Home » Diversity and Inclusion » Diversity Profile: Meet Our Researchers » Featured Researcher: Deborah Gold, PhD

Featured Researcher: Deborah Gold, PhD

deborah-goldNearly 30 years ago, my mentor, Bernice Neugarten, made one comment repeatedly: “If you want to continue in aging, you MUST go to Duke,” she intoned. Near the end of the dissertation process, I applied to the Duke Aging Center Postdoctoral Research Training Program, always intending to be in Durham for those two years and then return to Chicago. Somehow, that never happened!

Some say the weather kept me here; others believe it is the more sedate pace of life. But the truth is that I remained in Durham and at Duke because of one thing: The Duke Center for the Study of Aging and Human Development. The colleagues and potential collaborators associated with the Aging Center are the best in the world. In addition, a teacher for many years, I wanted to continue at some level. Coordinating the Aging Center Postdoc Program and directing the undergraduate Human Development Certificate allowed me to teach while doing research.  And although my aging interests predated my becoming a Senior Fellow in the Aging Center, the Duke Aging Center and its research was what enticed me to stay.

I arrived here after writing a dissertation on sibling relationships in late life and expected to continue that work. I did so, replicating my original study with an African-American sample and working with Max Woodbury to combine qualitative and quantitative analyses (Grade of Membership or GOM analysis) to see if there were identifiable types of sibling relationships. In fact, 5 of my first 7 publications focused on this topic.  But then an unexpected opportunity arose, and I followed a path that emphasized understanding the impact of chronic disease on older people’s biopsychosocial functioning.

This opportunity came from a program designed to diagnose and treat osteoporosis. At that point in chronological time, little was known about the disease and less about managing it. Physicians, physical therapists, and nutritionists worked with osteoporosis patients to improve their quality of life. At that time, no medication except estrogen was available to treat this devastating bone disease. Their work and the suffering of the women they saw fascinated me and the literature made clear that no research was focused on the non-skeletal outcomes of fractures. Since that time, I have done research on Parkinson’s disease, several types of cancer, Paget’s disease, syncope, dementia and even sickle cell disease,  but my intellectual curiosity and commitment have remained focused on osteoporosis.

My research began with a small study to determine whether having a mental health professional on the osteoporosis team would improve outcomes including pain, depression, and emotional functioning.  The data supported this hypothesis, and this and several other smaller projects led to a larger investigation of ways in which older women with osteoporosis could have improved quality of life through a multidisciplinary intervention of exercise and coping skills. Our longitudinal study showed that initial changes in psychological symptoms and back strength were positive, while longitudinally, only the psychological changes remained positive.

Interestingly, in the early years of this clinical trial, the first pharmacological treatment specifically for osteoporosis was released, changing the paradigm of care to include medication. Although my interests in quality of life and osteoporosis continued, I was intrigued by the sudden rush of medication interventions for bone health. Within a decade and a half, the FDA had approved 9 osteoporosis medications with differing effectiveness, delivery systems, and dosing intervals. I was fascinated by the fact that, despite this menu of options, osteoporosis patients had extraordinarily poor compliance and persistence with these medications. For the last 8 years, I have tried to identify why this is true while also evaluating interventions that might improve medication behaviors in osteoporosis patients.

My research and reading of the literature on aging has taught me much about how older people interact with their environments, especially those with chronic illness. The common stereotypes of older adults as depressed, senile, weak and helpless have been debunked by research that began with the Duke Longitudinal Studies in 1955 and has continued until now. The Duke Aging Center has led the nation in understanding the biopsychosocial issues related to aging and will continue to do so long after I have retired. It has been an honor to have spent my academic career there.

By the way, Neugarten was right. The Duke Aging Center is the place to go for research on aging.