REGARDS study secures NIH funding for another five years, expands research on stroke and brain health risks

Written by: Katherine Kirk
Media contact: Hannah Echols

The REasons for Geographic and Racial Differences in Stroke study at the University of Alabama at Birmingham is a cornerstone in cardiovascular and dementia research and has been awarded $40 million in funding for another five years by the National Institutes of Health. The UAB School of Public Health REGARDS study will continue its groundbreaking work to understand why Southern Americans and Black Americans have higher rates of stroke and related brain health issues.

Sponsored through a partnership between the National Institute of Neurologic Diseases and Stroke and the National Institute on Aging, REGARDS will continue following the 8,000 current participants and recruit a new cohort of 12,000 individuals ages 45-65 to explore the generational differenced in midlife health risks.

The study is led by Suzanne Judd, Ph.D., professor in the Department of Health Behavior; George Howard, DrPH, distinguished professor in the Department of Biostatistics; and Virginia Howard, Ph.D., distinguished professor from the Department of Epidemiology; all in the UAB School of Public Health, along with Jennifer Manly, Ph.D., from Columbia University and Mary Cushman, M.D., from the University of Vermont.

"For the first time in history, American life expectancy is decreasing," Judd said. "The additional funding allows us to understand how secular trends in society like the rise in obesity, migration away from rural areas and a major pandemic have changed health trajectories in those born in Generation X compared with those in their parents' generations. Beyond the research questions, the funding allows participants to continue engaging with this study they have known for more than two decades and provides funding for over 50 dedicated staff and students making this research a success."

Since its beginning, REGARDS has amassed more than $110 million in funding, conducted 46,000 home visits, retrieved 80,000 medical records and published 815 papers. The study that enrolled 30,239 Black and white participants between 2003-2007 has maintained a 97 percent annual retention rate over two decades, aiming to understand why Southern Americans and Black Americans have higher rates of stroke and related brain health issues. These data have underpinned a publication record that has provided substantial advances in the understanding of the differences in stroke risk and cognitive decline.

Additionally, REGARDS pioneered in-home visits to collect data on major stroke risk factors and developed a validated method for collecting cognitive function data over the telephone, which enabled data collection even during the COVID-19 pandemic. The methods used in REGARDS have been adopted by many other NIH projects, including the Sister Study, ARCADIA and RECOVER.

This approach has enabled broad participation, particularly from individuals in rural communities, lower income brackets and those without high school diplomas, providing greater equity in studying marginalized populations.

Beyond their commitment to original research and advancing data collection methods, REGARDS researchers have supported the development of ancillary studies with 148 funded, enriching scientific pursuits across the United States. Of note, REGARDS has contributed to the careers of many faculty beyond those on the investigative team who have published articles using REGARDS data.

"Examining stroke and dementia risk factors in those born in Generation X who have had very different life experiences than those in the baby boomer generation could offer real insights into healthy aging across generations," Howard said. "We are truly excited to look at how various societal changes have influenced the health of generations."

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