Screening for Cognitive Impairment: Decision-Making (U24 Clinical Trial Optional) | RFA AG 23 007

Opportunity Information: Apply for RFA AG 23 007

The NIH Funding Opportunity Announcement "Screening for Cognitive Impairment: Decision-Making (U24 Clinical Trial Optional)" (RFA-AG-23-007) supports the creation of a coordinated research network focused on a specific gap in cognitive aging and dementia research: the lack of strong, practical measurement tools for detecting and tracking problems in higher-order functioning, especially decision-making and planning, in older adults. Rather than funding a single stand-alone study, the opportunity is structured as a cooperative agreement (U24), which typically means NIH will have substantial programmatic involvement and expects awardees to work in a coordinated way toward shared deliverables. The overarching intent is to move the field beyond broad cognitive screening and toward tools that can meaningfully capture real-world functional capacities that often matter most to individuals, families, clinicians, and service systems.

The central scientific objective is to develop, validate, and disseminate instruments that can be used to screen for deficits tied to decision-making, planning, and related higher-order outcomes. These are the kinds of abilities that influence whether a person can manage medications, finances, appointments, driving choices, safety decisions, or complex healthcare decisions, and they can decline even when traditional memory-focused screening tools do not fully capture the functional impact. NIH is especially interested in measures that can sensitively track change over time in decision-making capacity, because that tracking could later support broader cognitive impairment screening approaches and could also serve as an outcome measure in interventions designed to preserve function or improve quality of life. The FOA explicitly links this work not only to outcomes for people living with cognitive impairment, but also to quality of life outcomes for care partners and caregivers, recognizing that decision-making difficulties often shift burden and risk onto families and support systems.

A key deliverable envisioned by the FOA is an enduring set of resources that other researchers can readily adopt. That includes the measurement instruments themselves, clear documentation on how the tools were developed and should be administered and interpreted, and normative data that allows future users to contextualize an individual score or change score against an appropriate reference group. The FOA emphasizes that the network should review and assess the relevant dimensions of higher cognitive abilities and functional capacities that are believed to underpin planning and decision-making, then translate that conceptual work into measures that are both valid (actually measuring the intended constructs) and reliable (producing stable, consistent results). Importantly, the FOA calls for support of pilot efforts during instrument development and validation, signaling that the network is expected to do hands-on empirical testing and refinement rather than stopping at theoretical frameworks or literature reviews.

Diversity and generalizability are built into the expectations. The FOA specifies that development and validation should be conducted in a racially, ethnically, geographically, and diagnostically diverse set of participants. In practice, this pushes applicants to ensure that tools are not narrowly calibrated to a single clinic population or one demographic group, and that normative data and performance characteristics reflect the populations who would realistically be screened in real-world settings. The mention of diagnostic diversity also implies attention across a spectrum that may include cognitively unimpaired older adults, people with mild cognitive impairment, and people living with Alzheimer disease and related dementias, as well as potentially other conditions that affect decision-making and executive functioning.

From an administrative standpoint, this is a discretionary funding opportunity from the National Institutes of Health, in the health activity category, associated with CFDA 93.866. The FOA is labeled "Clinical Trial Optional," meaning applicants may propose work that includes clinical trial elements if appropriate, but a clinical trial is not required. The original closing date listed for the opportunity was July 11, 2022, and the FOA was created February 23, 2022. While the award ceiling and expected number of awards are not specified in the provided source data, the U24 mechanism and the network language together suggest NIH is looking for a well-organized, multi-component effort with defined products that will have field-wide utility.

Eligibility is broad across U.S.-based organizations and includes state, county, and local governments; special district governments; independent school districts; public and private institutions of higher education; federally recognized Native American tribal governments; tribal organizations (including those other than federally recognized tribal governments); public housing authorities and Indian housing authorities; nonprofits with and without 501(c)(3) status; for-profit organizations other than small businesses; and small businesses. The FOA also highlights additional categories that are explicitly welcomed, such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, and Asian American Native American Pacific Islander Serving Institutions (AANAPISISs), as well as faith-based or community-based organizations, regional organizations, eligible federal agencies, and U.S. territories or possessions. Foreign institutions (non-U.S. entities) are not eligible to apply as the applicant organization, but non-domestic components of U.S. organizations are eligible, and foreign components are allowed as defined by the NIH Grants Policy Statement, which can enable collaboration or data collection elements abroad when well-justified within an otherwise U.S.-led application.

In plain terms, this FOA is about building the measurement foundation needed to identify and follow decision-making problems in aging and cognitive impairment, using tools that are rigorous enough for research yet designed with an eye toward future screening and intervention development. NIH is asking for a network that can do the conceptual clarification, instrument construction, pilot testing, validation, and broad dissemination work required to produce measures and norms that many other studies can reuse, accelerating progress toward functional outcomes that genuinely reflect everyday independence and caregiver impact.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Screening for Cognitive Impairment: Decision-Making (U24 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 2022-02-23.
• Applicants must submit their applications by 2022-07-11. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• 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.

Apply for RFA AG 23 007

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