Home » Claude D. Pepper Older Americans Independence Center (OAIC)

Claude D. Pepper Older Americans Independence Center (OAIC)

To understand and optimize reserve and resilience

sunflower-960×540 Pepper renewal text
fireworks-960×540 GEMSSTAR text

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 is understanding and optimizing reserve and resilience. Our approach is founded on the insight that independence in older adults is related to an individual’s 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.

Our goals are accomplished through the synergistic activities of the Leadership and Administration Core (LAC), Research Education Component (REC), Pilot/Exploratory Studies Core (PESC), and 3 Resource Cores: Molecular Measures Core (MMC), Health and Mobility Measures Core (HMC), and Analysis Core (AC).

AIMS of the Duke Pepper Center
  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 identify and develop the next generation of researchers who will become leaders in aging and geriatrics research related to the Duke OAIC focus.
  4. To support pilot studies through the PESC that acquire information needed to select or design successful, more definitive research studies related to the Duke OAIC focus.
Data Integration Working Group (DIWG) -- Thursday October 28th -- CVA Resilience
DIWG has resumed regular Zoom meetings on the 2nd and 4th Thursdays each month for Fall 2021. The DIWG is open to members of the Duke community and is a wonderful inlet for individuals who want to learn more about the resources and opportunities of the Duke Pepper Center.
Next session: Thursday Oct 28th, 9:30-11:00am
Where: Zoom link Meeting ID: 923 1032 9469 Passcode: pepper
Topics: Wayne Feng, MD and Pratik Chhatbar, PhD: Neurostimulation and CVA Resilience
Looking Ahead: Thursday Nov 18th
Topic: Rahima Zannadi, MD and Mike Devinney, MD, PhD: NIA funding for red cell activation of thrombosis of aging-Sleep Apnea, Neuroinflammation, and cognitive Dysfunction Manifesting After Non-cardiac surgery (SANDMAN) study
Thursday Dec 9th
Virginia Kraus, MD, PhD and Sisi Ma, PhD: Predictors of Longevity in EPESE study
Daniel Parker, MD: Progress on GEMSTARR
NOW Open! RFAs for Duke Pepper Center 2021 Career Development and Pilot Studies Awards and NIA-Awarded Research Supplement To Promote Diversity In Health-Related Research NOTE: NIH Biosketch due Nov 1, 2021/Decision March 2022/Funding received Summer 2022
Duke Pepper Center Research Career Development Award: The goal of the Research Education Component (REC) is to promote the development of future research leaders who are conducting basic, translational, epidemiological or clinical research within the Pepper Center focus: Physical reserve and resilience.

The REC will award up to 3 career development awards, of 2-year duration, with funding beginning July 1, 2022.

[Download Research Career Development Award RFA]

Duke Pepper Center Pilot Studies Award: The objective of this solicitation is to seek the highest quality pilot studies in aging research from within Duke University Medical Center. The scope of the Pilot/Exploratory Studies Core includes, but is not limited to, feasibility studies (i.e., for interventions or other research methodology), development of new methodologies or technologies, analysis of existing data, and exploration of high risk but innovative ideas. We are especially interested in studies that relate to our focus:

Enhancing Physical Reserve and Resilience to Promote Recovery from Late Life Stressors

The duration of the pilot study may be for one or two years. The budget request for pilot studies is $25,000 – $40,000 per year in direct costs.

[Download Pilot Studies Award RFA]

Research Supplement to Promote Diversity in Health-Related Research: The goal of this administrative supplement is to increase diversity in the Aging Research workforce
by promoting the research and career development of an eligible investigator with a focus area on physical reserve and resilience. Duke Pepper faculty will select one investigator to apply for a Diversity Supplement. OAIC researchers will work closely with the selected applicant to develop a competitive application. The National Institutes of Aging will make the final funding decision.

The expected duration of the supplement is two years. Applicants will be notified by December, 2021, if they are invited to submit a full application.

[Download Diversity Supplement Award RFA]

Duke Pepper Health and Mobility Measures Core and Veterans Affairs Researchers Examine Relationship Between An Exercise Intervention And Dietary Behavior In Older Vets With PTSD
Older veterans with posttraumatic stress disorder (PTSD) are at increased risk of obesity and cardiometabolic disease, yet few studies have examined the relationship between PTSD and diet quality. Researchers explored if participation in a supervised exercise intervention spurred simultaneous changes in dietary behavior. Results revealed that the diet quality of older veterans with PTSD is poor, and while the exercise intervention improved health through exercise, it did not make veterans any more likely to adopt a more healthful diet. Interventions targeting diet, or diet + exercise, are needed to manage the increased risk of obesity and cardiometabolic disease present in older veterans with PTSD.

[Journal link]

Duke Pepper Research Team, Led By PESC Core Co-Leader Heather Whitson MD, To Investigate Factors That Predict Resilience and Recovery Following Total Knee Arthroplasty
Older adults with similar health conditions often experience widely divergent outcomes following health stressors. Variable recovery after a health stressor may be due in part to differences in biological mechanisms at the molecular, cellular, or system level, that are elicited in response to stressors. PRIME-KNEE is an ongoing, prospective cohort study that will enroll 250 adults ≥60 years undergoing total knee arthroplasty. Data are collected pre- and post-surgery and include cognitive, psychological, physical performance and biomarker variables. If PRIME-KNEE validates feasible clinical tests and biomarkers that predict recovery trajectories in older surgical patients, these tools may inform surgical decision-making, guide pre-habilitation efforts, and elucidate mechanisms underlying resilience.
Molecular Measures Core Co-Leader Receives Duke Distinguished Professorship Appointment
Virginia Kraus, MD, PhD, Professor of Medicine and Orthopedic Surgery, has been appointed the Mary Bernheim Distinguished Professor Chair. A rheumatologist, Dr Kraus leads large-scale research projects that are investigating the mechanisms of osteoarthritis, predicting the progression of the disease, and drug responses. Her research focuses on the early treatment of osteoarthritis (OA) before serious damage occurs.
Appointment to a named chair is one of the highest honors Duke confers upon faculty and recognizes excellence in research, teaching and contributions to the university community.

[Read more]

Katherine Ramos, PhD Develops Behavioral Interventions For Older Adults To Enhance Psychological and Physical Well-Being In the Context Of Medical Complexity/Metastatic Cancer
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.
GSA 2021: November 10-14 Phoenix, AZ --- Abstracts Timeline

  1. Early June – Abstract Acceptance/Non-Acceptance Email Notifications to Submitters
  2. July 15 – Abstract Schedule and Session Information Email Notifications
  3. July 16 – August 26 – Late Breaker Poster Submissions
  4. November 10-14 – GSA 2021 Annual Scientific Meeting – Phoenix, AZ
Duke Pepper Pilot Study Awardee Elaine Guevara, PhD, Studies Our Primate Relatives Lemurs For Insights Into Physiological Reserves and Resilience and Healthspan
Elaine Gomez Guevara, PhD from the Dept. of Evolutionary Anthropology will study molecular aging processes in two species at the Duke Lemur Center: the ring-tailed lemur (Lemur catta) and Coquerel’s sifaka (Propithecus coquereli). The ring-tailed lemur exhibits fast maturation and a shorter lifespan than Coquerel’s sifaka, while Coquerel’s sifaka has extreme longevity for its body size, very slow development, and a low rate of actuarial senescence, as in humans. These lemurs are sympatric: they occupy the same environment on their native island of Madagascar.
The study will use matched urine and serum samples across the full recorded lifespan per species and measure multiple biomarkers to test two hypothesized pathways of aging, one involving oxidative stress and the other involving inflammation.
The lemur pictured above is Marcus (named after Roman emperor Marcus Aurelius). The blue box collar is an activity monitor developed in collaboration with Health and Mobility Measures Core researcher Kevin Caves, ME.
Available NOW As A Free Download: Mobile Technology for Adaptive Aging: Proceedings of a Workshop By The National Academies of Sciences, Engineering, and Medicine
To explore how mobile technology can be employed to enhance the lives of older adults, the Board on Behavioral, Cognitive, and Sensory Sciences of the National Academies of Sciences, Engineering, and Medicine commissioned 6 papers, which were presented at a workshop in 2019. These papers review research on mobile technologies and aging, and highlight promising avenues for further research.
Topics include privacy and security considerations when conducting mobile technologies research, use of technologies for social connectedness and well-being, machine learning based on sensor data to improve outcomes, and an overview of the challenges ahead as technologies continue to evolve and improve.

[Link to proceed to free download]

Duke Pepper Center Review Of Longitudinal Studies Demonstrates Association Of Walking With Lower Risk Of All-Cause Mortality, Independent Of Age, Gender, and Weight Status
In a systematic review of seventeen prospective longitudinal studies involving over 30,000 adults, Katherine S. Hall, PhD, and her colleagues found data consistently demonstrated that walking an additional 1000 steps per day can help lower the risk of all-cause mortality, and CVD morbidity and mortality in adults, and that health benefits are present below 10,000 steps per day. The shape of the dose-response relation is not yet clear. These associations appear to hold across age, gender, and weight status.

[Journal article]

Duke Pepper Center Health and Mobility Measures Core Co-Leader, Katherine S Hall, PhD Inducted Into 2020 Class Of Fellows of the Gerontological Society of America (GSA)
Katherine S Hall, PhD, FGSA is a member of the 2020 Class of Fellows of the GSA, the world’s oldest and largest interdisciplinary organization devoted to research, education, and practice in the field of aging. Her unanimous selection to Fellow status — the highest category of membership — is an acknowledgment of outstanding and continuing work in the field of gerontology. The 2020 Class of Fellows will be honored at the GSA Annual Scientific Meeting in November in Philadelphia.
Dr Hall’s research is focused on developing evidence-based physical activity interventions for older adults with an eye to preserving functional independence and quality of life, with a particularly interest in developing exercise programs to promote physical and psychological well-being among older veterans with posttraumatic stress disorder (PTSD). Congratulations Katherine!
Duke Pepper Center Announces Inaugural 'Pepper Incubator Awards' For Two Researchers
Kathryn Porter Starr, PhD, RD and Seth Cohen, MD, MPH are the inaugural recipients of Pepper Incubator Awards. The award includes seed funding, a consult studio, and access to the multi-dimensional expertise of the Pepper Center Core faculty.
The award will support their collaborative and inter-disciplinary efforts to improve outcomes in older surgical patients by addressing the inter-related problems of dysphagia and inadequate nutrition in the peri-operative period. Dr Starr is a nutrition scientist whose research interests include nutritional vulnerability in older adults and the association of protein intake with physical function and resilience. Dr Cohen is an ENT surgeon whose research interests include quality of life challenges for patients with voice and swallowing problems and the development and implementation of evidence-based treatments to resolve these problems.
Duke Pepper Center Co-Director and Health and Mobility Measures Core Leader, Miriam Morey, PhD, Receives Prestigious Paul B. Magnuson Award for Outstanding Achievement in Rehabilitation Research and Development from the VA
Miriam Morey, PhD, is the 2020 recipient of the VA Rehabilitation Research and Development Service’s highest honor—the Paul B. Magnuson Award. The honor is presented to a VA RR&D investigator who exemplifies the entrepreneurship, humanitarianism, and dedication to veterans displayed by Dr. Magnuson during his career.
“Dr. Morey’s research is a compelling example of blended clinical and research activities,” said Dr. Jean Beckham, co-chair for the research and development committee at the Durham VAMC. “Her clinical demonstration program, Gerofit, has provided robust improvements to aging Veterans by increasing their physical fitness, functional status, and well-being.”
Congratulations Miriam!

[Read award citation]

A Sample Of Duke Pepper Center Research Presentations at 2020 OAIC Nat'l Virtual Meeting
Heather Whitson, MD, MHS, Director of the Duke Center for the Study of Aging and Co-Leader of the Pilot/Exploratory Studies Core moderated a symposium on sensory loss and comorbidity. Presenters reviewed a sensory domain of health and its impact on aging outcomes and mechanisms, including suggestions for measures and biomarkers related to that domain.
A paper by Daniel Parker, MD on age-related adverse inflammatory and metabolic changes was included in a session on high-impact publications of 2019.

[Whitson presentation PDF]

[Parker presentation PDF]

Duke Pepper Center Researchers Rasheeda Hall, MD, MBA, MHS, and Barrett Bowling, MD, MSPH, Develop Discordant Index For Older Adults With Chronic Kidney Disease
Rasheeda Hall, MD, MBA, MHS, is the lead author of a recent retrospective cohort study to develop a CKD-Discordance Index using electronic health records to improve recognition of discordance. Discordant conditions are comorbid conditions such as heart failure, dementia, or cancer, with treatment recommendations that potentially complicate CKD management. This CKD-Discordance Index may prove to be useful in both population health management and clinical practice for identifying older adults with CKD-discordant conditions at increased risk for hospitalizations, ED visits, and mortality. C Barrett Bowling, MD, MSPH, Associate Professor of Medicine, is the senior author.

[Read article]

Duke Pepper Center Health and Mobility Measures Core Researcher, Charity Oyedeji, MD, Receives 2019 Maddox Award To Support Young Researchers
Charity Oyedeji, MD, is 1 of 2 Maddox Award winners for 2019. These prestigious annual awards support the academic endeavors of young and aspiring investigators. Dr Oyedeji is studying the relationship of biomarkers of inflammation, coagulation, and longevity to measures of resilience in older adults with sickle cell disease after hospitalization.
The award is named for the late Dr. George L. Maddox, a noted gerontologist and former director of Duke University’s Center for the Study of Aging and Human Development.

[View Dr Oyedeji’s Presentation at ASH Annual Meeting December 2019]

Duke Pepper Center Health and Mobility Measures Core Researcher, David Bartlett, PhD, Receives 2020 ASH Scholar Award by the American Society of Hematology (ASH)
David Bartlett, PhD, has been selected to receive a $150,000 clinical-junior-faculty-level 2020 ASH Scholar Award by the American Society of Hematology (ASH) to study the underlying mechanisms and clinical usefulness of exercise training on the immune system of older patients with chronic lymphocytic leukemia (CLL). These scholars conduct basic, translational, and clinical research that furthers the understanding and treatment of blood disorders.
Pilot Study Of Exercise Training For Older Vets with PTSD Shows Clinical Improvement Following Supervised Group-Based Exercise In Warrior Wellness Study By Duke Pepper Research Team BREAKING: Duke School Of Medicine News Article Features Author and Participant Interviews
Katherine S. Hall, PhD, and her colleagues published the results of the Warrior Wellness Study, a randomized controlled exercise trial for older veterans with PTSD. Clinically significant improvements in PTSD and related conditions were observed following exercise. This group-based exercise program could be expanded and implemented into clinical practice to improve post-traumatic resilience and achieve physical and psychological outcomes in older veterans.


[Journals of Gerontology: Series A article]

[Duke SOM News Article]

Duke Pepper Center Health and Mobility Measures Core Researcher, Amy Pastva, PT, MA, PhD, Named Assistant Director in Duke Health Center for Interprofessional Education and Care
Amy Pastva, PT, MA, PhD, has been named 1 of 4 Assistant Directors in the new Duke Health Center for Interprofessional Education and Care (aka IPEC Center). The ADs will work with the Center director, Mitch Heflin, the Advisory Committee, and their respective professions to continue the work of building the Center and its programs. Focus areas of the IPEC Center will include preclinical and clinical education, faculty development, evaluation and scholarship. Congratulations Amy!
Duke Pepper Researchers Part Of International Team To Find Association Between Slow Gait Speed At Age 45 And Measures of Accelerated Aging In Several Additional Domains of Function BREAKING: WRAL News 5 Story: Interview With First Author Line Rasmussen, PhD
Terrie Moffitt, PhD, Harvey Cohen, MD, and Miriam Morey, PhD, were part of an international team that found slower gait speed at age 45 is associated with smaller brain volume, older facial appearance, and poorer physical function, in addition to other measures of aging. Data from 904 participants in the Dunedin Study, a longitudinal cohort survey in New Zealand, also show that those with poor neurocognitive functioning as early as age 3 years had slower gait in midlife.
Stephanie Studenski, MD, MPH, discusses research implications and directions for clinical interventions based on these findings.

[JAMA Open Access PDF]

[Studenski Commentary]

[WRAL News 5 Story October 30, 2019]

New York Times Features Duke Pepper Center Researchers and 10-Year Legacy Effects of Exercise on Cardio-Metabolic Health Parameters
Duke Pepper researchers William Kraus, MD and Kim Huffman, MD, PhD, from the Molecular Measures Core, are among the authors of a study that looked at the legacy effects of exercise training interventions in participants from the STRRIDE (Studies Targeting Risk Reduction Interventions through Defined Exercise) protocol. Their research appears in the April issue of Frontiers of Physiology and was recently featured in the New York Times. Researchers found that vigorous intensity groups experienced less of a decrement in cardiorespiratory fitness than control or moderate intensity groups, and moderate intensity group members experienced the greatest 10-year reduction in fasting insulin and had greater reductions in mean arterial pressure. Their findings highlight the critical need to better understand the sustained legacy health effects of exercise training interventions.

[NY Times Article link]

[Frontiers in Physiology Article link]

[OVID link to original STRRIDE protocol]

Meaningful Change Estimates for the Late-Life Function and Disability Instrument (LLFDI) in Older Adults: An Exploratory Study
A team of university and VA GRECC researchers performed a secondary analysis of the Boston Rehabilitative Impairment Study of the Elderly (RISE) in order to estimate the minimal clinically important difference (MCID) of the Late-Life Function and Disability Instrument-Function Component (LLFDI-FC) and its subscales among community-dwelling older adults with mobility limitations. The LLFDI-FC is a patient-reported measure of function. The MCID for each LLFDI-FC scale over 1 year of follow-up was estimated by a variety of methods. These estimates can assist clinicians and researchers of functional disability in the elderly.

[Journal link]

Duke Pepper Center Researchers Investigate Quantitative Muscle Ultrasound (QMUS) as an Alternative Reliable, Inexpensive Method to Measure Muscle Health
Muscle health is recognized for its critical role in the functionality and well-being of older adults. Duke Pepper researchers Lisa Hobson-Webb, MD and Amy M. Pastva, PT, PhD, along with the director of the Michael W. Krzyzewski Human Performance Lab, Timothy Sell, PT, PhD, examined the reliability of quantitative muscle ultrasound (QMUS), standard electrical impedance myography (sEIM), and handheld electrical impedance myography (hEIM) measures of anterior thigh musculature in the December 2018 Special Issue of Geriatrics: Geriatric Assessment: Multidimensional, Multidisciplinary and Comprehensive. Multiple correlations with measures of strength and body composition were noted for each method. These point-of-care technologies may provide an alternative means of measuring health compared with more expensive traditional scan technologies.

[Journal link]

Duke Pepper Center Researcher Stresses the Importance of Stored Biospecimen Research As Complementary Investigative Path With Long-Term Clinical Trials on Human Healthspan
Duke Pepper researcher Daniel Belsky, PhD and Amal Harrati, PhD, a Stanford researcher, discuss the relevance of biospecimen research in their article, To the freezers! Stored biospecimens from human randomized trials are an important new direction for studies of biological aging, in the January 2019 issue of The Journals of Gerontology, Biological Sciences & Medical Sciences. Clinical trials testing effects on healthspan-relevant endpoints, like age-at-onset of chronic disease or disability, require many years or even decades of follow-up. While the field awaits a new generation of human trials of geroprotective therapies, analysis of stored biospecimens from now-completed studies can help test candidate surrogate endpoints in briefer research timeframes.

[Article link]

Duke Pepper Center Researchers Find Correlation Between Physical Activity and Physical Function in Persons 50 and Older Living With HIV/AIDS
Researchers from the Duke Pepper Center and the Duke Center for AIDS Research found that higher levels of physical activity were associated with better physical function in an older population of Persons Living with HIV/AIDS. This is believed to be the first study to examine these variables in this cohort. The researchers recommend that providers promote physical activity to improve physical performance in this population.

[Read more]

Duke Pepper Center Researchers Investigate Relationships of SES and Physical Functioning
Duke Pepper researchers, led by Grace Noppert, PhD, examined associations between multiple early and late life SES indicators with physical function. The research team discovered higher participant education and household income were associated with increased physical function. In an age-stratified analysis, SES disparities widened with increasing age among those in the two younger strata: lower SES was associated with worse physical function. Their findings highlight the significance of considering multiple dimensions of the social environment as important correlates of physical functioning over the life course.

[Article link]