLECULAR ANALYSIS OF CELLULAR SENESCENCE AND EVERYTHING IN BETWEEN AND I'VE BEEN ANXIOUS AND ENJOYABLE BECAUSE IT'S A WAY TO GAIN AND LEVERAGE ON THINGS THAT MATTER TO NIA. >> ALL RIGHT. DR. KIM. >> IF YOU DO HAVE FINAL COMMENTS OR QUESTIONS FOR OUR SPEAKERS, YOU CAN PLEASE FORWARD THEM TO ME OR TO JASMINE AND WE'LL MAKE SURE THAT WE'VE RELAYED THEM TO OUR SPEAKERS AND GET ANSWERS BACK FOR YOU AND DISTRIBUTE THEM. THANK YOU FOR THAT. AND THANK YOU ALL AGAIN, OUR COUNCIL MEMBERS AND STAFF FOR A TERRIFIC COUNCIL MEETINGS THE LAST TWO DAYS. I REALLY APPRECIATE ALL THE HARD WORK AND DEDICATION YOU HAVE HAD FOR MAKING THIS SO SUCCESSFUL. I JUST WANT TO REMIND OUR COUNCIL MEMBERS AND OUR DIVISION DIRECTORS THAT WE HAVE A NEW ZOOM MEETING LINK AFTER THIS SESSION AND I'D LAKE TO TAKE AT LEAST A FIVE-MINUTE BREAK AND WE'LL START THE NEXT SESSION AT 1:15 WITH THE NEW LINK. AGAIN, HAVE A WONDERFUL DAY EVERYONE AND I'LL SPEAK TO YOU ALL SOON. THANK YOU.