UPSTREAM DRIVERS OF HEALTHY AGING: ASSESSING THE ROLE OF STATE AND COUNTY EXPENDITURES IN EARLY LIFE ON MID…

Assistance award details

Assistance award identifier

ASST_NON_R00AG086672_075

FAIN

R00AG086672

Recipient

THE LELAND STANFORD JUNIOR UNIVERSITY

Awarding agency

Department of Health and Human Services

Funding agency

Department of Health and Human Services

Assistance listing (CFDA)

93.866

Total obligated

$249,000

Period

Jun 1, 2024 – May 31, 2029

Fiscal year

2026

Place of performance state

CA

Source file

FY2026_All_Assistance_Full_20261006.zip

Description

UPSTREAM DRIVERS OF HEALTHY AGING: ASSESSING THE ROLE OF STATE AND COUNTY EXPENDITURES IN EARLY LIFE ON MIDLIFE COGNITION AND LATER-LIFE DEMENTIA RISK - ALZHEIMER’S DISEASE AND RELATED DEMENTIAS (AD/ADRD) AFFECT 15% OF OLDER US ADULTS. EVENTS IN EARLY LIFE CAN DIRECTLY AND INDIRECTLY CONTRIBUTE TO LATER-LIFE AD/ADRD RISK. FOR EXAMPLE, ADVERSE CHILDHOOD EXPERIENCES, LIKE PARENTAL INCARCERATION, MAY INDUCE PHYSIOLOGIC DYSREGULATION DURING SENSITIVE DEVELOPMENTAL STAGES WITH IMPLICATIONS FOR ACCELERATED BIOLOGICAL AGING. FURTHER, THESE EARLY-LIFE EXPERIENCES SHIFT ACCUMULATED EXPOSURES OVER TIME TOWARD OTHER KNOWN AD/ADRD RISK FACTORS (E.G., LOWER EDUCATIONAL ATTAINMENT). IMPORTANTLY, SUCH MECHANISMS MAY BE SHAPED BY CONTEXTUAL FACTORS THAT REMAIN UNDEREXPLORED IN THE AD/ADRD LITERATURE. STATE AND COUNTY EXPENDITURES ARE ONE SUCH SET OF CONTEXTUAL FACTORS CONDITIONING EARLY LIFE ACROSS PLACE AND TIME. FOR EXAMPLE, VARIATION IN COUNTY EDUCATION EXPENDITURES OVER TIME CO-OCCUR WITH VARIATION IN COUNTY LEGAL EXPENDITURES. INCREASED EDUCATION SPENDING HAS BEEN SHOWN TO IMPROVE EDUCATIONAL ATTAINMENT AS WELL AS REDUCE INCARCERATION – BOTH OF WHICH ARE ASSOCIATED WITH LOWER AD/ADRD RISK. THUS, WHILE STATE AND COUNTY EXPENDITURES IN EARLY LIFE COULD BE LINKED TO AD/ADRD RISK - AND THEREFORE SERVE AS AN INNOVATIVE AND EFFICIENT LEVER TO PROTECT AND IMPROVE POPULATION HEALTH - THIS HAS YET TO BE EMPIRICALLY TESTED. THIS R00 LEVERAGES A NOVEL LONGITUDINAL EXPENDITURES DATABASE AND TWO LARGE, NATIONALLY REPRESENTATIVE, PROSPECTIVE DATASETS (NATIONAL LONGITUDINAL SURVEY OF YOUTH 1979; US HEALTH AND RETIREMENT STUDY) TO ESTIMATE EFFECTS OF STATE AND COUNTY EXPENDITURES IN EARLY LIFE ON MIDLIFE COGNITION AND LATER LIFE DEMENTIA PROBABILITY. TRIANGULATING ACROSS THE STRENGTHS OF CONFOUNDER-CONTROL AND QUASI-EXPERIMENTAL METHODS, THIS R00 ADVANCES A NASCENT EVIDENCE BASE BY (1) EXAMINING IF COUNTY K-12 EDUCATION EXPENDITURES AND LEGAL EXPENDITURES OVER EARLY LIFE ARE INDEPENDENTLY