Council Minutes - May 1998

NATIONAL ADVISORY COUNCIL ON AGING

The Seventy-fourth Meeting

Summary Minutes:
May 21-22, 1998

National Institutes of Health
Building 31, Conference Room 6
Bethesda, Maryland 20892

CONTENTS

1. Call to Order
2. Working Group on Program
3. Minority Aging Task Force Report
4. Minority Health Presentation
5. Task Force on Training
6. Program Highlights
7. New Business
8. Review of Applications
9. Adjournment
10. Certification
    

Department of Health and Human Services
Public Health Service
National Institutes of Health
National Institute on Aging

NATIONAL ADVISORY COUNCIL ON AGING
SUMMARY MINUTES
May 21-22, 1998

The 74th meeting of the National Advisory Council on Aging (NACA) was convened on Thursday, May 21, at 2:30 p.m. in Building 31, Conference Room 6, National Institutes of Health (NIH), Bethesda, Maryland. Dr. Richard J. Hodes, Director, National Institute on Aging (NIA), presided.

In accordance with the provisions of Public Law 92-463, the meeting was open to the public on Friday, May 22, from 8:00 a.m. to 1:00 p.m. The meeting was closed to the public on Thursday, May 21, from 2:30 p.m. to recess for the review, discussion, and evaluation of grant applications in accordance with the provisions set forth in Sections 552(b)(c)(4) and 552(b)(c)(6), Title 5, U.S. Code, and Section 10(d) of Public Law 92-463.

Council Participants:

Dr. Helen M. Blau
Dr. Fred H. Gage
Dr. Patricia S. Goldman-Rakic
Dr. Richard A. Goldsby
Dr. Mary S. Harper
Senator Mark Hatfield
Dr. William Hazzard
Dr. James S. Jackson
Dr. Gerald E. McClearn
Dr. John W. Rowe
Dr. Dennis Selkoe
Dr. James W. Vaupel
Dr. Jeanne Y. Wei
Dr. David A. Wise

Absent:

Dr. Elizabeth Barrett-Conner
Dr. Jeffrey Bluestone
Dr. Eugenia Wang
Dr. George F. Fuller
Dr. Judith A. Salerno

The Council Roster, which gives titles, affiliations, and terms of appointment, is appended to these minutes as Supplement A.

Members of the Public Present:

Nancy Aldrich, Aging Research and Training News
Shirley Brown, Gerontology News
Andrea Castrogionanni, American Speech-Language-Hearing Association
Al Nugent, Midwest Research Institute
Lisa Putman, The Blue Sheet

In addition to NIA Staff, other Federal employees attending were:

Bob Weller, Center for Scientific Review

1. Call To Order

Dr. Hodes welcomed Council members and guests and asked new members to introduce themselves. Dr. Hodes welcomed Senator Hatfield who was attending his first meeting.

Future Meeting Dates

• September 24-25, 1998 (Thursday-Friday)
• February 3-4, 1999 (Wednesday-Thursday)
• May 27-28, 1999 (Thursday-Friday)
• September 23-24, 1999 (Thursday-Friday)

Consideration of Minutes of Last Meeting

The minutes of the May 21-22, 1998 meeting were approved as submitted.

Director's Status Report

In his Director's Status Report, Dr. Hodes reviewed activities related to planning for possible budget increases, emphasizing that NIH Institutes and Centers are poised to take advantage of increases over a 4-5 year period. The President's budget for FY 1999 includes a 7.5% increase for NIA. With such an increase, research project grants, research centers, research contracts and the intramural program would benefit while the research management and support functions would remain constant. Such constraint is likely to affect workshops and other proactive staff activities.

Council members raised a number of questions about level of support for research centers. Dr. Hodes responded that the NIA supports centers that range in scope from exploratory and core centers to comprehensive research centers, and that their size and budgets vary accordingly. He said that the NIA strives for a balance of mechanisms to meet program development needs in a range of scientific areas. Other questions related to impact of managed care on the infrastructure of academic health centers, on our ability to conduct clinical research, on training and future human resources, and on rare diseases. Dr. Hodes responded that both NIH and NIA are interested in, and attending to, all of those issues. The Director's Status Report is appended to these Minutes.

2. Working Group On Program

Dr. McClearn, reporting on the meeting of the Working Group on Program, outlined plans for the September 1998 review of the Biology of Aging Program. He indicated that he will chair the review and plan it with program staff, and that both Council members and extramural scientists would serve as reviewers. Dr. Hodes noted that a search to fill the vacancy created by Dr. Sprott's resignation will be formed shortly and said that he welcomes suggestions of possible candidates from the outside community.

At a previous program review, it was suggested that staff work to develop assessment criteria applicable to all programs. It was reported that a staff committee is working to develop standardized outcome measures to serve as markers of program effectiveness. Examples of indicators to assess quality of science and of investigators include degree of recognition, measures of translation of research into practice, quality, and number of publications. In discussion, members pointed out that it might be costly to obtain such data and suggested that they may be more efficiently provided in annual reports submitted by investigators.

The statistical data prepared for each Council meeting were discussed. Working Group members requested data on trends in success rates and speculated on whether success rates below the NIH average indicate scientific merit or might reflect inappropriate assignment of applications and/or their review by scientists unfamiliar with aging research. These issues will be discussed with Dr. Ehrenfeld, Director, Center for Scientific Review, during the September Council meeting.

Dr. McClearn reported that Dr. Hodes presented the agenda including themes and plans for the June summer planning retreat. The Working Group observed that the number of topic areas might preclude depth of discussion. Dr. Hodes responded that these topics are in different stages of development and many have been discussed extensively already. The retreat is an opportunity for trans-NIA communication. Council members made suggestions of potential additional discussion topics, such as caregiving, standardizing assessment instruments with older persons, chronic illness and comorbidity, and issues surrounding infrastructure, including equipment. Dr. Hodes pointed out that such topics are important, already are represented in NIA's portfolio, and would be incorporated into future planning activities. He added that Council members would be informed of NIA-sponsored conferences and workshops being planned so that they may contribute to them. Dr. Warner indicated that a summer workshop on high throughput technology would address the equipment and infrastructure needs of NIA investigators in this area.

Dr. McClearn called on Dr. Abeles to summarize the Working Group's discussion of data sharing and archiving. Since 1986, NIH has had a policy for sharing unique biological resources, but no parallel policy has applied to sharing and archiving data sets. Such a policy would permit both replications and new analyses. The policy under consideration is to articulate principles on sharing that would be reflected in research grant applications. For example, privacy of data should be safeguarded. Confidentiality of data should be respected and legal restrictions on data sharing should be taken into account. The investigator should have exclusive access to the data for a period of time after which sharing should occur in a timely fashion. Funding should be budgeted for archiving data. The intent of the policy is to effect a wide-scale attitude shift toward acceptance of the principle of making data available for analysis by other investigators. It is not meant to be prescriptive. If a policy along these lines is adopted, the data archiving/sharing plan would be included in grant applications and evaluated as part of the peer review process. It was noted that, in some fields of science, archiving/sharing is common and accepted practice but that this is not the case for all fields. Council members observed that often journals require that data be made available upon request. Dr. Abeles said that as NIH develops a policy, there would be opportunity for consultation with and comment by the scientific community.

Dr. McClearn reported on the Working Group's discussion of animal resource issues. He said that many investigators perceive that animal care costs are so high that they inhibit research, and that the problem has become particularly acute because of how such costs are allocated as direct and indirect costs by research institutions. Dr. Strandberg, Professor of Comparative Medicine at Johns Hopkins, who is on a temporary assignment to the National Center for Research Resources under the Intergovernmental Personnel Act, provided information about OMB Circular A-21. Circular A-21 recommends that animal care costs should be allocated as direct costs. Although the costs per se do not change as a function of how they are allocated, investigators maintain that the substantial cost increases that ensue from charging animal care costs as direct costs influence peer reviewers. However, research institutions do not interpret or apply the policy uniformly, so that some institutions subsidize animal care costs, making them less apparent as direct costs charged on research grant applications. Some claimed that this practice may influence peer reviewers to rate these lower cost applications more favorably. Issues surrounding OMB Circular A-21 have been considered by a committee of the National Academy of Sciences and an interim report from that committee has been issued. Dr. Strandberg emphasized that standardized and consistent implementation of the policy set by A-21 is desirable and that comment to that effect is timely.

The second animal resource issue discussed concerns primate resources, specifically chimpanzees. Dr. Wetle summarized for Council. In 1998, the House of Representatives Appropriations Committee report language indicated that use of primates in research on aging might be useful in the study of Alzheimer's and Parkinson's diseases, and in the development and testing of vaccines for older persons. NIA was asked to consider supporting research utilizing primate models through various mechanisms, including research centers. Subsequently, there were conversations between NIA staff and congressional staff in which NIA was encouraged to consider support of a research center for aging chimpanzees. Potential grantees estimated the cost of such a center to range between $8 -$15 million per year.

Data about numbers of chimpanzees available and interest among potential NIA grantees in conducting research on those animals were summarized. The National Research Council recently issued a report on chimpanzees. A core population of about 1,000 chimpanzees is available that have been or might be used for research. The report recommends that: there be a moratorium on breeding chimpanzees; euthanasia not be endorsed for population control; chimpanzee sanctuaries be established for animals no longer needed for research; and a chimpanzee management program be established. NIH is implementing recommendations with some changes: that the colony have a birth or two every year to maintain a healthy colony, and that there be 3 colonies: an active research colony; a breeding colony; and a colony available for research.

NIA, to be both responsive and scientifically responsible, assessed available chimpanzee and other non-human primate resources and scientific demand for such resources. Data indicated that more than 500 chimpanzees are currently available through NIH-supported colonies. NIA conducts and supports research with non-human primates other than chimpanzees as well. Colonies of both chimpanzee and other non-human primates supported by NIA and NIH extramural resources are currently underutilized. All NIA grantees were surveyed regarding their interest in using chimpanzees for research. Of 1,600 grantees queried, 58 responded. Of these, 51 said they are not interested in using chimpanzees in research. Three grantees said they might be interested; four indicated a positive interest but, for three of those, the interest is limited to use of postmortem brains. Following discussion, Council passed the following motion unanimously: The National Advisory Council on Aging advises that there is no scientific demand for a center for aging chimpanzees. There is substantial current capacity not being utilized. NIA will establish a mechanism to make interested investigators aware of the available resources. Further, the NIA is advised not to accept any large-scale proposals to support such a center.

3. Minority Aging Task Force Report

Dr. James Jackson, Chair, Minority Aging Task Force, reminded Council members of the reasons for the existence of the Task Force – both the rapidly growing population of older ethnic minorities, and the continuing pattern of differences in morbidity and mortality by ethnic group. He mentioned recent legal challenges to programs that seek to build a workforce of minority researchers; he indicated that the Minority Task Force recommends that NIA should continue its efforts in human resource development despite these threats. He mentioned the separate issue of research to address the disparities in health between minority and majority older adults, and described strategies to address these disparities, some of which NIA had adopted.

Dr. Jackson asked Drs. Harden and Stahl of NIA to describe particular activities recently supported by the Institute. Dr. Harden mentioned the upcoming Summer Institute on Aging Research and described the success of efforts to increase the number of minority researchers who attend the Summer Institute. She also mentioned upcoming regional meetings in Tennessee and New York to recruit and inform potential applicants, the minority research and training newsletter, and a current request for applications that seeks to build networks to enhance recruitment of minority students and researchers to aging research. Dr. Stahl described the recently funded Resource Centers for Minority Aging Research that seek to increase the recruitment of minority investigators to aging research; to improve research measurement tests and questionnaires for different ethnic groups; and to enhance recruiting minority older adults to participate in aging research studies. He and Dr. Jackson described the successful collaboration of these centers with other NIA-supported centers and with centers supported by the Agency for Health Care Policy Research. All groups are seeking ways to increase minority participation in research.

To assess the full range of NIA's activities on minority aging and to develop a plan to promote these activities, Dr. Jackson urged that the Council approve a motion to determine the feasibility of focusing the next NIA-wide review by NACA on minority aging research supported by NIA, and overall strategies for supporting such research. Some discussion ensued on whether the review should be part of the normal schedule or be conducted ad hoc. Dr. Jackson proposed a schedule for preparing the review. Dr. Harper suggested that NIA should consider including on the review panel persons from other agencies and other individuals who are sponsoring or conducting related work, along with Council members. Council members unanimously approved the motion. Dr. Hodes expressed support for the idea.

4. Minority Health Presentation

Dr. Hodes introduced Dr. John Ruffin, NIH Associate Director for Minority Health. Dr. Ruffin directs the NIH Office of Minority Health, which is performing an important role coordinating and assisting in the development of minority research and training efforts across the institutes at NIH.

Dr. Ruffin first acknowledged the immediately preceding Council effort to establish a review of minority aging efforts at NIA. He indicated that what the Council accomplished, with ease, is a frustratingly difficult task in other contexts. He also acknowledged the good working relationships he has established with prior and current NIA directors. He emphasized that his office serves in a partnership role with the institutes at NIH to identify and address the gaps and disparities in health status that have emerged between minority and majority groups and among different minority groups.

Dr. Ruffin described the twin complexities of ensuring that the diverse concerns and health problems of many different minority groups are addressed by NIH, and the task of continuing to maintain and expand the resources for this work as these groups become more differentiated. Recently this endeavor has been made more difficult by changing public attitudes towards special initiatives that are limited to certain minority groups. Dr. Ruffin linked initiatives that build a minority research workforce to the target of reducing disparities in minority health. He also acknowledged the effects of recent challenges to affirmative action programs on efforts such as the minority-majority partnership program sponsored through his office. His office remains committed to efforts to build a minority research workforce and, through partnership with the National Science Foundation, to sponsor K through 12th grade science education initiatives.

Council members discussed both the issue of when to intervene in education in order to assure a steady stream of qualified minority students interested in research and the issue of appropriate interventions in education. Dr. Rowe observed that, based on family experience, teachers in schools with high minority enrollment often lack the skills to implement the interventions that have been shown to be effective through other programs.

5. Task Force On Training

Dr. Helen Blau, Chair, Council Task Force on Training, led the discussion. She expressed her fear that the nation is at risk of losing the best and the brightest students from biomedical research careers because of inadequate compensation levels on the several mechanisms that support training. She welcomed recent proposals to increase stipends for National Research Service Awards by 25%. She indicated, however, that such increases will continue to leave compensation levels below what other agencies and organizations pay students and postdoctoral researchers, and will leave the stipends substantially below what the same individuals can earn in industry or clinical practice.

Focusing on the NIA, she showed that in recent years the number of unfilled slots on training grants has increased, particularly for postdoctoral positions, and that the number of unfilled slots varies substantially depending upon the disciplinary area. In geriatrics, most training grants have unfilled slots. Though administrative reasons can explain why some slots are unfilled, such as lack of knowledge that appointments can be filled midway through a funding year, the recent increase and the differentiation by disciplines implies another cause. Dr. Blau suggested that the inadequate compensation levels are a factor. She mentioned new mechanisms (patient-oriented career awards) that are intended to address the problem of recruitment in clinical areas – such as geriatrics research. She indicated that similar mechanisms might need to be developed for junior Ph.D. researchers.

Other issues that the Task Force is addressing include the relative merits of training via training grants and training via assistantships on research grants, the need for cross-disciplinary training, and the issue of what constitutes appropriate training in aging research.

Council discussion clarified the nature of new career development mechanisms. Other points discussed included the particular problems of recruiting geriatricians to research given the high demand for their clinical services, and the problems of finding ways to support foreign-born students and junior researchers in biomedical research in the United States. Other possible reasons that training slots are not being filled and whether NIA supports training in community care research were explored.

6. Program Highlights

Research Highlights

Dr. Hodes reminded Council members that at each Council, short accounts of recent research highlights are presented by each of the extramural programs. Dr. Morrison-Bogorad, Associate Director, Neuroscience and Neuropsychology of Aging Program (NNA), introduced Dr. Fred Gage, a Council member, to provide the NNA program highlights.

Dr. Gage provided a brief overview of his and his colleagues' work on cell genesis in the adult brain. Though a long-held view has been that, after birth, the brain loses the capacity to create new neuronal cells, Dr. Gage has found that in both the hippocampus (an area important for learning and memory) and in the ventricular zone neuronal cells are generated throughout life. Dr. Gage and others have demonstrated this cellular generation through introducing a marker into brain cells that is incorporated only at the point of cell division (the generation of new cells).

In further confirmation of cell genesis, these immature progenitor cells have been isolated in culture and shown to proliferate. The cells give rise both to neuronal and nonneuronal cells. After being marked with a genetic marker, the new cells were introduced into the adult brain. When inserted in the appropriate area, the cells migrate to the olfactory bulb and to the hippocampus.

The work provides a mechanistic account of brain plasticity. Past research established that animals provided with enriched environmental experiences show increased brain weight and changes in other anatomical markers relative to controls in more impoverished environments. The new research offers the possibility that these anatomical markers are signaling that new neurons have been developed - an explanation of enrichment not previously thought possible.

In examining this possibility, Dr. Gage and his colleagues first established that rats who had been placed post-weaning into enriched environments were found to have as many as 80% more neurons in particular regions of their brains than their genetically identical litter mates who were raised in control environments. The laboratory then examined whether the same results would be obtained if the enriching intervention was introduced relatively late in the rats' lives. Dr. Gage and his colleagues found that cell genesis continues in the older control and experimental animals, and that the older treated animals demonstrated substantially more survival of the new cells than controls. He indicated that other researchers are now exploring whether cell genesis continues in the adult brain of other mammals, including humans.

Questions included whether such interventions might provide a treatment for spinal cord injury; whether the new cells have similar functional competence to existing cells; and whether the new cells induce behavioral change in the treated animals. Dr. Gage indicated that research is addressing these questions with encouraging results. However, there are no definitive answers at the present time.

Dr. Abeles, Associate Director, Behavioral and Social Research Program (BSR), described ongoing research by Dr. George Kaplan and his colleagues on the cumulative effects of socio-economic status (SES) on health and functioning in late life. Dr. Kaplan's group has collected longitudinal data on a population in Alameda County, California over 30 years in four waves (1965, 1974, 1983 and 1994). Because of the stratified sampling used, the research group was able to collect cumulative data on the effects of differences in SES on health and functioning.

Dr. Abeles indicated that prior research had established that differences in SES are associated with differences in health status, that the effects of SES are not confined to those at the poorest level in society but are spread throughout all levels, and that, at least in the short-term, reverse causation has been observed in which catastrophic health change has had a profound effect on SES of those affected and their families. Though data on the effects of SES in late life are sparse, evidence suggests that effects are attenuated but remain apparent with such devastating conditions as cardiovascular disease, many cancers, and Alzheimer's disease.

Dr. Kaplan's group focused on the sustained impact of lifelong low SES. His analysis was informed by the number of times in the repeated measures of 1965, 1974 and 1983 that individuals had reported total household income less than 200% of the poverty level. Using this information, they examined functioning in 1994. The group found that those who reported lifelong poverty (i.e., across all three measurements) were 3.7 times more likely to report difficulty with activities of daily living in 1994 than those with no history of economic hardship. Even after controlling for likely mediators of this relationship - smoking, alcohol consumption, obesity and physical activity levels - those showing sustained economic hardship still showed 2.9 times the odds of difficulties with activities of daily living compared to those reporting no economic hardship. Measures of psychological and cognitive functioning showed similar relationships. In a related study, the research group showed that residence in a poverty area also increases the likelihood of later-life difficulties with activities of daily living. Surprisingly the negative effects of living in a poverty area were strongest for those reporting the highest incomes within the poverty area.

Dr. Abeles indicated that NIA, in collaboration with several other institutes, is beginning a research initiative that seeks to explore the mechanisms through which SES exerts its effects, to improve the measurement and conceptualization of SES especially as applied to its lifelong effects, and to examine SES in relation to immigrant and special populations.

Dr. Huber Warner, Acting Associate Director, Biology of Aging Program (BAP), described a recent study reported by Timothy McCaffrey and his colleagues on disruption of cell-cycle control, related to the need to maintain constancy in the number of cells in different cell systems. Disruptions of these mechanisms can lead to the uncontrolled proliferation that is characteristic of cancer and some kinds of heart disease.

TGF-beta is a cytokine involved in tissue remodelling in many kinds of cells. McCaffrey and his colleagues focused on its action in smooth muscle cells. After TGF-beta binds to a receptor protein, the resulting signal transduction pathway normally induces the P21 gene which inhibits cell-cycle progression.

McCaffrey and his colleagues examined whether instabilities in the microsatellite region of the gene for a receptor protein for TGF-beta disrupt the binding of the TGF-beta to its receptor, which is composed of the R1 and R2 subunits. The researchers found that mutations in the gene for the R2 subunit are associated with loss of inhibition of cell-cycle progression. The result is that unbalanced proliferation of smooth muscle cells occurs. This finding of McCaffrey et al offers a plausible mechanistic account of the phenomenon of restenotic regrowth in some forms of cardiovascular disease.

Dr. Warner reported that similar deletions associated with the R2 gene have been noted in some human colon cancers. He also reported recent observations that similar disruption of cell-cycle control has been found in prostate cancer cell lines. He concluded that studying alterations of the signal transduction pathway induced by TGF-beta offers a promising line of research for understanding age-related changes in cell cycle control.

Comments and questions from Council members noted the substantially greater degree of difficulty in developing an intervention in this mechanism compared to the neuronal generation observed by Dr. Gage.

Dr. Evan Hadley, Associate Director, Geriatrics Program (GP), described the results of a protocol examining weight loss and sodium reduction as techniques to reduce hypertension and the risk of cardiovascular events in older adults. As older adults often are required to take multiple drugs associated with co-occurring conditions and as adverse side effects from taking multiple drugs are common, any non-pharmacological intervention that can reduce hypertension is especially useful in this group. Although physicians frequently recommend weight loss and reduction in sodium intake to older hypertensive patients, no prior clinical data had been collected on the efficacy of these interventions.

The investigators set standards of a reduction in sodium intake to 1,800 milligrams a day for the sodium intervention, and a weight loss of ten pounds for the obesity intervention. Subjects who were not obese were assigned either to the sodium intervention or to the no treatment control. Subjects who were obese were assigned to one of four groups: weight loss group alone, sodium reduction group alone, dual intervention group (weight loss and sodium reduction), or the no treatment control group. Medications were discontinued approximately 3 months after subjects were assigned to one of the groups. Subjects were returned to medication if there was a recurrence of hypertension. The investigators monitored both the probability of return to hypertension and the risk of any cardiovascular event.

The likelihood of hypertension recurring and the likelihood of a cardiovascular event were substantially lower in the treatment groups than in the control group. The effects were still apparent when the study was extended out to 30 months of follow-up. Surprisingly, even among the no treatment group, 25 percent of the subjects did not return to a hypertensive state.

Dr. Hadley pointed out that, in this controlled intervention study, subjects were advised by nutrition and exercise counselors. The effectiveness may be less marked in a standard clinical setting. Issues of who is most suitable for this intervention and how they should be monitored remain to be addressed.

7. New Business

Dr. Hodes encouraged Council members to raise issues which need discussion now or which may be suitable for a future agenda. Dr. Selkoe raised the issue of lack of growth in the RMS (research management and support) budget line and the constraints this limitation places on staff activities. Council members discussed the competing public pressures to downsize administration in government, to increase research support for particular diseases, and for Congress to earmark highly specific activities for research support. In the current environment, it would be difficult to make an independent statement in favor of increasing administrative support for research.

Dr. Harper mentioned that, following a meeting with the Association for Directors of Nursing in Nursing Homes, she learned that these administrators are asked to allow their facilities to become research sites but often are given little information about the proposed study and little sense of how the nursing home might benefit from the study. They seek more information on these topics from the investigators proposing the research.

Dr. Selkoe asked Dr. Hodes to give some sense of how the Institute will respond if NIA is provided a significant increase in appropriations. Dr. Hodes indicated that if the increase is sudden, it is unlikely that research program grants alone will absorb it; other mechanisms such as contracts and center supplements would be used as well. Institute staff also would consider infrastructural needs for aging research. Two topics that have already been considered are means to facilitate clinical trials and ways to provide expensive equipment and materials for research to extramural and intramural investigators.

In final comments, Senator Hatfield indicated that, although NIH is seen as the premier site of health-related research in the Federal government, important work is also being conducted at the Department of Agriculture, the Environmental Protection Agency, the Centers for Disease Control, and the National Science Foundation. In protecting the interests of NIH, it is important to take the broad view and protect the interests of these other agencies which play a vital part in promoting health and science research in the United States.

8. Review Of Applications

This portion of the meeting was closed to the public in accordance with the determination that it was concerned with matters exempt from mandatory disclosure under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix).

A total of 854 applications requesting $562,567,667 for all years was reviewed. Council recommended 593 for a total of $361,170,441 for all years. The actual funding of the awards recommended is determined by the availability of funds, percentile ranks, priority scores, and program relevance.

9. Adjournment

The 74th meeting of the National Advisory Council on Aging was adjourned at 12:30 p.m. on May 22, 1998. The next meeting is scheduled for September 24-25, 1998.

Attachments:

1. Roster of Council Members (Not available)
2. Director's Report to the NACA (Not available)
   

10. Certification

I hereby certify that to the best of my knowledge the foregoing minutes and attachments are accurate and complete.

Richard J. Hodes, M.D.
Chairman, National Advisory Council on Aging
Director, National Institute on Aging

Prepared by Miriam F. Kelty, Ph.D.