? DESCRIPTION (provided by applicant): Rapid growth of U.S. seniors in the next two decades will significantly increase the burden of chronic health conditions. The overwhelming majority of healthcare for seniors is delivered by physicians in subspecialties of internal medicine or surgery. Recognizing the demographic imperative and the need for a coherent strategy to infuse gerontology and geriatrics into the consciousness of specialists and NIH institutes/centers (ICs) outside NIA, we embarked on a series of scientific workshops over the last seven years with support from the John A. Hartford Foundation (JAHF) and the NIA (U13 AG040938) to conduct a series of meetings that resulted in state-of-the-art reviews in high impact journals with research-setting agendas, and provided the basis for funding opportunities jointly sponsored by NIA with other NIH ICs. In each conference, the importance of functional evaluation - physical, cognitive and sensory - to determine patient-centered, individualized goals and drive therapeutic decision-making was identified as a resounding need. However, a function first implementation strategy has lagged in specialty research, and function remains a rarely mentioned factor in clinical guidelines or quality metrics. We believe the time is right to bring together leaders and innovators in specialty medicine with researchers who have spent their entire professional careers thinking about physical, cognitive and sensory function to identify best practices and conceptual or empirical gaps that inhibit the use of functional assessment to guide care in specialty medicine. This U13 application leverages ongoing foundation funding from JAHF and is a request to renew and expand the trans-disciplinary approach employed in our prior grant to further these goals. This will require linking across all four branches of NIA, multiple NIH ICs, and other federal agencies (e.g. PCORI, CMS, CDC). The project includes health disparities as a major focus - given the great racial/ethnic/gender divide in functional outcomes - and fosters career development of minority and junior faculty.

U13AG040938

2011-09-15

2021-05-31