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Claude D. Pepper Older Americans Independence Center (OAIC)

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
  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.
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]

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!

[Read more]

Duke Pepper Center Molecular Measures Core Co-Leader Receives Honorary Doctorate
Virginia Kraus, MD, PhD, Professor of Medicine and Orthopedic Surgery, was awarded an honorary doctorate of the Faculty of Medicine and Life Sciences at the University of Tampere in Finland in August 2018. Dr Kraus also received a special hat and sword to protect the truth of science.
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.
Dr Kraus was also recognized for her mentorship to the next generation of researchers. She knows a few words in Finnish as a result of spending time in Finland as an exchange student.

[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]

Duke Pepper Center Physical Measures Core Co-Leader Investigates Benefits of Exercise in Older Vets with PTSD
Katherine S. Hall, PhD, Assistant Professor in the Division of Geriatrics, is launching a pilot study to learn if increased physical activity among older Vets with PTSD will help ease their symptoms. Veterans with PTSD have been shown to have low rates of exercise, and many report that they don’t work out at all. The heart of the study is a supervised 12-week exercise plan called the “Warrior Wellness” program. It consists of activities focusing on strength, flexibility, balance, and endurance training. Part of what makes the program special is its extensive exercise battery that can be adapted to individual musculoskeletal ailments.

[Read more]

Data Integration Working Group (DIWG) Semi-monthly (2nd and 4th Thursdays)
The Duke Pepper Data Integration Working Group meets the 2nd and 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.
When: Thursday Dec 13th, 9:30-11:00am
Where: Learning Lab 1502 Blue Zone, Duke Clinics
Topic: Bill Kraus, MD will discuss the recently released Physical Activity Guidelines for Americans (2nd ed) and share details about the process of developing a scientific report that serves as the basis for guidelines developed by the US Government.
Click here to learn more about the guidelines. He’ll also talk about a recent report on NPR about how lifetime exercisers feel like one is 40 when one is 70.
Looking Ahead: Dec 27th: TBA
Pepper Researcher Receives NIH Grant To Lead the Duke Center for REsearch to AdvanCe Healthcare Equity (REACH)
Kimberly Johnson, MD, has received one of 12 NIH awards to fund a specialized research center designed to conduct multidisciplinary research, research training and community engagement activities focused on improving minority health and reducing health disparities.
Dr Johnson also received funding from the Patient-Centered Outcomes Research Institute (PCORI) to study the barriers and facilitators of advance-care planning for different racial groups: Reducing Disparities in the Quality of Palliative Care for Older African Americans through Improved Advance Care Planning (EQUAL ACP).

[Duke Medicine News story]

Duke Pepper Center Researcher Receives K23 Funding
Richard Lee, MD, Assistant Professor of Medicine in Endocrinology, Metabolism, and Nutrition, and a former Duke Pepper Center Scholar, received an award (1K23-AG058797-01) from the National Institutes of Health for a project entitled “Metabolomic & Radiographic Markers of Fracture Risk among Older Adults with Diabetes.” Total funding, announced in April 2018, will be $541,667.
Duke Pepper Center Core Leaders Receive Leadership and Research Honors
Cathleen Colón-Emeric, MD, MHS, Co-Leader of the Research Education Component of the Duke Pepper Center, has been appointed associate dean for research mentoring for the School of Medicine. Dr. Colon-Emeric will lead two existing grant programs, the K-Club (to assist faculty writing career development awards) and the Path to Independence Program (to assist faculty writing their first R-grant).
Kenneth Schmader, MD, Director of the Leadership and Administration Core, is the 2018 recipient of the American Society for Clinical Pharmacology and Therapeutics William B. Abrams Award in Geriatric Clinical Pharmacology. The award recognizes scientists who have improved clinical care or therapies for older adults through research and honors an investigator in geriatric clinical pharmacology for outstanding contributions to the field.
Duke Pepper Center hosts Spring 2018 workshop: Physical Function Assessment in Older Adults
The Duke Pepper Physical Measures Core hosted a half-day workshop in May which highlighted functional assessments that can be utilized across the continuum of functional ability and implemented across a variety of settings (e.g., resource-rich vs. resource-limited, outpatient vs. inpatient). Participants came from several departments within the School of Medicine and the Health System to gain more knowledge and practical expertise in the implementation of performance-based measures of physical function in research.
Duke Pepper Center Research Posters at the 2018 Pepper OAIC Annual Meeting
An Innovative Approach to Building Posttraumatic Resilience in Late Life: The Warrior Wellness Exercise Study for Older Veterans with PTSD Poster Presentation Award
Katherine S. Hall, PhD, and her colleagues summarized the current status of the Warrior Wellness Study, a randomized controlled exercise trial for older veterans with PTSD. If the Warrior Wellness intervention is found to be effective at helping older veterans with PTSD improve resilience and achieve physical and psychological outcomes, this group-based exercise program could be expanded and implemented into clinical practice.
Age-Related Adverse Inflammatory and Metabolic Changes Begin Early in Adulthood
Daniel Parker, MD, and his team presented cross-sectional data which demonstrate the onset – as early as the fourth decade of age – of abnormalities of immune and metabolic biomarkers known to be associated with impaired physical function, morbidity, and mortality in older adults.
Macrophage-induced Meteorin-like secretion: A potential regenerative therapy for aging muscle
James P. White, PhD, and a research team across institutions presented studies that identified Meteorin-like (Metrnl) as a critical regulator in muscle regeneration and a viable therapeutic to enhance regeneration in aged muscle.
Duke Pepper Center Research Selected as Editor's Choice in Journals of Gerontology, Biological Sciences & Medical Sciences Special Edition On Caloric Restriction and the Biology of Aging
Duke Pepper researchers Daniel Belsky, PhD, Kim Huffman, MD, PhD, Carl Pieper, DrPH, and William Kraus, MD are among the co-authors of the Editor’s Choice selection in the January 2018 issue of The Journals of Gerontology, Biological Sciences & Medical Sciences, which focuses on Caloric Restriction and the Biology of Aging. Their article, Change in the Rate of Biological Aging in Response to Caloric Restriction: CALERIE Biobank Analysis, is a retrospective examination of data from the National Institute on Aging CALERIE randomized trial. Their analysis across 3 time points found that caloric restriction slowed biological aging as measured by Klemera–Doubal Method Biological Age and homeostatic dysregulation.

[Article link]

Pepper Researcher Receives OREF MTF Research Grant To Enhance Integrative Meniscus Repair
Amy McNulty, PhD and William E. Garrett, Jr., MD, PhD, received a $98,000 OREF MTF Research Grant for their project entitled: Improving Meniscus Repair Using a Meniscus-derived Matrix Allograft.
The goal of their study is to generate a novel cell and allograft scaffold combination that will improve meniscus repair.
The research team will assess the therapeutic potential of different cell sources and mechanical loading for optimal repair.

[Duke Orthopedic Surgery News link]

Pepper Researcher Testifies on Nutrition & Aging Before US Senate Committee
Connie Bales, PhD, RN testified before the US Senate Special Committee on Aging in July 2017 on the association of proper nutrition with healthy aging. Two trends have combined to alter the profile of malnutrition in the elderly: the obesity epidemic and population aging.

[Read Transcript]

Duke Pepper Center Resilience Symposium at the 21st IAGG World Congress (San Francisco, CA)

Jack Rowe, IAGG President, extols the virtues of a Pepper Center symposium focused on resilience!

Left to right: Daniel Belsky, PhD – Duke Pepper Center presenter, Stephanie Studenski, MD, NIA – presenter,
Jack Rowe, MD, IAGG President, Cathleen Colon-Eméric, MD – Duke Pepper Center session Co-Chair,
Heather Whitson, MD – Duke Pepper Center session Co-Chair, Karen Bandeen Roche, PhD – Johns Hopkins Pepper Center – session Discussant, Kenneth Manning, MS, Durham VAMC – presenter, Janet Bettger, SCD, Duke Pepper Center presenter.

A Sample of Duke Pepper Center Research Presentations at IAGG 2017
    1. Researchers in the Physical Measures Core presented an overview and initial findings from The 6th Vital Sign: A Mobile App for Population Health Surveillance of Walking Speed. Walking speed is a more accurate predictor of life expectancy than age or gender.

      [View Slideshow]

    2. Cathleen Colón-Emeric, MD, presented Measuring Physical Resilence in Older Adults, which discussed definitions of resilience and challenges in its functional measurement.

      [View Slideshow]

    3. Nicki Hastings, MD, presented Association of Age with Patient Experience of Care in Medically Complex Veterans. For primary care recipients in the VA system, overall satisfaction with care differed by age, but assessment of quality of chronic illness care did not differ.

      [View Slideshow]

    4. Researchers from Duke Medical Center and the National University of Singapore collaborated on a presentation: Does Healthcare Complexity Relate to Lower Confidence or Non-adherence to Medication?: Analysis of SAFE-PHASE study.

      [View PDF]