PROJECT ABSTRACT: Emergency care of older adults with Alzheimer's Disease and related dementias (ADRD) is suboptimal despite greater rates of emergency department (ED) use than for matched controls. Persons with dementia (PwD) are poorly identified in the ED, are more likely to have an avoidable ED visit, be admitted to the hospital, struggle in the ED environment, and experience numerous other challenges. Despite calls in the National Plans to Address Alzheimer's Disease and their updates, limited research has been performed to optimize the emergency care of PwD. To advance the emergency care of PwD first requires delineation of the research gaps related to identifying PwD receiving emergency care and providing them optimal care, followed by establishing and testing strategies to resolve the gaps. To effectively and efficiently identify and address these gaps, the goal of this proposal is to launch the Geriatric Emergency Care Applied Research Network 2.0 - Advancing Dementia Care (GEAR 2.0 ADC). Specifically, this network would partner and leverage existing ADRD and emergency care focused networks, foundations, stakeholders, and organizations through a transdisciplinary team of leading investigators and consultants who have already transformed the emergency care of older adults and the care of PwD through rigorous NIH-funded research. During the first phase of this proposal, a stakeholder engagement approach will be used that has been previously and successfully implemented by investigators. They will determine research priorities for ED patients and caregivers using a consensus process in four domains: 1. ED practices 2. ED care transitions 3. Detection, and 4. Communication and decision making. The GEAR 2.0 - ADC infrastructure and its network will be established that includes the GEDC, ADRCs, and GEAR 2.0 Cores: 1. Administrative; 2. Research; 3. Data/Informatics; and 4. Dissemination & Implementation. The second phase of the proposal will solicit, review, select and fund research that will lead to future full-scale proposals addressing research gaps in emergency care for PwD and their caregivers identified during the first phase. There will be over $1.1M in pilot study awards. This proposal will create a platform from which GEAR 2.0 ADC and future investigators will generate preliminary data for large-scale funding opportunities, including multicenter project proposals. This “priming” of the research pipeline will promote further transdisciplinary studies and science and lay the groundwork for a sustainable research network infrastructure to support development of an evidence base to optimize the emergency care of PwD.

PROJECT NARRATIVE: The Geriatric Emergency care Applied Research network 2.0 – Advancing Dementia Care brings together leaders who have transformed the emergency care of older adults and partners them with Alzheimer's disease and related dementia (ADRD) experts to optimize care and improve the health of older persons with dementia. It will leverage existing networks and organizations to prioritize research gaps and support pilot grant opportunities for future larger-scale, full proposals.