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Military personnel and other individuals living with traumatic brain injury (TBI) face an increased risk for developing several long-term health problems. These include Alzheimer’s-like dementia, aggression, memory loss, depression, and symptoms similar to those of other neurological diseases. The PRARP (formerly the Militarily Relevant Peer Reviewed Alzheimer’s Disease Research Program) was initiated in 2011 to address the long-term consequences of TBI as they pertain to Alzheimer’s disease (AD). In FY16, the program was expanded to include AD-related dementias (ADRD) research as it pertains to TBI.


Consistent with the PRARP's mission and vision, the program faces 6 overarching challenges for FY16. These overarching challenges represent longstanding research goals for the program:

• Paucity of Research Resources: The paucity of research resources to examine the interrelationship between TBI and subsequent AD/ADRD for the military, Veteran, and civilian communities.
• Paucity of Clinical Studies: The paucity of clinical studies to examine the interrelationship between TBI and subsequent AD/ADRD for the military, Veteran, and civilian communities.
• Diagnostic Technologies, Tests, Biomarkers or Devices: The need for technologies, tests, or devices to detect the progression to AD/ADRD subsequent to TBI.
• Epidemiology: The paucity of epidemiological research to examine the interrelationship between TBI and subsequent AD/ADRD for the military, Veteran, and civilian communities.
• Quality of Life: The need for technologies, assessments, interventions, or devices to benefit individuals living with the common symptoms of TBI and AD/ADRD.
• Caregiver Burden: The need for technologies, assessments, interventions, or devices with the goal of reducing burden for caregivers of individuals living with the common symptoms of TBI and AD/ADRD.

The PRARP has identified 7 research focus areas which are viewed as avenues towards addressing the FY16 PRARP overarching challenges. These are technical in nature, and represent research disciplines most suited to the PRARP's overarching challenges:

• Genomics/Proteomics: Studies or technologies (e.g., genetic, proteomic, and epigenetic strategies) intended to characterize neurological change(s) associated with TBI and subsequent AD/ADRD. In addition, relevant technologies or tests may be considered under this focus area.
• Mechanisms of Pathogenesis: Identification of contributing mechanisms (e.g., pathology of Tau, non-neuronal cells, inflammatory factors and vascular contributions) associated with TBI and subsequent AD/ADRD pathogenesis.
• Diagnostics and Biomarkers: Development of strategies to characterize neurological changes associated with TBI and subsequent AD/ADRD (e.g., fluid-based, imaging, physiological, and clinical approaches).
• Novel Target Identification: Basic research (non-human) directly leading to the identification of new targets for the development of existing or new investigational medicines, drugs, or agents.
• Care Interventions and Quality of Life: Research intended to stabilize or improve the quality of life of those affected by TBI or AD/ADRD. Examples of research in this focus area include: Identification and management of comorbidities and modifiable risk factors (e.g., sleep apnea, obesity), cognitive training interventions, studies of health and wellness, and behavioral interventions.
• Caregiver Support: Research intended to reduce the burden of care on the caregiver for individuals affected by the symptoms of TBI or AD/ADRD. Examples of research in this focus area include: Caregiver training, home-based support, behavioral interventions, and relationship interventions.
• Epidemiological Research: Research focusing on the incidence, distribution, outcomes, and other factors relating to the health of individuals affected by TBI and subsequent AD/ADRD.