Advancing the Research-to-Policy and Practice Pipeline in Aging and Dementia Care.

This is a period of striking and unprecedented population aging that involves more individuals not merely attaining old age but reaching very old ages at which they are at heightened risk for chronic age-related conditions such as sensory loss, frailty, functional disability, and cognitive decline (Ortman et al., 2014). The delivery of person- and family-centered care to the right person at the right time and tailored to meet the needs of individuals and families based on their values and preferences to achieve optimal outcomes is thought to represent the pinnacle of health care quality (Berwick, 2009), but is particularly challenging in the care of older persons due to misaligned payment and delivery systems, the complexity and heterogeneity of health and function, and variable treatment preferences and goals (Boyd et al., 2019; Tinetti et al., 2012; Wolff & Boyd, 2015). Despite major payment and care delivery reforms to promote more comprehensive, coordinated, affordable, and person- and family-centered care, formidable challenges remain for the growing numbers of older adults living with complex health needs. These include high costs and fragmentation of health care and long-term services and supports, inadequate workforce of health care and allied health professionals with competency in geriatric medicine and nursing, and heavy reliance on family and other unpaid caregivers who are often not well supported or prepared for their roles. Within this context, there is a critical need to expand the community of investigators who are trained in health services and outcomes research and public policy, who both understand the specific issues affecting older adults and who possess rigorous methodological training, understanding of health services and systems, and an appreciation of the policy process; have built relationships with advocacy and policy leaders; and thus possess the requisite knowledge to conduct applied policy-oriented research that improves and integrates care for older adults who are frail or have complex health needs such as multiple chronic conditions, dementia, or functional disability.