Opportunity Information: Apply for RFA NS 20 013
The grant opportunity "White Matter Lesion Etiology of Dementia in the U.S. Including in Health Disparity Populations (U19 Clinical Trial not Allowed)" (RFA-NS-20-013) is a National Institutes of Health cooperative agreement designed to fund a single large, prospective clinical research study in the United States focused on vascular contributions to cognitive impairment and dementia (VCID). The central problem it targets is that, while white matter lesions are well known to be associated with cognitive decline and dementia, researchers still do not know which features of these lesions actually drive impairment in a way that is necessary and sufficient. In practical terms, the initiative is meant to move beyond broad correlations and pinpoint the lesion volumes, anatomical locations, and cellular or molecular characteristics that most strongly and reliably predict cognitive impairment and progression to dementia.
A defining feature of the program is its emphasis on prospective, longitudinal observation in people who already have white matter lesions and are therefore at elevated risk for cognitive decline. The study is expected to map how lesion burden and lesion location relate to cognition over time, and to determine whether there are thresholds or specific brain regions where white matter damage becomes especially consequential. The language "necessary and sufficient" signals that the study should be designed to test whether certain lesion patterns are consistently present when dementia develops (necessary) and whether those patterns, on their own or in combination with a defined set of factors, can account for dementia risk (sufficient). This pushes applicants to build rigorous imaging, clinical, and analytic approaches that can distinguish mere associations from more causal or causal-like relationships.
Health disparities are not treated as an optional add-on. The study is explicitly expected to include populations experiencing health disparities and to evaluate whether the white matter lesion to cognition relationship differs across groups due to differences in exposures, comorbidities, access to care, or structural and social determinants of health. In addition, the initiative calls for careful examination of clinical factors and comorbidities that could modify the impact of white matter lesions, including factors that might be protective. That means the project should not only document vascular and metabolic risks, but also test how these risks interact with lesion characteristics to accelerate, slow, or otherwise alter cognitive trajectories.
Another major requirement is the use and advancement of "clinical trial-ready" VCID biomarkers. Rather than purely exploratory measures, the program encourages biomarkers that could realistically be deployed in future interventional trials, such as standardized neuroimaging markers, blood-based measures, or other validated indicators relevant to vascular brain injury and dementia. Applicants are encouraged to use these biomarkers as-is, to refine them further, and/or to conduct implementation research that addresses how to apply them reliably across sites and populations. This reflects a translational goal: producing measures and evidence that can directly inform the design of later prevention or treatment trials.
While the funded work itself cannot be a clinical trial, the grant is oriented toward preparing the field for trials by identifying actionable targets. Secondary goals include uncovering clinical and mechanistic targets for future VCID interventions, and clarifying how white matter lesions relate to both cerebrovascular and cardiovascular disease over time. The initiative also emphasizes understanding relationships with vascular risk factors and dementia-relevant genes, suggesting that genetic susceptibility and vascular injury should be analyzed together where feasible. The expected outcome is a clearer model of how vascular pathology, systemic vascular risk, genetics, and brain imaging findings jointly influence cognitive impairment and dementia progression.
The opportunity also encourages leveraging existing national research infrastructure to increase rigor and efficiency. Applicants are invited to make scientifically justified use of established VCID and stroke resources such as MarkVCID and StrokeNet, as well as Alzheimer’s Centers and large NIH-funded cohort studies like Framingham, ARIC, CHS, and NOMAS. The intent is to build on proven recruitment networks, standardized protocols, and existing datasets or biospecimen pipelines when that strengthens the study. This can help with enrolling diverse participants, harmonizing measurements across sites, and ensuring that findings are comparable with other major efforts in dementia and vascular brain health.
From an administrative and funding standpoint, this is a discretionary NIH cooperative agreement (U19), meaning the NIH expects substantial programmatic involvement and coordination rather than a fully investigator-driven grant with minimal oversight. The program anticipated a single award, with a very high ceiling (up to $35,000,000), reflecting the scale of the prospective study envisioned. Eligibility is broad and includes government entities, public and private universities, tribal governments and organizations, nonprofits (both 501(c)(3) and non-501(c)(3)), and for-profit organizations (other than small businesses as well as small businesses), among others as clarified in the full announcement. The sponsoring agency is the U.S. Department of Health and Human Services through the NIH, with CFDA listings 93.853 and 93.866, aligning with neurological disorders and stroke-related research missions.
Overall, the initiative is structured to deliver a definitive, clinically meaningful understanding of which white matter lesion features matter most for dementia risk, how those effects vary across populations including groups facing health disparities, and which biomarkers and mechanistic pathways are most ready to be carried forward into future VCID interventional trials. The intended deliverables are not just publications, but a stronger evidentiary and methodological foundation for prevention and treatment strategies that address vascular contributions to dementia in real-world U.S. populations.Apply for RFA NS 20 013
- The Department of Health and Human Services, National Institutes of Health in the health sector is offering a public funding opportunity titled "White Matter Lesion Etiology of Dementia in the U.S. Including in Health Disparity Populations (U19 Clinical Trial not Allowed)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.853, 93.866.
- This funding opportunity was created on Dec 30, 2019.
- Applicants must submit their applications by Mar 31, 2020. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $35,000,000.00 in funding.
- The number of recipients for this funding is limited to 1 candidate(s).
- 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 (see text field entitled Additional Information on Eligibility for clarification).
[Watch] Creating a grant proposal using the step-by-step wizard inside the applicant portal:
Frequently Asked Questions (FAQs)
What is the official title and number of this grant opportunity?
The opportunity is titled "White Matter Lesion Etiology of Dementia in the U.S. Including in Health Disparity Populations (U19 Clinical Trial not Allowed)" and is identified as RFA-NS-20-013.
What type of NIH funding mechanism is this?
This is an NIH cooperative agreement (U19). A cooperative agreement typically involves substantial NIH programmatic involvement and coordination, rather than a fully investigator-driven project with minimal federal oversight.
Is this opportunity intended to fund one project or multiple projects?
It is designed to fund a single large, prospective clinical research study in the United States.
Are clinical trials allowed under this grant?
No. The funded work itself cannot be a clinical trial ("Clinical Trial not Allowed"). The program is oriented toward preparing the field for future trials by identifying actionable targets and trial-ready biomarkers.
What scientific problem is this initiative trying to solve?
The program targets a key gap in the field: white matter lesions are known to be associated with cognitive decline and dementia, but it remains unclear which specific lesion features actually drive impairment in a way that is "necessary and sufficient." The initiative aims to move beyond broad correlations to identify the lesion volumes, anatomical locations, and cellular or molecular characteristics most strongly and reliably linked to cognitive impairment and progression to dementia.
What does the grant mean by identifying lesion features that are "necessary and sufficient" for dementia risk?
The "necessary and sufficient" framing signals that the study should be designed to test whether particular lesion patterns are consistently present when dementia develops (necessary) and whether those patterns, on their own or in combination with a defined set of factors, can account for dementia risk (sufficient). This encourages rigorous imaging, clinical, and analytic approaches that can distinguish association from more causal or causal-like relationships.
What study design does the announcement emphasize?
The program emphasizes a prospective, longitudinal observational study in people who already have white matter lesions and are therefore at elevated risk for cognitive decline. The expectation is to follow participants over time and map how lesion burden and lesion location relate to cognitive outcomes.
Who is the intended participant population for the research?
The focus is on individuals who already have white matter lesions and are at elevated risk for cognitive decline. The study is also explicitly expected to include populations experiencing health disparities.
How are health disparities addressed in this opportunity?
Health disparities are a central expectation rather than an optional component. The study is expected to include health disparity populations and evaluate whether the relationship between white matter lesions and cognition differs across groups due to differences in exposures, comorbidities, access to care, or structural and social determinants of health.
What specific lesion characteristics is the study expected to examine?
The initiative calls for identifying which lesion volumes, anatomical locations (including potentially specific brain regions), and cellular or molecular characteristics best predict cognitive impairment and progression to dementia. It also expects investigation of whether there are thresholds of lesion burden where cognitive consequences become especially significant.
What role do comorbidities and clinical factors play in the proposed research?
The study is expected to examine clinical factors and comorbidities that may modify the impact of white matter lesions, including factors that might be protective. This includes documenting and testing how vascular and metabolic risks interact with lesion characteristics to change cognitive trajectories over time.
What are "clinical trial-ready" VCID biomarkers in the context of this program?
These are biomarkers that could realistically be deployed in future interventional trials, rather than being purely exploratory. The announcement points to possibilities such as standardized neuroimaging markers, blood-based measures, or other validated indicators relevant to vascular brain injury and dementia.
Does the opportunity allow biomarker development or implementation research?
Yes. Applicants are encouraged to use trial-ready biomarkers as-is, refine them further, and/or conduct implementation research aimed at applying them reliably across sites and populations.
How does this study connect to future prevention or treatment trials if clinical trials are not allowed?
The translational aim is to identify actionable targets and produce evidence and measures that can directly inform the design of later prevention or treatment trials in VCID. Secondary goals include uncovering clinical and mechanistic targets for future interventions.
What disease area and scientific theme does this opportunity focus on?
The initiative focuses on vascular contributions to cognitive impairment and dementia (VCID), with an emphasis on white matter lesions and how they relate to cognitive decline and progression to dementia.
Does the program address relationships to cardiovascular and cerebrovascular disease?
Yes. One of the secondary goals is to clarify how white matter lesions relate to both cerebrovascular and cardiovascular disease over time.
Is genetics expected to be part of the research?
The announcement emphasizes understanding relationships with vascular risk factors and dementia-relevant genes, indicating that genetic susceptibility and vascular injury should be analyzed together where feasible.
Are applicants encouraged to use existing NIH or national research infrastructure?
Yes. The opportunity encourages leveraging existing national research infrastructure to improve rigor and efficiency. Examples mentioned include MarkVCID and StrokeNet, as well as Alzheimer’s Centers and large NIH-funded cohort studies such as Framingham, ARIC, CHS, and NOMAS, when scientifically justified.
Why does the announcement encourage using resources like MarkVCID, StrokeNet, Alzheimer’s Centers, or large cohort studies?
The intent is to build on proven recruitment networks, standardized protocols, and existing datasets or biospecimen pipelines when that strengthens the study. This can support enrollment of diverse participants, harmonize measurements across sites, and improve comparability with other major efforts in dementia and vascular brain health.
What deliverables or outcomes does NIH appear to be seeking?
The expected outcome is a clinically meaningful, more definitive understanding of which white matter lesion features matter most for dementia risk, how effects vary across populations (including health disparity groups), and which biomarkers and mechanistic pathways are most ready to carry forward into future VCID trials. The emphasis is on building a stronger evidentiary and methodological foundation, not just publishing results.
What is the anticipated funding scale for this opportunity?
The program anticipated a single award with a very high ceiling of up to $35,000,000, reflecting the scale of the prospective study envisioned.
Who is the sponsoring agency?
The sponsoring agency is the U.S. Department of Health and Human Services through the National Institutes of Health (NIH).
What CFDA listings are associated with this opportunity?
The opportunity lists CFDA 93.853 and 93.866, aligning with neurological disorders and stroke-related research missions.
What kinds of organizations are eligible to apply?
Eligibility is described as broad and includes government entities, public and private universities, tribal governments and organizations, nonprofits (both 501(c)(3) and non-501(c)(3)), and for-profit organizations (including small businesses and other-than-small businesses), as further clarified in the full announcement.
Is this research limited to the United States?
Yes. The opportunity is designed to fund a large, prospective clinical research study in the United States.
Browse more opportunities from the same category: Health
Next opportunity: 20.PMWRA.Angola.HMA.NOFO
Previous opportunity: Health Promotion and Disease Prevention Research Centers: 2020 Special Interest Project Competitive Supplements (SIPS)
Applicant Portal:
Are you interested in learning about about how to apply for this government funding opportunity? You can create a free applicant account and receive instant access to our applicant portal that many business owners like you have benefited from.
Apply for RFA NS 20 013
Applicants also applied for:
Applicants who have applied for this opportunity (RFA NS 20 013) also looked into and applied for these:
| Funding Opportunity |
|---|
| PEPFAR Small Grants Program 2020-2021 Apply for DOS MSU PEPFARSGP FY20 Funding Number: DOS MSU PEPFARSGP FY20 Agency: Department of State, U. S. Mission to Lesotho Category: Health Funding Amount: $25,000 |
| Scholarships for Disadvantaged Students Apply for HRSA 20 006 Funding Number: HRSA 20 006 Agency: Department of Health and Human Services, Health Resources and Services Administration Category: Health Funding Amount: $650,000 |
| Ryan White HIV/AIDS Program Part F Dental Reimbursement Program Apply for HRSA 20 069 Funding Number: HRSA 20 069 Agency: Department of Health and Human Services, Health Resources and Services Administration Category: Health Funding Amount: Case Dependent |
| U4D Maternal and Child Health (MCH) Pregnancy-Related Care Research Network (PRC-RN) Program Apply for HRSA 20 058 Funding Number: HRSA 20 058 Agency: Department of Health and Human Services, Health Resources and Services Administration Category: Health Funding Amount: $300,000 |
| Technical Assistance for Accelerating the Coverage and Quality of Effective HIV Prevention, Treatment and Care Activities Among Key Populations and People Living with HIV in Thailand under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2006 Funding Number: CDC RFA GH20 2006 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Support to the Government of Botswana to Ensure Quality HIV-Related Strategic Information Services under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2007 Funding Number: CDC RFA GH20 2007 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Strategic Prevention Framework – Partnerships for Success Apply for SP 20 002 Funding Number: SP 20 002 Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Adminis Category: Health Funding Amount: $1,000,000 |
| Supporting the Provision of Quality Cervical Cancer Screening and Pre-Cancer Treatment Services for Women Living with HIV in Botswana under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2009 Funding Number: CDC RFA GH20 2009 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Strengthening National Epidemiologic and Research Capacity to Track the HIV/TB Epidemic and Improve Health Outcomes in the Kingdom of Eswatini under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2025 Funding Number: CDC RFA GH20 2025 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Support for the Republican AIDS Center of the Republic of Tajikistan to Maintain and Promote High-Quality HIV Services to Achieve Epidemic Control under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2014 Funding Number: CDC RFA GH20 2014 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Planning and Developing Infrastructure to Promote the Mental Health of Children, Youth and Families in American Indian/Alaska Natives (AI/AN) Communities Apply for SM 20 010 Funding Number: SM 20 010 Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Adminis Category: Health Funding Amount: $5,492,314 |
| Suicide Prevention Resource Center Apply for SM 20 011 Funding Number: SM 20 011 Agency: Department of Health and Human Services, Substance Abuse and Mental Health Services Adminis Category: Health Funding Amount: $7,586,977 |
| Support Government of the Kingdom of Eswatini (GKoE) to Provide Comprehensive, Quality Assured Care, Treatment and Prevention HIV/TB Services to Achieve and Sustain Epidemic Control under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2027 Funding Number: CDC RFA GH20 2027 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Strengthening the Delivery of Quality HIV/TB Laboratory Services at all Levels Including Quality Management Systems, Equipment, and Laboratory Network Optimization for Efficient Patient Management in the Kingdom of Eswatini under PEPFAR Apply for CDC RFA GH20 2026 Funding Number: CDC RFA GH20 2026 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Coordination and Strengthening of the Kingdom of Eswatini Ministry of Health's HIV and TB Programs under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2028 Funding Number: CDC RFA GH20 2028 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Service Area Competition Apply for HRSA 20 100 Funding Number: HRSA 20 100 Agency: Department of Health and Human Services, Health Resources and Services Administration Category: Health Funding Amount: Case Dependent |
| Strengthening of the Kingdom of Eswatini's Voluntary Medical Male Circumcision (VMMC) Program under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2029 Funding Number: CDC RFA GH20 2029 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Expanding Access to Quality Laboratory Service (EQUALS) in the Kingdom of Lesotho under the President's Emergency Plan for AIDS Relief (PEPFAR) Apply for CDC RFA GH20 2044 Funding Number: CDC RFA GH20 2044 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Enhancing the Government of India's Capacity through Technical Assistance to India's National AIDS Control Organization (NACO) to Strengthen the Prevention to Treatment Cascade for People Living with HIV, Including Key Populations, under PE Apply for CDC RFA GH20 2038 Funding Number: CDC RFA GH20 2038 Agency: Department of Health and Human Services, Centers for Disease Control - CGH Category: Health Funding Amount: Case Dependent |
| Pilot Centers for Precision Disease Modeling (U54)(Clinical Trials Not Allowed) Apply for PAR 20 085 Funding Number: PAR 20 085 Agency: Department of Health and Human Services, National Institutes of Health Category: Health Funding Amount: $1,250,000 |
Grant application guides and resources
It is always free to apply for government grants. However the process may be very complex depending on the funding opportunity you are applying for. Let us help you!
Apply for Grants
Inside Our Applicants Portal
Access Applicants Portal
- Grants Repository - Access current and historic funding opportunities with ease. Thousands of funding opportunities are published every week. We can help you sort through the database and find the eligible ones to apply for.
- Applicant Video Guides - The grant application process can be challenging to follow. We can help you with intuitive video guides to speed up the process and eliminate errors in submissions.
- Grant Proposal Wizard - We have developed a network of private funding organizations and investors across the United States. We can reach out and submit your proposal to these contacts to maximize your chances of getting the funding you need.
Premium leads for funding administrators, grant writers, and loan issuers
Thousands of people visit our website for their funding needs every day. When a user creates a grant proposal and files for submission, we pass the information on to funding administrators, grant writers, and government loan issuers.
If you manage government grant programs, provide grant writing services, or issue personal or government loans, we can help you reach your audience.
Learn More
Request more information:
Would you like to learn more about this funding opportunity, similar opportunities to "RFA NS 20 013", eligibility, application service, and/or application tips? Submit an inquiry below:
Don't forget to subscribe to our grant alerts mailing list to receive weekly alerts on new and updated grant funding opportunities like this one in your email.