Funding Opportunity Number: PAR-24-273
Deadlines: February 5, 2025, March 5, 2025, May 5, 2025
Background:
The U.S. older adult (those aged 65 and over) population is rapidly growing and becoming more diverse. By year 2060, it is projected that nearly half of this population will be comprised of persons from racial and/or ethnic minority populations. Older adults from populations that experience health disparities are more likely to report poorer physical health, mental health, and quality of life. They also tend to have more coexisting health conditions including cognitive impairment and functional limitations, less access to timely diagnosis and optimal quality of care, and experience more hospital admissions, readmissions, and multiple care transitions. Furthermore, disparities in health and healthcare continue to persist among these populations and were magnified during the COVID-19 pandemic. Therefore, the current U.S. health care systems and workforce’s lack of preparedness to meet the challenges of caring for older adults, especially those from populations that experience health disparities is a serious public health and societal concern.
There is ample research evidence indicating that there are many factors that may lead to omissions and commissions of care for older adults that often result in preventable adverse outcomes including delays in or over-screening, missed or delayed diagnoses, and untimely treatment or over-treatment. Such factors include ageism, mistreatment, delivery of substandard care, errors in clinical judgement, providing care that may do more harm than good, and dismissal of health concerns by healthcare providers and/or caregivers. All of these can negatively affect the physical and mental health of older adults and co-occur with other forms of discrimination (e.g., racism).
In addition, making a correct and timely diagnosis and care plan for older adults is a process influenced by a myriad of factors that can influence screening and diagnostic tests’ performance and accuracy. Some of these include:
- Underrepresentation of older adults, especially those over the age of 75, in clinical research.
- Age-dependent variations in sensitivity and/or specificity of screening and/or diagnostic tests.
- Screening tests for which diagnostic and/or treatment benefit is unclear after a certain age, or within the context of health status, quality of life, and/or projected life expectancy.
- Screening tests recommendations that consider patient preferences and weigh benefits versus risks/ harms.
- Symptoms and signs that are different from the clinical profiles observed in younger populations.
- Delayed recognition of health conditions by patients and caregivers/family members due to attribution of symptoms as part of the normal aging process.
- Family dynamics, built environment, and sociocultural environment factors that influence optimal care and quality of life.
- Diagnostic protocols or guidelines that create gaps in care delivery.
- Diagnostic, treatment, and continuity of care complexities associated with multiple coexisting chronic conditions.
- Side effects and adverse events associated with complex pharmacological therapy.
- Unfamiliarity or lack of proficiency in key cultural factors across different levels in the healthcare continuum and across various stages of the aging continuum.
- Limited health system resources and infrastructure, and health care policies that may limit coverage eligibility or access to optimal care and health equity.
- Lack of shared decision-making that is guided by principles of aging with dignity, self-determination, and autonomy.
For more information, please see the opportunity website.