To understand and optimize reserve and resilience
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), Physical Measures Core (PMC), and Analysis Core (AC).
AIMS of the Duke Pepper Center
- To better understand and optimize reserve and resilience in older adults through an integrated research program.
- To develop and evaluate new methods that advance the study of reserve and resilience.
- To identify and develop the next generation of researchers who will become leaders in aging and geriatrics research related to the Duke OAIC focus.
- 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.
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.
Duke Pepper Center Physical Measures Core (PMC) Co-Leader, Katherine S Hall, PhD Inducted In 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 Physical Measures Core (PMC) 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.”
[Read award citation]
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.
Duke Pepper Center Physical Measures Core (PMC) 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 Physical Measures Core (PMC) 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.
Data Integration Working Group (DIWG) Monthly (Cancelled until Summer 2020)
The Duke Pepper Data Integration Working Group meets the 4th Thursday of each month. 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.
: Thursdays, 9:30-11:00am
: Conference Room 3512 Blue Zone, Duke Clinics
Charlotte Observer Article Features Duke Pepper Center Research in MURDOCK Study
The Charlotte Observer recently featured the Duke Pepper Center’s PALS (Physical Performance Across the Life-Span) study in an in-depth article about the broader MURDOCK Study and the North Carolina Research Campus
in Kannapolis, NC. A video accompanying the article illustrates some of the physical skills tests for participants and features a 97-year old woman who did 11 sit-to-stands in 30 seconds!
Duke Pepper Center Physical Measures Core Actigraphy Workshop Attracts Researchers Across The School Of Medicine For Insights Into Activity Measurement In Older Adults
Participants from various disciplines in the School of Medicine gathered in Trent Semans CHE to learn more about outcome selection and data processing as Katherine Hall, PhD, from the Duke Pepper Center Physical Measures Core led a hands-on workshop for clinical researchers interested in using the Actigraph-TM- accelerometer, a specific brand of research-grade device, to assess physical activity in older populations.
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 Physical Measures Core (PMC) 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]
[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.
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.
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.
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.
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.