Basic and Translation Research on Decision Making in Aging and Alzheimer's Disease (R21 - Clinical Trial Optional) | PAR 18 538

Opportunity Information: Apply for PAR 18 538

The National Institutes of Health (NIH) grant opportunity "Basic and Translation Research on Decision Making in Aging and Alzheimer's Disease (R21 - Clinical Trial Optional)" (Funding Opportunity Number: PAR-18-538) supports early-stage, exploratory research aimed at understanding how decision making changes with normal aging and with Alzheimer's disease (AD). It is designed for projects that dig into the underlying building blocks of decision behavior, including affective factors (like emotion and stress responses), cognitive factors (like memory, attention, and executive function), social influences (like trust, persuasion, and interpersonal dynamics), and motivational drivers (like reward sensitivity and goal priorities). A core theme is separating what is typical for older adulthood from what is specifically altered by AD, and clarifying the behavioral and neural mechanisms that explain those differences.

A major focus of the FOA is basic research that characterizes the behavioral and brain-based processes involved in decision making and how those processes may be differentially affected by normal aging versus Alzheimer's disease. In practice, this can include studies of risk and uncertainty, reward learning, impulse control, value-based choice, delay discounting, judgment under ambiguity, and the ability to integrate information across time. The FOA explicitly encourages work that links observable decision patterns to neural processes, which can mean leveraging neuroscience methods or biomarkers where appropriate, as long as the work remains centered on decision-making mechanisms and how they shift across aging and disease states.

Another central priority is understanding how social context shapes decision making in midlife and older adults, including those with cognitive impairment. This includes examining how social pressure, advice, trust, social network characteristics, caregiver involvement, or isolation influence choices and vulnerability. The FOA also emphasizes research on the decision-making conditions that increase the likelihood of financial exploitation and other forms of mistreatment, abuse, or fraud. That can involve identifying which cognitive or emotional changes make people easier targets, what kinds of scams or coercive situations are most dangerous, and what measurable decision-related markers could signal heightened vulnerability before serious harm occurs.

Beyond foundational science, the announcement encourages translational efforts that use what is learned about decision mechanisms to create decision-support approaches for midlife and older populations with and without AD. The intent is not only to describe deficits, but also to build practical tools and strategies that help people make better choices in real life settings. Examples called out in the FOA include interventions that intentionally leverage remaining strengths (cognitive, emotional, or motivational) rather than only compensating for weaknesses, as well as tools to assess decisional capacity in a more precise and evidence-based way. It also highlights strategies for simplifying choices, improving how options are presented, and creating better defaults that reduce burden and error, especially when decisions are complex or high-stakes.

The FOA also points to encouraging timely adoption of "optimal delegation practices," meaning supports that help individuals plan ahead and appropriately share or transfer decision authority when needed. This includes promoting earlier and more effective use of mechanisms such as power of attorney, living wills, or other legal/financial safeguards. The broader idea is to reduce crisis-driven decision making and lower the risk of exploitation or harmful outcomes by improving planning, timing, and the structure of decision responsibility.

This opportunity uses the NIH R21 mechanism, which is generally intended for exploratory and developmental projects that can generate strong preliminary evidence, novel methods, or proof-of-concept findings. The FOA states "Clinical Trial Optional," meaning applicants may propose a clinical trial if it fits the scientific aims, but a clinical trial is not required. The opportunity falls under the Health funding activity category and is associated with CFDA number 93.866. The listed award ceiling is $200,000. The original closing date provided in the source information is 2020-07-22, and the FOA creation date is 2017-12-21.

Eligibility is broad and includes many types of organizations, such as state, county, city, township, and special district governments; public and state-controlled institutions of higher education; private institutions of higher education; independent school districts; federally recognized Native American tribal governments; tribal organizations that are not federally recognized; public housing authorities and Indian housing authorities; nonprofits with and without 501(c)(3) status (excluding higher education institutions in those nonprofit categories); for-profit organizations (other than small businesses); small businesses; and additional "other" entities. The FOA also explicitly notes additional eligible applicant types, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Historically Black Colleges and Universities (HBCUs), Hispanic-serving institutions, Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and even non-U.S. (foreign) organizations.

Overall, the grant opportunity is aimed at advancing both the science and the practical impact of decision-making research in aging and Alzheimer's disease: identifying the core mechanisms that change, understanding how social and environmental pressures influence choices, clarifying why exploitation and abuse occur, and translating that knowledge into concrete decision supports, capacity assessment tools, and planning strategies that improve safety and autonomy for older adults.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Basic and Translation Research on Decision Making in Aging and Alzheimer's Disease (R21 - Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.866.
• This funding opportunity was created on 2017-12-21.
• Applicants must submit their applications by 2020-07-22. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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