Claude D. Pepper Older Americans Independence Center

Principal Investigator    Kenneth Schmader, M.D.  919-660-7500  kenneth.schmader@duke.edu
Principal Investigator (MPI)    Miriam Morey  919-286-0411 x 176776  miriam.morey@duke.edu
Program Administrator    Emily Herbert  919-660-7502  emily.herbert@duke.edu

The overall goal of the Duke Claude D. Pepper Older Americans Independence Center (Duke OAIC) is to support research and training that improves the independence of older Americans. Our primary focus: To understand and optimize reserve and resilience. Our approach is founded on the insight that independence in older adults is related to an individuals ability to withstand or recover from functional decline following acute or chronic health stressors. Our overall strategy for the OAIC is to serve as a sustained resource to our investigators through a broad range of training and research studies; the goal will be to address knowledge gaps in our focus with an emphasis on translational and interdisciplinary research. We recruit and develop early stage investigators in aging research related to our focus and utilize the substantial strengths of the Duke academic and health system environment to advance our focus.

The Duke Pepper Center has been at the forefront of geriatric research and training focused on the development of interventions to improve the functional status of older adults and the support of research that identifies risk factors predictive of functional decline. The Duke Pepper Center originally began its funding as a Geriatric Research and Training Center (GRTC) in 1991. The GRTC was originally funded with three research cores and support for junior faculty and pilot projects, which reflects the organization of the current OAIC structure. One year later, Duke was awarded a Pepper Center and, at the direction of the National Institute on Aging, the two programs were combined into one. Initial Pepper Center support focused on the development of promising interventions to promote the independence of older Americans and faculty development. Since then, the Duke OAIC has produced an impressive portfolio of relevant research and innovations in faculty development.

The specific goals of the Duke Pepper Center are:

  1. To better understand and optimize reserve and resilience in older adults through an integrated research program.
  2. To develop and evaluate new methods that advance the study of reserve and resilience.
  3. To support pilot studies through the PESC that acquire information needed to select or design, more definitive research studies related to the Duke OAIC focus.
  4. To identify and develop the next generation of researchers who will become leaders in aging and geriatrics research related to the Duke OAIC focus.

Leadership and Administrative Core (LAC)
Leader 1:    Kenneth Schmader, MD   kenneth.schmader@dm.duke.edu
Leader 2:    Miriam C. Morey, PhD   miriam.morey@dm.duke.edu
The Leadership and Administrative Core (LAC) provides the scientific leadership and administrative infrastructure to create a robust environment for aging and geriatrics research in our theme. The Leadership and Administrative Core promotes the development of early investigators with interests in aging and geriatrics research and ensures the coordination, integration, funding, and translation of research within the Duke OAIC, a mission that supports our ultimate goal of improving the independence of older adults. The specific aims of the Leadership and Administrative Core are to: 1) To provide overall coordination, integration, and administration of the Duke OAIC. 2) To stimulate, assist, monitor and evaluate the progress of the OAIC towards achieving the research and education goals of the Duke OAIC. 3) To assess scientific opportunities for innovative research in our theme with an emphasis on translational and interdisciplinary research. 4) To utilize and develop resources effectively to meet the goals of the Duke Pepper OAIC.

Research Education Component (REC)
Leader 1:    Cathleen Colon-Emeric, M.D.   colon001@mc.duke.edu
Leader 2:    Kimberly Johnson, M.D.   kimberly.s.johnson@duke.edu
The objective of the Research Education Component is to develop the next generation of researchers who will become leaders in integrating basic science and clinical insights into innovative interventions promoting reserve and resilience in late life. Guided by educators in the Aging Center with nationally recognized expertise in curriculum development and evaluation, the REC measures the impact of OAIC programs on Scholars' career progression using innovative evaluation methods such as nominal group sessions. We have established a close partnership with the Duke Clinical Translational Science Award Center (CTSA) KL2 program to enhance scholar recruitment and to share curriculum and resources; the Duke OAIC REC and CTSA share the same co-leader and project director to facilitate interactions. The School of Medicine offers excellent professional development programs, research leadership training, and grant-writing education and support services that are utilized by our scholars. The specific aims of the Research Education Component are to: 1. Coordinate delivery of aging research curriculum to early investigators across the University. 2. Provide a structure for individualized aging and research mentorship at Duke. 3. Evaluate the effectiveness of aging research across the Duke OAIC.

Pilot and Exploratory Studies Core (PESC)
Leader 1:    Heather E. Whitson, MD   heather.whitson@duke.edu
Leader 2:    William Kraus, MD   william.kraus@duke.edu
The Pilot/Exploratory Studies Core emphasizes physiological reserve at the cell/tissue/organ level, which we hypothesize is a key contributor to resilience at the whole person level. The PESC impacts public health by performing studies that develop knowledge to maintain or recover independence in older Americans, by promoting reserve and resilience in the face of chronic and acute stressors. We use small exploratory pilot monies as a rapid response mechanism to take advantage of cutting edge areas. The PESC solicits and selects high quality pilot studies from across Duke University Medical Center using a rigorous, multi-stage process that incorporates internal and external review. The PESC carefully monitors study progress and assists in the development of larger grant proposals from pilot study findings. The Duke PESC includes several highly innovative features: 1) the Pilot Grants Workshop, developed by OAIC Director Kenneth Schmader and frequently requested in national venues, 2) the inclusion of patient/community representatives on the Review Panel that selects pilots, 3) the Data Integration Working Group, which is a central hub for scientific development, oversight, and translation, and 4) mechanisms that support the science and careers of unfunded pilot study applicants. The specific aims of the Pilot/ Exploratory Studies Core are to: 1. Advance top quality science related to late-life reserve and resilience. 2. Attract and nurture a diverse cadre of outstanding early investigators in aging research or established investigators pursuing promising new directions related to our theme. 3. Build and sustain relationships with critical stakeholders to maximize the impact and translation of the work conducted through this and future OAICs.

Leader 1:    Carl F. Pieper, DPH   carl.pieper@dm.duke.edu
Leader 2:    Jane F. Pendergast, Ph.D.   jane.pendergast@duke.edu
The Analysis Core provides specialized expertise in the design, collection, and management of data, and in analytic methodologies. The Analysis Core promotes novel lines of research by developing new methods specifically targeted to detect and measure reserve and resilience. Finally, the Analysis Core supports training objectives by developing fellow and faculty understanding of biostatistics and research methodology—critical areas of the research enterprise that are typically a knowledge gap in basic, translational, and clinical researchers. The Analysis Core works closely with other components of the Duke OIAC to achieve shared goals. The Analysis Core collaborates with the two Resource Cores (Molecular Measures Core and Physical Measures Core) to manage data and perform analyses. The Analysis Core collaborates with OAIC investigators to direct study design and analysis, to insure studies are properly powered and address targeted research questions. Furthermore, the Analysis Core is uniquely positioned to expand studies to evaluate additional or emerging hypotheses, including those that support methodologic investigations in statistical science, a unique goal of this Core. The specific aims of the Analysis Core are to: 1) Provide data management and analytic support to funded and proposed projects, pilots, and junior faculty and OAIC investigations to enable research and to address hypotheses within our theme. 2) Develop and disseminate analytic methodologies in biostatistics to advance the study of resilience and reserve. 3) Provide training and mentoring to the fellows and faculty in the Duke OAIC.

Molecular Measures Core
Leader 1:    Virginia B. Kraus, MD, PhD   vbk@duke.edu
Leader 2:    James Bain, PhD   james.bain@duke.edu
Molecular profiling can uniquely discover biomarkers, and predict and monitor traits and processes to understand and optimize reserve and resilience. The goal of the Molecular Measures Core is to promote an understanding of the means to optimize whole person reserve and resilience through analyses of molecular factors indicative of cellular and tissue level ability to withstand and recover from stressors. The Molecular Measures Core complements the whole person level analyses offered through the Physical Measures Core and is inter-dependent with the Analysis Core, which is responsible for statistical analysis and modeling of data generated by the Physical Measures Core and Molecular Measures Core. The Molecular Measures Core has extensive molecular profiling capabilities, including, among others: inflammatory, metabolic, tissue matrix, genetic and genomic analyses. The Molecular Measures Core has capabilities to expand and adapt existing core capabilities to facilitate the many needs of the novel investigator-initiated research projects affiliated with our Duke OAIC. The specific aims of the Molecular Measures Core are to: 1) Perform molecular analyses to support and assist research projects of the Duke OAIC. 2) Develop new molecular profiling and testing capabilities to evaluate cellular, tissue, and organ resiliencies. 3) Perform systems pathway analyses to identify biological pathways indicative of resilient phenotypes. 4) Serve as a resource for research-oriented advice and training on principles and methods of molecular analyses.

Physical Measures
Leader 1:    Miriam C. Morey, PhD   miriam.morey@dm.duke.edu
Leader 2:    Katherine Hall, Ph.D.   katherine.hall@duke.edu
The Physical Measures Core serves as the central resource for Center investigators seeking advice, training, laboratory access, and equipment for valid, sensitive, and reliable physical/ no biological measures. A panel of 13 members, with complementary expertise in measurement across multiple domains, comprises the Core and provides highly integrated, customized support to investigators supported by our Research Education Component, Pilot/Exploratory Studies Core, Externally Funded Projects, and the larger Duke Community engaged by the Duke OAIC. The PMC supports investigators by meeting regularly throughout the full spectrum of project development, from early phase planning, to final interpretation of findings, to subsequent grant preparations, to dissemination and/or implementation. These meetings concurrently involve members of the Analysis and Molecular Measures Cores to assure maximal synergy. The specific aims of the Physical Measures Core are to: 1) Provide centralized expertise available for consultation on the measurement of reserve and resilience. 2) Develop measurement protocols and train personnel in administration and data collection. 3) Identify gaps in resiliency measures and develop or adapt innovative new measurement approaches across the adult lifespan for related outcomes.

REC Scholar, Research & Grants Funded During Pepper Supported Time Years Publications
Brian James Andonian, MD MHSc
Assistant Professor of Medicine / Department of Medicine, Division of Rheumatology and Immunology
Accelerated metabolic aging in rheumatoid arthritis immune cells and skeletal muscle: A pilot study
Rheumatoid arthritis (RA) is a model disease for studying premature aging. Persons with RA suffer from early aging-associated metabolic comorbidities, and are at risk for low resilience, a decreased ability to resist functional decline. Mitochondrial function in RA and aging is a marker of cellular reserve, and is thus important for preserving resilience. RA and aged immune cells have abnormal mitochondrial function, which coincide with immune dysregulation. Skeletal muscle in both RA and aging is also marked by altered mitochondria. The pilot study will investigate whether dysfunction of mitochondria, the cellular metabolic “engine,” connects RA peripheral helper T-cells, macrophages and skeletal muscle abnormlities. Objectives are twofold: 1) to determine whether RA T cell, macrophage and skeletal muscle mitochondrial function abnormalities are associated, and 2) to determine associations of exercise training on RA immune cell and skeletal muscle mitochondria.
  • 1R03-AG067949-02 (Andonian PI): Accelerated Metabolic Aging in Rheumatoid Arthritis Immune cells and Skeletal Muscle: A Pilot Study
  • 5R21-AR076663-02 (Andonian Co-I): Weight loss and exercise to improve rheumatoid arthritis cardiovascular risk

2020-2022  4 (3 1st/Sr)
Ming-Feng Hsueh, PhD
Medical Instructor / Department of Orthopaedic Surgery
Harness human cartilage repair capability to prevent and reverse osteoarthritis
Humans have a natural cartilage repair response which is high in the ankle, intermediate in the knee and low in hip cartilages. This repair response in humans is highly associated with the microRNAs used by salamanders and other limb regenerating animals to regenerate whole limbs. This project will evaluate the ability of microRNAs as a therapy to improve cartilage resilience to injury in vitro, and build the foundation for further evaluation in animals for microRNAs’ ability to prevent and reverse the most prevalent of age-related diseases, osteoarthritis, for which we currently have no disease-modifying treatments.
  • Zimmer Biomet Company (Hsueh Post-Doctoral Associate) Development of an Early Osteoarthritis Diagnostic Panel via a Proteomic Approach

2020-2022  0 (0 1st/Sr)
Daniel Parker, MD
Assistant Professor of Medicine / Department of Medicine
Identification of biomarkers of cognitive resilience
Cognitive resilience is defined as preserved cognitive function in the setting of “stressors” that adversely affect cognitive function; it may explain – in part – the heterogeneity of cognitive function in older adults who otherwise appear clinically similar, especially with respect to risk factors for Alzheimer’s disease and related dementias (ADRD). Blood-based biomarkers of cognitive resilience would be useful to identify protective factors and test resilience-building interventions that preserve cognitive function in the setting of these stressors; currently, no such biomarkers exist. Building on previous work, I propose to develop a measure of cognitive resilience in a subset of community-dwelling older adults from the Duke Performance Across the LifeSpan (PALS; N=297) study with repeat cognitive testing over 3 years. Using this measure, I will identify biomarkers reflecting dysregulation in “Hallmarks of Aging” pathways that are predictive of cognitive resilience.
  • 5R03-AG067897-02 (Parker PI): Healthy Skeletal Muscle, Healthy Brain: Are Kynurenine Metabolites the Link?
  • 5UH3-AG056925-04 (Parker Co-I): Physical Resiliencies: Indicators and Mechanisms in the Elderly Collaborative
  • 1R01-HL153497-01A1 (Parker Co-I): Skeletal Muscle Molecular Drug Targets for Exercise-induced Cardiometabolic Health
  • 1R01-AG070146-01 (Parker Co-I): Extracellular Vesicle Analyses to Develop Aging and Resilience Biomarkers
  • 1R33-AG070455-01 (Parker Co-I): Enhancing the CALERIE Network to advance Aging Biology
  • 7R01-HL135009-04 (Parker Scientist): A Longitudinal Epigenetic Study of Atherosclerosis

2020-2022  4 (3 1st/Sr)

Past Scholars
Corey Simon, Orthopaedic Surgery (2018-2020)
Nazema Siddiqui, MD, MHS, Obstetrics and Gynecology (2018-2020)
Anthony Sung, MD, Senior Fellow in the Duke Center for the Study of Aging and Human Development, Center for the Study of Aging and Human Development, Institutes and Centers (2018-2020)

1. Project Title: ApoE: A new target to improve aged bone healing
  Leader: Gurpreet Baht, PhD

    1. Aim 1: Develop a therapeutic intervention to improve aged bone fracture healing. In our recent study, we showed that lowered circulating ApoE levels in knockout mice were associated with improved aged fracture repair. To test whether temporarily lowering circulating ApoE levels during fracture healing will improve fracture outcome, we will perform fracture studies with small molecule reverse agonists to a nuclear receptor that controls ApoE expression.
    2. Aim 2: Identify the immunophenotypic differences in the fracture calluses of aged mice treated with inhibitors of ApoE expression. We hypothesize that ApoE-based age-associated changes in fracture repair are due to changes in the immunophenotype of the fracture callus.
    2. Project Title: Resilience after heart transplant or LVAD in patients with advanced heart failure
      Leader: Adam DeVore, MD MHS

      1. Aim 1: Determine the feasibility of a comprehensive assessment to predict resilience and to describe normative values in patients with advanced heart failure. We will enroll approximately 50 patients undergoing evaluation for heart transplant or LVAD at Duke. We will collect information on the completion rate of each assessment during the study protocol and collect qualitative data from the study teams on feasibility and study burden.
      2. Aim 2: Describe at what time point after surgery patients with advanced heart failure recover using assessments of physical, cognitive and psychosocial health.
      3. Project Title: Mechanisms underlying variation in primate physiological reserve
        Leader: Elaine Gomez Guevara, PhD
      1. Aim 1: Measure oxidative stress and telomere dynamics across the lifespan in species of Lemur (fast maturation, shorter lifespan than Propithecus, while sympatric) and Propithecus (extreme longevity for body size in nature, very slow development, low rate of actuarial senescence, evidence for enhanced somatic maintenance). Lemur catta, the ring-tailed lemur, and Propithecus coquereli, Coquerel’s sifaka, will be monitored at the Duke Lemur Center.
      2. Aim 2: Validate inflammatory biomarkers as age-related markers in these models.
      4. Project Title: Understanding the role of IL-15 signaling in podocyte resilience and survival
        Leader: Gentzon Hall, MD PhD

        1. Hypothesis: A functioning IL-15/IL-15R axis is essential for homeostatic prosurvival signaling in podocytes, and impaired IL-15 signaling reduces podocyte resiliency to proapototic stimuli, increasing risk of glomerulosclerosis
        2. .Aim 1: To characterize the effects of IL-15/IL-15R knockdown a) on podocyte resiliency and loss in response to proapoptotic stimuli and b) on signaling through three prosurvival transcriptional regulatory pathways.
        3. Aim 2: To characterize the effects of targeted IL-15/IL-15R KD on pronephric integrity and function in DBP-GFP zebrafish.
        DEVELOPMENT PROJECTS (2 Development Projects Listed)
        1. Project Title: Cellular senescence burden as a molecular indicator of resilience
          Leader: Virginia Kraus, MD PHD
          Core(s): Molecular Measures Core (Molecular Measures Core)

        Stress elicits the Senescence Associated Secretory Phenotype (SASP) and the upregulation of lysosomal hydrolases. These cellular senescence responses have recently been discovered to be physiological tissue repair and remodeling responses. The complex systems of tissue repair and remodeling comprise the molecular foundation for resilience. We established the model system and markers in the classic @I38 human fibroblast cell line. These recent exciting insights define a beneficial role in tissue repair for SASP, the increased expression and secretion of a suite of inflammatory cytokines, growth factors, and proteases. When senescence reverts from an acute and transient state, such as in wound healing, to a chronic state with accumulation of senescent cells, the well-known phenomena of aging, including loss of reserve and resilience, are observed. In fact, the SASP is very similar to the inflammatory and coagulation markers associated with frailty and mortality in the elderly. Clearance of senescent cells in mouse models reduces expression of SASP factors in tissue and delays aging. The Specific Aims of this project are: Aim 1) To develop a panel of molecular markers indicative of senescent cell burden based on markers associated with SASP, soluble lysosomal exoglycosidases able to be detected in serum that might be a marker of a senescence process, and microRNAs we identified, through Duke OAIC pilot funding, as associated in elders with high function and longevity; and Aim 2) To evaluate the expression and interdependence of these factors in an in vitro model system followed by analyses of these factors in the CALERIE cohort and in future collaborations with other Duke OAIC projects. We hypothesize that methods that are senomorphic (change senescence) promote resilience.

        2. Project Title: Testing the resilience of the latent class trajectory model when the conditions of the model are not met
          Leader: Carl Pieper, DrPH and Jane Pendergast, PhD
          Core(s): Analysis (Analysis )
          The objective of this project is to examine factors which impact the validity of discovering and defining latent classes of change under two types estimation models: commonly latent class trajectory model and Generalized mixed models. Both models are in wide use in assessing latent classes of trajectories, but make different underlying assumptions about the data structure. Initially, in the analysis of a panel data set, we observed that the 2 model types gave different results. We were surprised by the magnitude of the differences and research implications of these initial findings. In a deeper dive into the causes of the differences we observed, we learned that mis-specification of the error structure of the replicate observations led to incorrect definition of the number of classes contained in the data. The mis-classification occurred even in the presence of small correlations (0.1). These findings have implications for the validity of the findings derived under statistical packages used in the field. We demonstrated this both in simulations, where external factors could be controlled, and in real data. Using simulation, we plan to extend these investigations into other analytic issues commonly observed in longitudinal investigations change.
        RESEARCH (16 Projects Listed)
            VA I01HX002704 / (2019-2023)
          ABSTRACTBackground: Older Veterans with advanced chronic kidney disease (CKD) face complex decisions to initiateor forgo dialysis in the context of uncertainty about their future health and physical function. Making thesedecisions is complicated by the course of advanced CKD which is characterized by frequent health events thatfurther worsen function. Decisions support tools are needed that are sp...
          Leader(s): HALL, KATHERINE SHEPARD
            VA I01RX003120 / (2020-2024)
          Posttraumatic stress disorder (PTSD) is prevalent among military Veterans, and affects over 30% of older, Vietnam-era Veterans. These servicemembers have endured nearly 40 years with these symptoms, and as a result, have significantly poorer health, higher rates of chronic disease and obesity, and an excess mortality rate 3 times higher than the general population. Clearly PTSD is more than just a...
          Leader(s): WHITE, JAMES P.
            NIH K01AG056664 / (2017-2022)
          a. Project summary/abstract:Sarcopenia is the age-related loss in skeletal muscle mass and strength; it leads to a host of co-morbiditiesincluding loss of physical function and overall resilience. One such perturbation in persons with sarcopenia isthe diminished ability to regenerate muscle after injury. Muscle stem cells, referred to as satellite cells, arerequired to activate, proliferate and di...
          Leader(s): PAVON, JULIESSA M
            NIH K23AG058788 / (2019-2024)
          This K23 Career Development Award in Aging focuses on the development of Dr. Juliessa Pavon, a hospital-based geriatrician, and on reducing central nervous system (CNS) medication use in hospitalized older adults.Dr. Pavon s long-term goal is to improve the resilience of older adults against the acute stressors ofhospitalization. She has built her research program on investigating hazards of hospi...
          Leader(s): LEE, RICHARD H.
            NIH K23AG058797 / (2018-2023)
          ABSTRACTAmong its medical complications, type 2 diabetes mellitus in older adults is associated with atwo-fold increase in the risk of hip and other low-trauma bone fractures. Paradoxically, thisincreased risk occurs despite a higher average bone mineral density. This increased fracturerisk is likely multifactorial, stemming from metabolic dysfunction that results in both increasedfalls risk and d...
          Leader(s): BERGER, MILES
            NIH K76AG057022 / (2017-2022)
          This is a K76 Beeson career development award for Dr. Miles Berger, a geriatric neuro-anesthesiologist with a focus on postoperative cognitive disorders. Each year >16 million olderAmericans undergo anesthesia and surgery, and up to 40% of these patients developpostoperative cognitive dysfunction (POCD), a syndrome of postoperative thinking and memorydeficits. Although distinct from delirium, POCD...
          Leader(s): HALL, RASHEEDA K
            NIH K76AG059930 / (2018-2023)
          ABSTRACTThis is a Beeson Emerging Leaders in Aging career development award (K76) for Dr. Rasheeda Hall, MD,MBA, MHS. Dr. Hall is a nephrologist who conducts aging research at Duke University, and her long-term goalis to become a leader in geriatric nephrology and develop effective interventions targeting geriatric conditionsin older dialysis patients. Compared to older adults without kidney disea...
          Leader(s): NEWGARD, CHRISTOPHER B
            NIH P30DK124723 / (2020-2021)
          PROJECT SUMMARY/ABSTRACT METABOLOMICS CORE Comprehensive metabolic analysis, or metabolomics , is a technology that defines the chemical phenotype of living systems. Given that metabolic fluxes and metabolite levels are downstream of genomic, transcriptomic, and proteomic variability, metabolomics provides a highly integrated profile of biological status. As such, it has unique potential for di...
          Leader(s): KRAUS, VIRGINIA
            NIH R01AG054840 / (2018-2023)
          AbstractCirculating small regulatory RNAs (sRNAs) are short non-coding RNAs (typically ~19-25nt in size). They mediatea broad spectrum of biological processes through regulation of gene expression. Our experimental evidenceindicates that serum levels of miRNAs (one form of sRNA) change considerably, the vast majority increasingwith age. The ability of circulating sRNAs to travel among tissues enab...
          Leader(s): BELSKY, DANIEL WALKER
            NIH R01AG061378 / (2019-2024)
          SUMMARYThe graying global population makes interventions to extend healthy lifespan (healthspan) a public heathpriority. Therapies targeting basic biological processes of aging show proof-of-concept in animals: early-to-midlife intervention can delay disease onset and prolong healthspan. But translating these geroprotectivetherapies to humans faces the barrier that human clinical trials of midlife...
            NIH R01AG062502 / (2020-2023)
          Project summary/Abstract The burden of functional limitations (restrictions in basic physical actions) and disability (problems with daily activities and life participation) may be more common in middle-aged US adults than previously recognized. However, studies of middle-age populations have not typically included functional assessments. The Coronary Artery Risk Development in Young Adults (CARDI...
          Leader(s): MCNULTY, AMY L
            NIH R01AR073221 / (2019-2023)
          ABSTRACT.Meniscal injuries are a significant clinical problem as each year 850,000 meniscal surgeries are performed in theUnited States and nearly twice as many worldwide. Meniscal tears in the avascular inner zone of the tissue donot heal well with suturing or conservative treatments and can ultimately lead to the development of osteoarthritis(OA). Therefore, new strategies are needed to enhance ...
          Leader(s): SUNG, ANTHONY; CHAO, NELSON J. ;
            NIH R21AG066388 / (2019-2021)
          Allogeneic hematopoietic stem cell transplant (HCT) has the potential to cure patients with hematologicmalignancies. However, HCT is associated with significant treatment related mortality (TRM) ranging from 20-30%. (1). TRM is particularly high in patients with advanced age (hazard ratio 1.84, age >60 years vs. <20) anddecreased physical function (hazard ratio 2.94, bottom quartile vs. top quarti...
            NIH U01AR071128 / (2016-2022)
          ABSTRACT Exercise is a powerful physiological stimulus contributing to disease prevention and intervention. Theprotective and preventive effects of exercise are well-documented for metabolic, neurodegenerative, andcardiovascular diseases, and certain cancers. While scientists acknowledge the extensive benefits ofexercise, there is still insufficient understanding about the underlying mechanisms by...
            NIH U19AG065188 / (2019-2026)
          There is an urgent need for evidence to guide clinical care of older adults due to demographic shifts, includinglonger life expectancy and a recent doubling of the older adult population. Statins reduce recurrent CVD eventsand prevent initial events in patients younger than 75 years. However, clinical research has often excludedpersons older than 75 years due to a higher prevalence of comorbidity ...
          Leader(s): COLON-EMERIC, CATHLEEN S
            NIH UH3AG056925 / (2017-2022)
          ABSTRACTThe overarching objectives of the PRIME Collaborative (Physical Resilience: Indicators and Mechanisms inthe Elderly) are to characterize specific resilience phenotypes, elucidate biological mechanisms, and validateclinically valuable predictive tools and measures of physical resilience. The application focuses on resilience inthree systems that are central to older adults' overall health: ...
        1. Relationship of physical function with quality of life in older patients with acute heart failure.
          Aladin AI, Whellan D, Mentz RJ, Pastva AM, Nelson MB, Brubaker P, Duncan P, Reeves G, Rosenberg P, Kitzman DW
          J Am Geriatr Soc, 2021 Apr 10
          https://doi.org/10.1111/jgs.17156 | PMID: 33837953
          Citations: | AltScore: 8.7
        2. Parabiosis: Assessing the Effects of Circulating Cells and Factors on the Skeleton.
          Alman B, Baht G
          Methods Mol Biol, 2021, 2230: 105-113
          https://doi.org/10.1007/978-1-0716-1028-2_7 | PMID: 33197011
          Citations: | AltScore: NA
        3. Considering Frailty in SARS-CoV-2 Vaccine Development: How Geriatricians Can Assist.
          Andrew MK, Schmader KE, Rockwood K, Clarke B, McElhaney JE
          Clin Interv Aging, 2021, 16: 731-738
          https://doi.org/10.2147/CIA.S295522 | PMID: 33953551 | PMCID: PMC8088982
          Citations: | AltScore: 15.1
        4. Chronic caloric restriction maintains a youthful phosphoproteome in aged skeletal muscle.
          Bareja A, Draper JA, Katz LH, Lee DE, Grimsrud PA, White JP
          Mech Ageing Dev, 2021 Apr, 195: 111443
          https://doi.org/10.1016/j.mad.2021.111443 | PMID: 33529682 | PMCID: PMC8035222
          Citations: | AltScore: NA
        5. APOE4 Copy Number-Dependent Proteomic Changes in the Cerebrospinal Fluid.
          Berger M, Cooter M, Roesler AS, Chung S, Park J, Modliszewski JL, VanDusen KW, Thompson JW, Moseley A, Devinney MJ, Smani S, Hall A, Cai V, Browndyke JN, Lutz MW, Corcoran DL, and Alzheimer?s Disease Neuroimaging Initiative.
          J Alzheimers Dis, 2021, 79(2): 511-530
          https://doi.org/10.3233/JAD-200747 | PMID: 33337362 | PMCID: PMC7902966
          Citations: | AltScore: 95.326
        6. The association of alcohol use with all-cause and cardiovascular disease-related hospitalizations or death in older, high-risk Veterans.
          Blalock DV, Grubber J, Smith VA, Zulman DM, Weidenbacher HJ, Greene L, Dedert EA, Maciejewski ML
          Alcohol Clin Exp Res, 2021 Apr 12
          https://doi.org/10.1111/acer.14610 | PMID: 33844300
          Citations: | AltScore: NA
        7. Subgroups of High-Risk Veterans Affairs Patients Based on Social Determinants of Health Predict Risk of Future Hospitalization.
          Blalock DV, Maciejewski ML, Zulman DM, Smith VA, Grubber J, Rosland AM, Weidenbacher HJ, Greene L, Zullig LL, Whitson HE, Hastings SN, Hung A
          Med Care, 2021 May 1, 59(5): 410-417
          https://doi.org/10.1097/MLR.0000000000001526 | PMID: 33821830 | PMCID: PMC8034377
          Citations: | AltScore: 6.9
        8. Recombinant Zoster Vaccine Is Efficacious and Safe in Frail Individuals.
          Curran D, Kim JH, Matthews S, Dessart C, Levin MJ, Oostvogels L, Riley ME, Schmader KE, Cunningham AL, McNeil SA, Schuind AE, Andrew MK, Zoster-064 Study Group.
          J Am Geriatr Soc, 2021 Mar, 69(3): 744-752
          https://doi.org/10.1111/jgs.16917 | PMID: 33197294 | PMCID: PMC7984267
          Citations: 2 | AltScore: 18.75
        9. Goldilocks and propofol dosage in older adults: Too much, too little, or just right?
          Devinney MJ, Berger M
          J Am Geriatr Soc, 2021 May 8
          https://doi.org/10.1111/jgs.17221 | PMID: 33964173
          Citations: | AltScore: 7.15
        10. Disparities in the pace of biological aging among midlife adults of the same chronological age have implications for future frailty risk and policy.
          Elliott ML, Caspi A, Houts RM, Ambler A, Broadbent JM, Hancox RJ, Harrington H, Hogan S, Keenan R, Knodt A, Leung JH, Melzer TR, Purdy SC, Ramrakha S, Richmond-Rakerd LS, Righarts A, Sugden K, Thomson WM, Thorne PR, Williams BS, Wilson G, Hariri AR, Poulton R, Moffitt TE
          Nat Aging, 2021 Mar, 1(3): 295-308
          https://doi.org/10.1038/s43587-021-00044-4 | PMID: 33796868 | PMCID: PMC8009092
          Citations: | AltScore: 592.058
        11. Immune cell profiling in the joint following human and murine articular fracture.
          Furman BD, Zeitlin JH, Buchanan MW, Huebner JL, Kraus VB, Yi JS, Adams SB, Olson SA
          Osteoarthritis Cartilage, 2021 Feb 25, 29(6): 915-923
          pii: S1063-4584(21)00621-X. https://doi.org/10.1016/j.joca.2021.02.565 | PMID: 33640582
          Citations: | AltScore: 1
        12. Geriatric conditions and treatment burden following diagnosis of non-muscle- invasive bladder Cancer in older adults: A population-based analysis.
          Garg T, Johns A, Young AJ, Nielsen ME, Tan HJ, McMullen CK, Kirchner HL, Cohen HJ, Murphy TE
          J Geriatr Oncol, 2021 May 7
          pii: S1879-4068(21)00104-1. https://doi.org/10.1016/j.jgo.2021.04.005 | PMID: 33972184
          Citations: | AltScore: 8.45
        13. Predictors of Lumbar Spine Degeneration and Low Back Pain in the Community: The Johnston County Osteoarthritis Project.
          Goode AP, Cleveland RJ, George SZ, Schwartz TA, Kraus VB, Renner JB, Gracely RH, DeFrate LE, Hu D, Jordan JM, Golightly YM
          Arthritis Care Res (Hoboken), 2021 May 10
          https://doi.org/10.1002/acr.24643 | PMID: 33973412
          Citations: | AltScore: 2.85
        14. Synergistic Roles of Macrophages and Neutrophils in Osteoarthritis Progression.
          Hsueh MF, Zhang X, Wellman SS, Bolognesi MP, Kraus VB
          Arthritis Rheumatol, 2021 Jan, 73(1): 89-99
          https://doi.org/10.1002/art.41486 | PMID: 32783329 | PMCID: PMC7876152
          Citations: | AltScore: 2.5
        15. Exercise protects against cardiac and skeletal muscle dysfunction in a mouse model of inflammatory arthritis.
          Huffman KM, Andonian BJ, Abraham DM, Bareja A, Lee DE, Katz LH, Huebner JL, Kraus WE, White JP
          J Appl Physiol (1985), 2021 Jan 7, 130(3): 853-864
          https://doi.org/10.1152/japplphysiol.00576.2020 | PMID: 33411638 | PMCID: PMC7988790
          Citations: | AltScore: 11.008
        16. Fecal microbiota diversity disruption and clinical outcomes after auto-HCT: a multicenter observational study.
          Khan N, Lindner S, Gomes ALC, Devlin SM, Shah GL, Sung AD, Sauter CS, Landau HJ, Dahi PB, Perales MA, Chung DJ, Lesokhin AM, Dai A, Clurman A, Slingerland JB, Slingerland AE, Brereton DG, Giardina PA, Maloy M, Armijo GK, Rondon-Clavo C, Fontana E, Bohannon L, Ramalingam S, Bush AT, Lew MV, Messina JA, Littmann E, Taur Y, Jenq RR, Chao NJ, Giralt S, Markey KA, Pamer EG, van den Brink MRM, Peled JU
          Blood, 2021 Mar 18, 137(11): 1527-1537
          https://doi.org/10.1182/blood.2020006923 | PMID: 33512409 | PMCID: PMC7976512
          Citations: 1 | AltScore: 14.3
        17. Physical Rehabilitation for Older Patients Hospitalized for Heart Failure.
          Kitzman DW, Whellan DJ, Duncan P, Pastva AM, Mentz RJ, Reeves GR, Nelson MB, Chen H, Upadhya B, Reed SD, Espeland MA, Hewston L, O'Connor CM
          N Engl J Med, 2021 May 16
          https://doi.org/10.1056/NEJMoa2026141 | PMID: 33999544
          Citations: | AltScore: 436.806
        18. Temporal Trends and Factors Associated With Cardiac Rehabilitation Participation Among Medicare Beneficiaries With Heart?Failure.
          Pandey A, Keshvani N, Zhong L, Mentz RJ, Pi?a IL, DeVore AD, Yancy C, Kitzman DW, Fonarow GC
          JACC Heart Fail, 2021 May 5
          pii: S2213-1779(21)00106-2. https://doi.org/10.1016/j.jchf.2021.02.006 | PMID: 33992563
          Citations: | AltScore: 19.3
        19. Towards \mobility is medicine\: Socioecological factors and hospital mobility in older adults.
          Pavon JM, Fish LJ, Col?n-Emeric CS, Hall KS, Morey MC, Pastva AM, Hastings SN
          J Am Geriatr Soc, 2021 Mar 23
          https://doi.org/10.1111/jgs.17109 | PMID: 33755991
          Citations: | AltScore: 36.23
        20. Longitudinal Associations of Mental Disorders With Physical Diseases and Mortality Among 2.3 Million New Zealand Citizens.
          Richmond-Rakerd LS, D'Souza S, Milne BJ, Caspi A, Moffitt TE
          JAMA Netw Open, 2021 Jan 4, 4(1): e2033448
          https://doi.org/10.1001/jamanetworkopen.2020.33448 | PMID: 33439264 | PMCID: PMC7807295
          Citations: 1 | AltScore: 279.21
        21. Effects of Amount, Intensity, and Mode of Exercise Training on Insulin Resistance and Type 2 Diabetes Risk in the STRRIDE Randomized Trials.
          Ross LM, Slentz CA, Zidek AM, Huffman KM, Shalaurova I, Otvos JD, Connelly MA, Kraus VB, Bales CW, Houmard JA, Kraus WE
          Front Physiol, 2021, 12: 626142
          https://doi.org/10.3389/fphys.2021.626142 | PMID: 33613319 | PMCID: PMC7892901
          Citations: | AltScore: 5.6
        22. Safety, Reactogenicity, and Health-Related Quality of Life After Trivalent Adjuvanted vs Trivalent High-Dose Inactivated Influenza Vaccines in Older Adults: A Randomized Clinical Trial.
          Schmader KE, Liu CK, Harrington T, Rountree W, Auerbach H, Walter EB, Barnett ED, Schlaudecker EP, Todd CA, Poniewierski M, Staat MA, Wodi P, Broder KR
          JAMA Netw Open, 2021 Jan 4, 4(1): e2031266
          https://doi.org/10.1001/jamanetworkopen.2020.31266 | PMID: 33443580 | PMCID: PMC7809592
          Citations: | AltScore: 81.5
        23. Static and Dynamic Pain Sensitivity in Adults With Persistent Low Back Pain: Comparison to Healthy Controls and Associations With Movement-evoked Pain Versus Traditional Clinical Pain Measures.
          Simon CB, Lentz TA, Ellis L, Bishop MD, Fillingim RB, Riley JL 3rd, George SZ
          Clin J Pain, 2021 Jul 1, 37(7): 494-503
          https://doi.org/10.1097/AJP.0000000000000945 | PMID: 33999558 | PMCID: PMC8194013
          Citations: | AltScore: NA
        24. Physiological Fitness and the Pathophysiology of Chronic Lymphocytic Leukemia (CLL).
          Sitlinger A, Deal MA, Garcia E, Thompson DK, Stewart T, MacDonald GA, Devos N, Corcoran D, Staats JS, Enzor J, Weinhold KJ, Brander DM, Weinberg JB, Bartlett DB
          Cells, 2021 May 11, 10(5):
          pii: 1165. https://doi.org/10.3390/cells10051165 | PMID: 34064804 | PMCID: PMC8151485
          Citations: | AltScore: 3.45
        25. Immunomodulatory lipid mediator profiling of cerebrospinal fluid following surgery in older adults.
          Terrando N, Park JJ, Devinney M, Chan C, Cooter M, Avasarala P, Mathew JP, Quinones QJ, Maddipati KR, Berger M, MADCO-PC Study Team.
          Sci Rep, 2021 Feb 4, 11(1): 3047
          https://doi.org/10.1038/s41598-021-82606-5 | PMID: 33542362 | PMCID: PMC7862598
          Citations: 1 | AltScore: 3.85
        26. Protective Effects of APOE e2 Genotype on Cognition in Older Breast Cancer Survivors: The Thinking and Living With Cancer Study.
          Van Dyk K, Zhou X, Small BJ, Ahn J, Zhai W, Ahles T, Graham D, Jacobsen PB, Jim H, McDonald BC, Nudelman Holohan K, Patel SK, Rebeck GW, Root JC, Saykin AJ, Cohen HJ, Mandelblatt JS, Carroll JE
          JNCI Cancer Spectr, 2021 Apr, 5(2): pkab013
          https://doi.org/10.1093/jncics/pkab013 | PMID: 33748669 | PMCID: PMC7962698
          Citations: | AltScore: NA
        27. Cerebrospinal Fluid Proteome Changes in Older Non-Cardiac Surgical Patients with Postoperative Cognitive Dysfunction.
          VanDusen KW, Li YJ, Cai V, Hall A, Hiles S, Thompson JW, Moseley MA, Cooter M, Acker L, Levy JH, Ghadimi K, Qui?ones QJ, Devinney MJ, Chung S, Terrando N, Moretti EW, Browndyke JN, Mathew JP, Berger M, MADCO-PC Investigators.
          J Alzheimers Dis, 2021, 80(3): 1281-1297
          https://doi.org/10.3233/JAD-201544 | PMID: 33682719 | PMCID: PMC8052629
          Citations: | AltScore: 5
        1. Meteorin-like facilitates skeletal muscle repair through a Stat3/IGF-1 mechanism.
          Baht GS, Bareja A, Lee DE, Rao RR, Huang R, Huebner JL, Bartlett DB, Hart CR, Gibson JR, Lanza IR, Kraus VB, Gregory SG, Spiegelman BM, White JP
          Nat Metab, 2020 Mar, 2(3): 278-289
          https://doi.org/10.1038/s42255-020-0184-y | PMID: 32694780 | PMCID: PMC7504545
          Citations: 8 | AltScore: 20.5
        2. Rejuvenation of Neutrophil Functions in Association With Reduced Diabetes Risk Following Ten Weeks of Low-Volume High Intensity Interval Walking in Older Adults With Prediabetes - A Pilot Study.
          Bartlett DB, Slentz CA, Willis LH, Hoselton A, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Muoio DM, Koves TR, Wu H, Huffman KM, Lord JM, Kraus WE
          Front Immunol, 2020, 11: 729
          https://doi.org/10.3389/fimmu.2020.00729 | PMID: 32431698 | PMCID: PMC7214668
          Citations: 1 | AltScore: 7.95
        3. Of Parachutes, Speedometers, and EEG: What Evidence Do We Need to Use Devices and Monitors?
          Berger M, Mark JB, Kreuzer M
          Anesth Analg, 2020 May, 130(5): 1274-1277
          https://doi.org/10.1213/ANE.0000000000004653 | PMID: 32287134 | PMCID: PMC7735682
          Citations: 4 | AltScore: 1.5
        4. A comparison of antibiotic prophylaxis regimens to decrease the risk of post-procedure urinary tract infection after onabotulinum toxin A injection.
          Bickhaus JA, Vaughan M, Truong T, Li YJ, Siddiqui NY
          Int Urogynecol J, 2020 Sep, 31(9): 1907-1912
          https://doi.org/10.1007/s00192-020-04230-7 | PMID: 31989204 | PMCID: PMC7498079
          Citations: 1 | AltScore: NA
        5. Machine Learning Algorithms to Predict Mortality and Allocate Palliative Care for Older Patients With Hip Fracture.
          Cary MP Jr, Zhuang F, Draelos RL, Pan W, Amarasekara S, Douthit BJ, Kang Y, Col?n-Emeric CS
          J Am Med Dir Assoc, 2020 Oct 29, 22(2): 291-296
          pii: S1525-8610(20)30822-7. https://doi.org/10.1016/j.jamda.2020.09.025 | PMID: 33132014 | PMCID: PMC7867606
          Citations: | AltScore: 2.25
        6. Synovial cell cross-talk with cartilage plays a major role in the pathogenesis of osteoarthritis.
          Chou CH, Jain V, Gibson J, Attarian DE, Haraden CA, Yohn CB, Laberge RM, Gregory S, Kraus VB
          Sci Rep, 2020 Jul 2, 10(1): 10868
          https://doi.org/10.1038/s41598-020-67730-y | PMID: 32616761 | PMCID: PMC7331607
          Citations: | AltScore: 4.35
        7. Succeeding in Aging Research During the Pandemic: Strategies for Fellows and Junior Faculty.
          Cohen AB, Parks AL, Whitson HE, Zieman S, Brown CJ, Boyd C, Covinsky KE, Steinman MA
          J Am Geriatr Soc, 2020 Oct 13, 69(1): 8-11
          https://doi.org/10.1111/jgs.16868 | PMID: 33047812 | PMCID: PMC7675665
          Citations: | AltScore: 51.25
        8. Cost trajectories as a measure of functional resilience after hospitalization in older adults.
          Col?n-Emeric CS, Huang J, Pieper CF, Bettger JP, Roth DL, Sheehan OC
          Aging Clin Exp Res, 2020 Feb 14, 32(12): 2595-2601
          https://doi.org/10.1007/s40520-020-01481-8 | PMID: 32060803 | PMCID: PMC7426235
          Citations: | AltScore: NA
        9. Pain-Reducing Effects of Physical Therapist-Delivered Interventions: A Systematic Review of Randomized Trials Among Older Adults With Dementia.
          Coronado RA, Albers HE, Allen JL, Clarke RG, Estrada VA, Simon CB, Galloway RV, Fisher SR
          J Geriatr Phys Ther, 2020 Jul/Sep, 43(3): 159-169
          https://doi.org/10.1519/JPT.0000000000000235 | PMID: 30998563 | PMCID: PMC6800767
          Citations: 1 | AltScore: 2.75
        10. Incidence, Risk Factors, and Outcomes of Patients Who Develop Mucosal Barrier Injury-Laboratory Confirmed Bloodstream Infections in the First 100 Days After Allogeneic Hematopoietic Stem Cell Transplant.
          Dandoy CE, Kim S, Chen M, Ahn KW, Ardura MI, Brown V, Chhabra S, Diaz MA, Dvorak C, Farhadfar N, Flagg A, Ganguly S, Hale GA, Hashmi SK, Hematti P, Martino R, Nishihori T, Nusrat R, Olsson RF, Rotz SJ, Sung AD, Perales MA, Lindemans CA, Komanduri KV, Riches ML
          JAMA Netw Open, 2020 Jan 3, 3(1): e1918668
          https://doi.org/10.1001/jamanetworkopen.2019.18668 | PMID: 31913492 | PMCID: PMC6991246
          Citations: 4 | AltScore: 20.1
        11. Hospitalization Risk Among Older Adults with Sensory Impairments: Development of a Prognostic Model.
          Deardorff WJ, Sloane RJ, Pavon JM, Hastings SN, Whitson HE
          J Am Geriatr Soc, 2020 Aug 27, 68(11): 2650-2655
          https://doi.org/10.1111/jgs.16800 | PMID: 32852787 | PMCID: PMC7988218
          Citations: | AltScore: 14.2
        12. High Prevalence of Fall-Related Medication Use in Older Veterans at Risk for Falls.
          Elias AM, Ogunwale AN, Pepin MJ, Bailey JC, Adams AD, Col?n-Emeric CS, Vognsen JD, Schmader KE, Pavon JM
          J Am Geriatr Soc, 2020 Feb, 68(2): 438-439
          https://doi.org/10.1111/jgs.16233 | PMID: 31657005 | PMCID: PMC7002268
          Citations: 1 | AltScore: 25.3
        13. A cell non-autonomous mechanism of yeast chronological aging regulated by caloric restriction and one-carbon metabolism.
          Enriquez-Hesles E, Smith DL Jr, Maqani N, Wierman MB, Sutcliffe MD, Fine RD, Kalita A, Santos SM, Muehlbauer MJ, Bain JR, Janes KA, Hartman JL 4th, Hirschey MD, Smith JS
          J Biol Chem, 2020 Nov 26
          pii: jbc.RA120.015402. https://doi.org/10.1074/jbc.RA120.015402 | PMID: 33243834 | PMCID: PMC7949035
          Citations: 1 | AltScore: 6.25
        14. Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample.
          Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, Col?n-Emeric CS
          J Am Med Dir Assoc, 2020 Feb 6, 21(8): 1141-1147.e1
          pii: S1525-8610(19)30891-6. https://doi.org/10.1016/j.jamda.2019.12.021 | PMID: 32037299 | PMCID: PMC7396287
          Citations: | AltScore: NA
        15. Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.
          George SZ, Coffman CJ, Allen KD, Lentz TA, Choate A, Goode AP, Simon CB, Grubber JM, King H, Cook CE, Keefe FJ, Ballengee LA, Naylor J, Brothers JL, Stanwyck C, Alkon A, Hastings SN
          Pain Med, 2020 Dec 12, 21(Suppl 2): S62-S72
          https://doi.org/10.1093/pm/pnaa348 | PMID: 33313728 | PMCID: PMC7734660
          Citations: | AltScore: 7.7
        16. Multi-omics analyses of radiation survivors identify radioprotective microbes and metabolites.
          Guo H, Chou WC, Lai Y, Liang K, Tam JW, Brickey WJ, Chen L, Montgomery ND, Li X, Bohannon LM, Sung AD, Chao NJ, Peled JU, Gomes ALC, van den Brink MRM, French MJ, Macintyre AN, Sempowski GD, Tan X, Sartor RB, Lu K, Ting JPY
          Science, 2020 Oct 30, 370(6516):
          pii: eaay9097. https://doi.org/10.1126/science.aay9097 | PMID: 33122357 | PMCID: PMC7898465
          Citations: 7 | AltScore: 236.614
        17. Systematic review of the prospective association of daily step counts with risk of mortality, cardiovascular disease, and dysglycemia.
          Hall KS, Hyde ET, Bassett DR, Carlson SA, Carnethon MR, Ekelund U, Evenson KR, Galuska DA, Kraus WE, Lee IM, Matthews CE, Omura JD, Paluch AE, Thomas WI, Fulton JE
          Int J Behav Nutr Phys Act, 2020 Jun 20, 17(1): 78
          https://doi.org/10.1186/s12966-020-00978-9 | PMID: 32563261 | PMCID: PMC7305604
          Citations: 7 | AltScore: 204.8
        18. Warrior Wellness: A Randomized Controlled Pilot Trial of the Effects of Exercise on Physical Function and Clinical Health Risk Factors in Older Military Veterans With PTSD.
          Hall KS, Morey MC, Beckham JC, Bosworth HB, Sloane R, Pieper CF, Pebole MM
          J Gerontol A Biol Sci Med Sci, 2020 Oct 15, 75(11): 2130-2138
          https://doi.org/10.1093/gerona/glz255 | PMID: 31646339 | PMCID: PMC7973256
          Citations: | AltScore: 5.8
        19. Unmet Needs of Older Adults Receiving In-Center Hemodialysis: A Qualitative Needs Assessment.
          Hall R, Rutledge J, Col?n-Emeric C, Fish LJ
          Kidney Med, 2020 Sep-Oct, 2(5): 543-551.e1
          https://doi.org/10.1016/j.xkme.2020.04.011 | PMID: 33094273 | PMCID: PMC7568084
          Citations: | AltScore: 5.15
        20. Physical Function Assessment in Older Hemodialysis Patients.
          Hall RK, Rutledge J, Luciano A, Hall K, Pieper CF, Col?n-Emeric C
          Kidney Med, 2020 Jul-Aug, 2(4): 425-431
          https://doi.org/10.1016/j.xkme.2020.03.008 | PMID: 32775982 | PMCID: PMC7406854
          Citations: | AltScore: 7.95
        21. A Novel Approach to Developing a Discordance Index for Older Adults With Chronic Kidney Disease.
          Hall RK, Zhou H, Reynolds K, Harrison TN, Bowling CB
          J Gerontol A Biol Sci Med Sci, 2020 Feb 14, 75(3): 522-528
          https://doi.org/10.1093/gerona/glz248 | PMID: 31644788 | PMCID: PMC7768728
          Citations: 2 | AltScore: 10.7
        22. Increase in Free and Total Plasma TGF-?1 Following Physical Activity.
          Han AJ, Alexander LC Jr, Huebner JL, Reed AB, Kraus VB
          Cartilage, 2020 Apr 27 1947603520916523
          https://doi.org/10.1177/1947603520916523 | PMID: 32340467
          Citations: | AltScore: 1
        23. Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial.
          Hastings SN, Stechuchak KM, Coffman CJ, Mahanna EP, Weinberger M, Van Houtven CH, Schmader KE, Hendrix CC, Kessler C, Hughes JM, Ramos K, Wieland GD, Weiner M, Robinson K, Oddone E
          J Gen Intern Med, 2020 Jan, 35(1): 79-86
          https://doi.org/10.1007/s11606-019-05319-6 | PMID: 31489559 | PMCID: PMC6957582
          Citations: 1 | AltScore: 18.3
        24. Mobilizing Hospitals to Mobilize Patients.
          Hastings SN, Zullig LL
          J Am Geriatr Soc, 2020 Aug 5, 68(10): 2202-2204
          https://doi.org/10.1111/jgs.16698 | PMID: 32757213
          Citations: | AltScore: 15
        25. Anti-inflammatory effects of naproxen sodium on human osteoarthritis synovial fluid immune cells.
          Hsueh MF, Bolognesi MP, Wellman SS, Kraus VB
          Osteoarthritis Cartilage, 2020 May, 28(5): 639-645
          https://doi.org/10.1016/j.joca.2020.01.013 | PMID: 32028022 | PMCID: PMC7214189
          Citations: 2 | AltScore: 1
        26. Maresin 1 resolves aged-associated macrophage inflammation to improve bone regeneration.
          Huang R, Vi L, Zong X, Baht GS
          FASEB J, 2020 Oct, 34(10): 13521-13532
          https://doi.org/10.1096/fj.202001145R | PMID: 32794246 | PMCID: PMC7719599
          Citations: 2 | AltScore: NA
        27. Faecal microbiota transplantation from metabolically compromised human donors accelerates osteoarthritis in mice.
          Huang Z, Chen J, Li B, Zeng B, Chou CH, Zheng X, Xie J, Li H, Hao Y, Chen G, Pei F, Shen B, Kraus VB, Wei H, Zhou X, Cheng L
          Ann Rheum Dis, 2020 May, 79(5): 646-656
          https://doi.org/10.1136/annrheumdis-2019-216471 | PMID: 32205337 | PMCID: PMC7384301
          Citations: 3 | AltScore: 3
        28. ?-Cell-specific ablation of sirtuin 4 does not affect nutrient-stimulated insulin secretion in mice.
          Huynh FK, Peterson BS, Anderson KA, Lin Z, Coakley AJ, Llaguno FMS, Nguyen TN, Campbell JE, Stephens SB, Newgard CB, Hirschey MD
          Am J Physiol Endocrinol Metab, 2020 Oct 1, 319(4): E805-E813
          https://doi.org/10.1152/ajpendo.00170.2020 | PMID: 32865009 | PMCID: PMC7750516
          Citations: | AltScore: 4.45
        29. Accelerometer-Based Machine Learning Categorization of Body Position in Adult Populations.
          Jarvis L, Moninger S, Pavon J, Throckmorton C, Caves K
          Comput Help People Spec Needs, 2020 Sep, 12377: 242-249
          https://doi.org/10.1007/978-3-030-58805-2_29 | PMID: 33047112 | PMCID: PMC7548108
          Citations: | AltScore: NA
        30. Development, Validity, and Reliability of a Novel Walking Speed Measurement Device: the GaitBox.
          Jarvis LM, Peterson MJ, Caves KM
          Gait Posture, 2020 Nov 13, 84: 52-57
          https://doi.org/10.1016/j.gaitpost.2020.11.009 | PMID: 33271417 | PMCID: PMC7902333
          Citations: | AltScore: NA
        31. Rapid Transition to Telehealth Group Exercise and Functional Assessments in Response to COVID-19.
          Jennings SC, Manning KM, Bettger JP, Hall KM, Pearson M, Mateas C, Briggs BC, Oursler KK, Blanchard E, Lee CC, Castle S, Valencia WM, Katzel LI, Giffuni J, Kopp T, McDonald M, Harris R, Bean JF, Althuis K, Alexander NB, Padala KP, Abbate LM, Wellington T, Kostra J, Allsup K, Forman DE, Tayade AS, Wesley AD, Holder A, Morey MC
          Gerontol Geriatr Med, 2020 Jan-Dec, 6: 2333721420980313
          https://doi.org/10.1177/2333721420980313 | PMID: 33403222 | PMCID: PMC7739082
          Citations: | AltScore: 12.93
        32. Cognitive function prior to systemic therapy and subsequent well-being in older breast cancer survivors: Longitudinal findings from the Thinking and Living with Cancer Study.
          Kobayashi LC, Cohen HJ, Zhai W, Zhou X, Small BJ, Luta G, Hurria A, Carroll J, Tometich D, McDonald BC, Graham D, Jim HSL, Jacobsen P, Root JC, Saykin AJ, Ahles TA, Mandelblatt J
          Psychooncology, 2020 Mar 10, 29(6): 1051-1059
          https://doi.org/10.1002/pon.5376 | PMID: 32154959 | PMCID: PMC7299808
          Citations: 1 | AltScore: 0.25
        33. Defining the relationship between vaginal and urinary microbiomes.
          Komesu YM, Dinwiddie DL, Richter HE, Lukacz ES, Sung VW, Siddiqui NY, Zyczynski HM, Ridgeway B, Rogers RG, Arya LA, Mazloomdoost D, Levy J, Carper B, Gantz MG, Eunice Kennedy Shriver National Institute of Child Health and Human Development Pelvic Floor Disorders Network.
          Am J Obstet Gynecol, 2020 Feb, 222(2): 154.e1-154.e10
          https://doi.org/10.1016/j.ajog.2019.08.011 | PMID: 31421123 | PMCID: PMC6995424
          Citations: 6 | AltScore: 13.7
        34. Leisure activities and disability in activities of daily living among the oldest-old Chinese population: evidence from the Chinese Longitudinal Healthy Longevity Study.
          Li ZH, Chen Q, Byers Kraus V, Shen D, Zhang XR, Zhang PD, Zhong WF, Lv YB, Huang QM, Song WQ, Wang D, Wu XB, Shi XM, Mao C
          Aging (Albany NY), 2020 Jun 12, 12(11): 10687-10703
          https://doi.org/10.18632/aging.103287 | PMID: 32532929 | PMCID: PMC7346052
          Citations: | AltScore: NA
        35. Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study.
          Li ZH, Gao X, Chung VC, Zhong WF, Fu Q, Lv YB, Wang ZH, Shen D, Zhang XR, Zhang PD, Li FR, Huang QM, Chen Q, Song WQ, Wu XB, Shi XM, Kraus VB, Yang X, Mao C
          Ann Rheum Dis, 2020 Jun, 79(6): 829-836
          https://doi.org/10.1136/annrheumdis-2020-217176 | PMID: 32253185 | PMCID: PMC7286049
          Citations: 2 | AltScore: 80.204
        36. Trends in the Incidence of Activities of Daily Living Disability Among Chinese Older Adults From 2002 to 2014.
          Li ZH, Lv YB, Kraus VB, Yin ZX, Liu SM, Zhang XC, Gao X, Zhong WF, Huang QM, Luo JS, Zeng Y, Ni JD, Mao C, Shi XM
          J Gerontol A Biol Sci Med Sci, 2020 Oct 15, 75(11): 2113-2118
          https://doi.org/10.1093/gerona/glz221 | PMID: 31603986 | PMCID: PMC7973258
          Citations: 3 | AltScore: 1
        37. Associations of habitual fish oil supplementation with cardiovascular outcomes and all cause mortality: evidence from a large population based cohort study.
          Li ZH, Zhong WF, Liu S, Kraus VB, Zhang YJ, Gao X, Lv YB, Shen D, Zhang XR, Zhang PD, Huang QM, Chen Q, Wu XB, Shi XM, Wang D, Mao C
          BMJ, 2020 Mar 4, 368: m456
          https://doi.org/10.1136/bmj.m456 | PMID: 32131999 | PMCID: PMC7249244
          Citations: 2 | AltScore: 346.55
        38. Higher dietary diversity scores and protein-rich food consumption were associated with lower risk of all-cause mortality in the oldest old.
          Lv Y, Kraus VB, Gao X, Yin Z, Zhou J, Mao C, Duan J, Zeng Y, Brasher MS, Shi W, Shi X
          Clin Nutr, 2020 Jul, 39(7): 2246-2254
          https://doi.org/10.1016/j.clnu.2019.10.012 | PMID: 31685303 | PMCID: PMC7182467
          Citations: 1 | AltScore: 9.45
        39. Long-term exposure to PM<sub>2.5</sub> and incidence of disability in activities of daily living among oldest old.
          Lv Y, Zhou J, Kraus VB, Li T, Sarnat JA, Wang J, Liu Y, Chen H, Brasher MS, Mao C, Zeng Y, Zheng T, Shi X
          Environ Pollut, 2020 Apr, 259: 113910
          https://doi.org/10.1016/j.envpol.2020.113910 | PMID: 32023791 | PMCID: PMC7261238
          Citations: 2 | AltScore: NA
        40. Specific Leisure Activities and Cognitive Functions Among the Oldest-Old: The Chinese Longitudinal Healthy Longevity Survey.
          Mao C, Li ZH, Lv YB, Gao X, Kraus VB, Zhou JH, Wu XB, Shi WY, Li FR, Liu SM, Yin ZX, Zeng Y, Shi XM
          J Gerontol A Biol Sci Med Sci, 2020 Mar 9, 75(4): 739-746
          https://doi.org/10.1093/gerona/glz086 | PMID: 30946444 | PMCID: PMC6776703
          Citations: 3 | AltScore: 1
        41. Pre-transplant hepatic steatosis (fatty liver) is associated with chronic graft-vs-host disease but not mortality.
          Maung K, Ramalingam S, Chaudhry M, Ren Y, Jung SH, Romero K, Corbet K, Chao NJ, Choi T, Diehl AM, Diehl L, Gasparetto C, Horwitz M, Long GD, Lopez RD, Rizzieri DA, Sarantopoulos S, Sullivan KM, Bashir MR, Sung AD
          PLoS One, 2020, 15(9): e0238824
          https://doi.org/10.1371/journal.pone.0238824 | PMID: 32915853 | PMCID: PMC7485815
          Citations: | AltScore: NA
        42. Novel approaches to metabolic assessment and structured exercise to promote recovery in ICU survivors.
          Molinger J, Pastva AM, Whittle J, Wischmeyer PE
          Curr Opin Crit Care, 2020 Aug, 26(4): 369-378
          https://doi.org/10.1097/MCC.0000000000000748 | PMID: 32568800 | PMCID: PMC8104451
          Citations: | AltScore: 81.4
        43. A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.
          Nobuhara CK, Bullock WM, Bunning T, Colin B, Cooter M, Devinney MJ, Ferrandino MN, Gadsden J, Garrigues G, Habib AS, Moretti E, Moul J, Ohlendorf B, Sandler A, Scheri R, Sharma B, Thomas JP, Young C, Mathew JP, Berger M, MADCO-PC and INTUIT Investigators Teams.
          J Neurol, 2020 Mar 20, 267(7): 2002-2006
          https://doi.org/10.1007/s00415-020-09797-1 | PMID: 32198714 | PMCID: PMC7336280
          Citations: 4 | AltScore: 2
        44. Geriatric assessment for older adults with sickle cell disease: protocol for a prospective cohort pilot study.
          Oyedeji CI, Hall K, Luciano A, Morey MC, Strouse JJ
          Pilot Feasibility Stud, 2020, 6: 131
          https://doi.org/10.1186/s40814-020-00673-3 | PMID: 32974042 | PMCID: PMC7495855
          Citations: | AltScore: NA
        45. Cognition, Physical Function, and Quality of Life in Older Patients With Acute Decompensated Heart Failure.
          Pastva AM, Hugenschmidt CE, Kitzman DW, Nelson MB, Brenes GA, Reeves GR, Mentz RJ, Whellan DJ, Chen H, Duncan PW
          J Card Fail, 2020 Sep 18, 27(3): 286-294
          pii: S1071-9164(20)30954-4. https://doi.org/10.1016/j.cardfail.2020.09.007 | PMID: 32956816 | PMCID: PMC7914148
          Citations: | AltScore: 9.5
        46. Microbiota as Predictor of Mortality in Allogeneic Hematopoietic-Cell Transplantation.
          Peled JU, Gomes ALC, Devlin SM, Littmann ER, Taur Y, Sung AD, Weber D, Hashimoto D, Slingerland AE, Slingerland JB, Maloy M, Clurman AG, Stein-Thoeringer CK, Markey KA, Docampo MD, Burgos da Silva M, Khan N, Gessner A, Messina JA, Romero K, Lew MV, Bush A, Bohannon L, Brereton DG, Fontana E, Amoretti LA, Wright RJ, Armijo GK, Shono Y, Sanchez-Escamilla M, Castillo Flores N, Alarcon Tomas A, Lin RJ, Y??ez San Segundo L, Shah GL, Cho C, Scordo M, Politikos I, Hayasaka K, Hasegawa Y, Gyurkocza B, Ponce DM, Barker JN, Perales MA, Giralt SA, Jenq RR, Teshima T, Chao NJ, Holler E, Xavier JB, Pamer EG, van den Brink MRM
          N Engl J Med, 2020 Feb 27, 382(9): 822-834
          https://doi.org/10.1056/NEJMoa1900623 | PMID: 32101664 | PMCID: PMC7534690
          Citations: 6 | AltScore: 364.68
        47. Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities.
          Pepin MJ, Valencia WM, Bettger JP, Pearson M, Manning KM, Sloane R, Schmader KE, Morey MC
          Gerontol Geriatr Med, 2020 Jan-Dec, 6: 2333721420956751
          https://doi.org/10.1177/2333721420956751 | PMID: 32995368 | PMCID: PMC7503003
          Citations: | AltScore: NA
        48. Impact of exercise on the immune system and outcomes in hematologic malignancies.
          Sitlinger A, Brander DM, Bartlett DB
          Blood Adv, 2020 Apr 28, 4(8): 1801-1811
          https://doi.org/10.1182/bloodadvances.2019001317 | PMID: 32343800 | PMCID: PMC7189285
          Citations: 1 | AltScore: 3.25
        49. Clinical and Neuroimaging Correlates of Post-Transplant Delirium.
          Smith P, Thompson JC, Perea E, Wasserman B, Bohannon L, Racioppi A, Choi T, Gasparetto C, Horwitz ME, Long G, Lopez R, Rizzieri DA, Sarantopoulos S, Sullivan KM, Chao NJ, Sung AD
          Biol Blood Marrow Transplant, 2020 Dec, 26(12): 2323-2328
          https://doi.org/10.1016/j.bbmt.2020.09.016 | PMID: 32961373 | PMCID: PMC7977594
          Citations: | AltScore: NA
        50. Microtransplantation in older patients with AML: A pilot study of safety, efficacy and immunologic effects.
          Sung AD, Jauhari S, Siamakpour-Reihani S, Rao AV, Staats J, Chan C, Meyer E, Gadi VK, Nixon AB, Lyu J, Xie J, Bohannon L, Li Z, Hourigan CS, Dillon LW, Wong HY, Shelby R, Diehl L, de Castro C, LeBlanc T, Brander D, Erba H, Galal A, Stefanovic A, Chao N, Rizzieri DA
          Am J Hematol, 2020 Jun, 95(6): 662-671
          https://doi.org/10.1002/ajh.25781 | PMID: 32162718 | PMCID: PMC7433709
          Citations: 1 | AltScore: 1
        51. House calls for stem cell transplant patients during the COVID-19 pandemic.
          Sung AD, Nichols KR, Chao NJ
          Blood, 2020 Jul 16, 136(3): 370-371
          https://doi.org/10.1182/blood.2020006573 | PMID: 32488235 | PMCID: PMC7365917
          Citations: | AltScore: 0.25
        52. Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults.
          Swenor BK, Lee MJ, Varadaraj V, Whitson HE, Ramulu PY
          Gerontologist, 2020 Aug 14, 60(6): 989-995
          https://doi.org/10.1093/geront/gnz117 | PMID: 31504483 | PMCID: PMC7427480
          Citations: 5 | AltScore: 1.5
        53. The MARBLE Study Protocol: Modulating ApoE Signaling to Reduce Brain Inflammation, DeLirium, and PostopErative Cognitive Dysfunction.
          VanDusen KW, Eleswarpu S, Moretti EW, Devinney MJ, Crabtree DM, Laskowitz DT, Woldorff MG, Roberts KC, Whittle J, Browndyke JN, Cooter M, Rockhold FW, Anakwenze O, Bolognesi MP, Easley ME, Ferrandino MN, Jiranek WA, Berger M, MARBLE Study Investigators.
          J Alzheimers Dis, 2020, 75(4): 1319-1328
          https://doi.org/10.3233/JAD-191185 | PMID: 32417770 | PMCID: PMC7923142
          Citations: 1 | AltScore: 6.05
        54. A New Severity Scoring Scale for the 3-Minute Confusion Assessment Method (3D-CAM).
          Vasunilashorn SM, Devinney MJ, Acker L, Jung Y, Ngo L, Cooter M, Huang R, Marcantonio ER, Berger M
          J Am Geriatr Soc, 2020 Jun 1, 68(8): 1874-1876
          https://doi.org/10.1111/jgs.16538 | PMID: 32479640 | PMCID: PMC7429287
          Citations: | AltScore: 10.5
        55. Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability.
          Venkataraman K, Amis K, Landerman LR, Caves K, Koh GC, Hoenig H
          Phys Ther, 2020 Apr 17, 100(4): 708-717
          https://doi.org/10.1093/ptj/pzaa005 | PMID: 31984420 | PMCID: PMC7439231
          Citations: 1 | AltScore: 2
        56. Fine Particulate Matter and Poor Cognitive Function among Chinese Older Adults: Evidence from a Community-Based, 12-Year Prospective Cohort Study.
          Wang J, Li T, Lv Y, Kraus VB, Zhang Y, Mao C, Yin Z, Shi W, Zhou J, Zheng T, Kinney PL, Ji J, Tang S, Shi X
          Environ Health Perspect, 2020 Jun, 128(6): 67013
          https://doi.org/10.1289/EHP5304 | PMID: 32551881 | PMCID: PMC7302441
          Citations: 2 | AltScore: 17.55
        57. Neurovascular and immune mechanisms that regulate postoperative delirium superimposed on dementia.
          Wang P, Velagapudi R, Kong C, Rodriguiz RM, Wetsel WC, Yang T, Berger M, Gelbard HA, Colton CA, Terrando N
          Alzheimers Dement, 2020 May, 16(5): 734-749
          https://doi.org/10.1002/alz.12064 | PMID: 32291962 | PMCID: PMC7317948
          Citations: 8 | AltScore: 47.05
        58. Cognitive Impairment among Veterans in Outpatient Vision Rehabilitation.
          Whitson HE, Woolson S, Olsen M, Massof R, Ferguson SM, Muir KW, Dziadul JA Jr, McConnell E, Stelmack JA
          Optom Vis Sci, 2020 Jun, 97(6): 462-469
          https://doi.org/10.1097/OPX.0000000000001522 | PMID: 32511169 | PMCID: PMC7291825
          Citations: | AltScore: NA
        59. Long-term exposure to ambient fine particulate matter and fasting blood glucose level in a Chinese elderly cohort.
          Zhang Y, Li T, Ma R, Yin Z, Wang J, He MZ, Xu D, Gao X, Wang Q, Kraus VB, Lv Y, Zhong Y, Kinney PL, Shi X
          Sci Total Environ, 2020 May 15, 717: 137191
          https://doi.org/10.1016/j.scitotenv.2020.137191 | PMID: 32062280 | PMCID: PMC7183512
          Citations: | AltScore: NA
        60. Development and Validation of a Nomogram for Predicting the 6-Year Risk of Cognitive Impairment Among Chinese Older Adults.
          Zhou J, Lv Y, Mao C, Duan J, Gao X, Wang J, Yin Z, Shi W, Luo J, Kang Q, Zhang X, Wei Y, Kraus VB, Shi X
          J Am Med Dir Assoc, 2020 Jun, 21(6): 864-871.e6
          https://doi.org/10.1016/j.jamda.2020.03.032 | PMID: 32507532 | PMCID: PMC7299771
          Citations: 1 | AltScore: 7
        61. Relationship between neural functional connectivity and memory performance in age-related macular degeneration.
          Zuo X, Zhuang J, Chen NK, Cousins S, Cunha P, Lad EM, Madden DJ, Potter G, Whitson HE
          Neurobiol Aging, 2020 Nov, 95: 176-185
          https://doi.org/10.1016/j.neurobiolaging.2020.07.020 | PMID: 32829250 | PMCID: PMC7609595
          Citations: | AltScore: 0.25


        Karen Bandeen Roche
        John Hopkins University
        Serving since 2010 (11 years)

        George Kuchel MD
        University of Connecticut, Geriatrics and Gerontology
        Serving since 2016 (5 years)

        Neil Alexander, MD
        University of Michigan
        Serving since 2016 (5 years)

        RECOGNITION AND AWARDS (2020-2021)
        Ashley Poole, PT, DPT, CCS (2021)
        • American Physical Therapy Association Centennial Scholar
        Daniel Parker, MD (2020)
        • American Geriatrics Society New Investigator Award
        Kenneth Schmader, MD (2021)
        • Appointed to CDC Advisory Committee on Immunization Practices (ACIP) COVID-19 Vaccine Effectiveness Work Group
        • American Geriatrics Society Annual Scientific Meeting Plenary Symposium Presenter on COVID-19 Vaccines
        Miles Berger, MD, PhD (2020)
        • Inaugural Ann Bussel Award from the Ruth K Broad Biomedical Research Foundation at Duke University
        Rasheeda Hall, MD, MBA, MHS (2020)
        • American Journal of Kidney Diseases Reviewer Hall of Fame
        Virginia Byers Kraus, MD PhD (2021)
        • Dr Kraus was appointed the Mary Bernheim Distinguished Professor Chair.


        General Brief Description of Minority Activities:

        Determinants of maintenance and recovery of function in a representative older community-resident biracial sample

        Gerda Fillenbaum, PhD, co-investigator, Katherine Hall, PhD, Carl Pieper, DPh, Heather Whitson, MD, MHS, Cathleen Colón-Emeric, MD, MHS, Core leaders

        Focus on decline in performance of activities of daily living (ADL) has not been matched by studies of recovery of function. Advised by a broad conceptual model of physical resilience, we ascertain characteristics that identify (1) maintenance, (2) decline, and (3) recovery of personal self-maintenance activities over six years in an older (age 65-105 years), community representative sample (n = 3187; African American: 54%, White: 45%). All were participants in the Duke Established Populations for Epidemiologic Studies of the Elderly, and were unimpaired at baseline.

        Over six years, ~75% remained unimpaired, of whom 30% were unimpaired when they dropped out or died. Of ~25% who became impaired, just over half recovered. Analyses, which took into account demographic characteristics, health conditions, health service use, social services provided and received, neighborhood safety, and survival status, indicated that those who became impaired were in poorer health, were younger, and more likely to be African American. Characteristics of recovery included younger age, not hospitalized in the previous year, and increased social support.

        Our analyses indicate that maintenance of health status facilitated continued unimpaired basic activities of daily living. While decline was associated with poorer health, younger age, and being African American, recovery was also associated with younger age, and in addition social support, and no further deterioration in health as measured here.

        Following decline in functioning, increased effort is needed to improve health and avoid further decline, and effort that takes into account not only physical but also personal social conditions.


        Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, Colón-Emeric CS.  Determinants of maintenance and recovery of function in a representative older community- resident biracial sample. J Am Med Dir Assoc. 2020 Feb 6:S1525-8610(19)30891-6. doi: 10.1016/j.jamda.2019.12.021. Online ahead of print. PMID: 32037299 NIHMS 1569426   https://doi.org/10.1016/j.jamda.2019.12.021

        Minority Trainee(s):
        • Charity Oyedeji, MD, PESC Scholar, Assistant Professor of Medicine (Hematology)
          Dr. Charity Oyedeji's research focuses on implementing a geriatric assessment into clinical assessments of older adults with sickle cell disease. Due to advances in care and access, patients with sickle cell disease (SCD) are living longer than they have in previous generations. SCD is recognized as a condition that mimics accelerated aging, but little is known about aging with SCD. In particular, SCD patients face frequent health stressors including hypoxia, pain crises, and frequent hospitalizations, but little is known about how aging with SCD affects one’s resilience to these stressors. The objective of this study is to test the feasibility and safety of focused geriatric assessment and provocative tests that measure physiological reserve in SCD patients over age 50 and to determine the feasibility of a protocol to assess resilience to the stressor of hospitalization in older SCD patients. In addition, biomarkers of inflammation, coagulation, and longevity will be compared in 20 older (age 50-70) people with SCD and 20 younger (age 18-49) people with SCD. Thus far, the study has demonstrated that focused geriatric assessment, including provocative performance measures was safe and well-tolerated by older SCD patients. 50% of the older participants experienced a hospitalization within 12 months of a baseline assessment, indicating the feasibility of a future study to prospectively measure resilience after hospitalization by following a cohort of well-characterized participants for 2 years. Measures of physiological reserve in older SCD patients, on average, were consistent with normative measures from healthy seniors 20-30 years older. In 2020, Dr. Oyedeji used these findings to support a successful application for funding from the American Society of Hematology. She was also the recipient of 3 outstanding abstract awards at national meetings, and the recipient of the 2019 Duke Maddox Award for Aging Research. In 2021, Dr. Oyedeji received a Duke REACH Equity Career Development Award, an invitation to present at the American Society of Hematology Annual Meeting in December, and submitted a manuscript to the ASH Education Program.
        • Gentzon Hall, MD, PhD, Assistant Professor of Medicine (Nephrology)
          Dr. Hall is an Assistant Professor of Medicine (Nephrology) whose lab utilizes sophisticated genetic studies to better understand contributors to glomerulosclerosis (AAGS), a common cause of chronic kidney disease (CKD) in older adults. His ultimate goal is to identify targets for pharmacological intervention that will protect kidney function, especially in populations at highest risk for AAGS. Progressive loss of glomerular visceral epithelial cells (i.e. podocytes) with age is thought to be the principal driver of AAGS. Based on his own previous findings, Dr. Hall hypothesizes that impaired IL-15/IL-15R axis signaling reduces podocyte resiliency to proapototic stimuli, increasing risk of AAGS across the lifespan. In Aim 1 of his pilot study, he utilizes immortalized human podocyte lines to quantify podocyte apoptosis in gene knockdown and controls after exposure to two well-validated proapototic stimuli. In Aim 2, he will utilize targeted gene deletion in zebrafish embryos to understand the role of the IL-15 signaling in vivo. A validated surrogate model for albuminuria in humans will be used to detect and quantify proteinuria in knockdown IL-15 and IL-15R zebrafish compared to controls. If these experiments confirm the role ofIL-15 signaling in podocyte survival and function after nephrotoxic stressors, it will justify future research to develop IL-15 signaling agents to enhance kidney resilience and protect against AAGS.
        • Katherine Ramos, PhD, Assistant Professor of Medicine, Psychiatry and Behavioral Sciences
          Dr. Ramos' research focuses on developing and implementing behavioral interventions for older adults to enhance both their psychological and physical well-being in the context of medical complexity and/ or metastatic cancer. Despite the availability of interventions to improve functioning and quality of life in older adults by targeting their behaviors and mental health, there is a scarcity of research that focuses exclusively on older adults living with serious, life-limiting illness such as late-stage lung cancer. The objective of the Roybal study was to provide 8-12 sessions of Self-System Therapy (an evidenced-based psychotherapy treatment for depression) adapted and implemented for older adults over 65 years of age with Stage III or Stage IV lung cancer. The intervention primarily focuses on teaching older adults how to integrate promotion-focused and prevention-focused goal setting to improve self-regulation and increase behaviors that promote mental health and physical well-being. The study was recently completed with a sample of 12 focus group members, 5 user testers, 5 advisory members, and 30 participants enrolled in the pilot. Analyses are underway. An extension of this work has been recently funding by the NIA Research Centers Collaborative Network (RCCN) via Wake Forest School of Medicine. This study is currently underway with a focus on piloting measures targeting physical and psychological resilience(including accelerometry data collection) as older adults with late-stage lung cancer participate in the Self-System Therapy for Lung Cancer Intervention. Study completion is anticipated by March 2022. Thus far, from this work Dr. Ramos has presented her findings in national and international conferences, these include the: Association for Behavioral and Cognitive Therapies (ABCT), the American Psychological Association (APA), and the International Society for Psychotherapy Research in Heidelberg, Germany. A special issue paper abstract has been submitted for a full manuscript submission and an NIH R21 grant submission is currently underway to test the initial efficacy of the intervention in a larger randomized control trial.

        Minority Grant(s):