DEVELOP AD Research
Deploying High Value Longitudinal Population-based data in Dementia Research
Deploying High Value Longitudinal Population-based data in Dementia Research (DEVELOP AD RESEARCH) is our multi-institution research program that breaks new ground by employing rich population-based data to develop a comprehensive longitudinal understanding of dementia that will better inform clinical and policy interventions and improve healthcare for persons with dementia and their families. Our program projects leverage two national, longitudinal, population-based studies, the Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS), both of which are linked to Centers for Medicare and Medicaid Services (CMS) claims and assessment files, to expand our understanding of the longitudinal course of dementia and the complex interactions of medical, social, and health system factors.
Who We Are
Highlights of Our Work
Publications
Browse our latest findings in understanding dementia and complex health system factors.
Developed Codes
Find our GitHub Repositories, SAS Macros, ICD Codes used in our work
Guides, Tutorials, and Datasets
Browse through resources we created to augment our work
Conceptual Frameworks
Find models of healthcare utilization and health outcomes
RP 1: Double Danger: Additive Effects of Dementia and Additional Serious Illness on Patient, Caregiver, and Health System Outcomes
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Claire Ankuda, MD, MPH, MSc
Ken Covinsky, MD, MPH
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Assemble a prospectively framed sample, combining HRS and NHATS, defined by time of incident dementia (T0), and evaluate the prevalence of another coexistent serious illness over time until death.
Examine within this sample differences in treatment intensity (i.e., total Medicare costs, total hospital days, days away from home) annually and cumulatively until death, among person with dementia alone and those with dementia and another serious illness. We will also examine differences across vulnerable subgroups.
Examine within this sample differences in patient and family experience of care (i.e., caregiving hours, caregiver strain, care-setting transitions, nursing home admission and in-hospital death), among person with dementia alone and those with dementia and another serious illness. We will also examine differences across vulnerable subgroups.
Research Projects
RP 2: The Impact of Disruptive Events Among Community-Dwelling Persons with Dementia
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R. Sean Morrison, MD
Alex Smith, MD, MPH, MS
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To determine the incidence of the disruptive events A) hip fracture, B) hospitalization for pneumonia, and C) death of a spouse
To compare the impact of disruptive events in persons with and without dementia
To examine disruptive events’ impact on patient and family, cost, and utilization outcomes among PWD
RP 3: Unnecessary and Harmful Medication Use in Older Adults with Dementia
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Ken Bockvar, MD
Mike Steinman, MD
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To characterize the frequency and types of unnecessary and harmful medication use in community dwelling PWD, and to compare this to usage patterns in people without dementia.
To evaluate risk factors for use of unnecessary and harmful medication use among community-dwelling PWD, with a special focus on the role of hospitalization, and to determine whether these risk factors are different than in people without dementia.
Using validated survey questions from NHATS, to characterize the attitudes of community-dwelling PWD and their caregivers toward their medications and their willingness to stop medications.
RP 4: Home-Based Clinical Care for Persons with Dementia
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Katherine Ornstein, PhD, MPH
Christine Ritchie, MD, MSPH
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To characterize utilization and timing of home-based clinical services among PWD and persons without dementia (PWoD) residing in the community.
To determine community (e.g., geospatial) and individual (e.g., socioeconomic) factors associated with disparities in use of home-based clinical services among PWD residing in the community.
To evaluate the consequences of receipt of HBMedC with and without SHHC for homebound PWD (e.g. healthcare utilization, days at home), accounting for illness burden.
RP 5: Hospice Care for Community-Dwelling Persons with Dementia
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Melissa Aldridge, PhD, MBA
Krista Harrison, PhD
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Evaluate the impact of hospice on perceived quality of end-of-life care (unmet needs for pain and symptom management, interactions with care teams, and goal concordant care) in the community.
Evaluate the impact of hospice on healthcare utilization at the end of life (nursing home admission, hospitalization, end-of-life care transitions, and home death).
Characterize longitudinal patterns of hospice use (enrollment, duration, disenrollment) for community-dwelling PWD and quantify the impact of MHB payment reform on hospice use rates.