Director of the Center for the Study of Aging and Human Development
Box 3003, Duke University Medical Center
Durham NC, 27710
Phone: (919) 660-7502
Fax: (919) 684-8569
Dr. Cohen’s research program involves clinical research exploring overlapping aspects of geriatric assessment, cancer in the elderly and the mechanisms behind age-related functional decline, comorbidities and frailty.
GERIATRIC ASSESSMENT: This part of the program explores the outcomes to be derived from varying approaches to geriatric assessment. Utilizing specifically designed clinical trials we have studied geriatric consultation teams, inpatient geriatric evaluation units and outpatient geriatric clinics. We are particularly interested in functional and quality of life outcomes and also in relationship of such programs to drug prescribing appropriateness and related outcomes. Substantial data from completed studies are available for secondary analyses and prospective studies under consideration.
CANCER: BIOLOGIC BEHAVIOR AND TREATMENT IN THE ELDERLY: This program explores ways that neoplasia differs in clinical presentation, aggressiveness, management and outcome as a function of patient age; and the application of geriatric assessment approach, functional assessment and the use of quality of life measures in diagnosing, designing and evaluating treatment of the elderly cancer patient. Clinical trials of elderly cancer patients are performed with CALGB and local clinical oncology consortium, including pharmacokinetic studies of new agents. Secondary analysis of CALGB data and EPESE cancer and cancer prevention data are available.
BIOLOGIC UNDERPINNINGS OF FRAILTY: Utilizing clinical, functional biologic and demographic data from several epidemiological studies, e.g., EPESE, we are exploring the possible mechanisms by which frailty and its subsequent outcomes develop. The impact of multiple morbidities, physiologic decline and environmental influences on functional status is of particular interest. A major focus is the activation of inflammatory and coagulation pathways in this process. Additional prospective studies are in development.
Representative publications of his work:
- McVey LJ, Becker PM, Saltz CC, Feussner JR, Cohen HJ: Effect of a Geriatric Consultation Team on Functional Status of Elderly Hospitalized Patients. Annals of Internal Med 110(1):79-84, 1989.
- Cohen HJ, Saltz CC, Samsa G, McVey LJ, Davis D, and Feussner JR: Predictors of Two-Year Post- Hospitalization Mortality Among Elderly Veterans in a Study Evaluating a Geriatric Consultation Team. Journal of the American Geriatrics Society 40:1231-1235, 1992.
- Cohen HJ, Pieper CF, Harris T, Rao KMK, and Currie MS: The Association of Plasma IL-6 Levels with Functional Disability in Community-Dwelling Elderly. JG: Med Sci 52A(4):M201-M208,1997.
- Cohen HJ, Feussner JR, Weinberger M, Carnes M, Hamdy RC, Hsieh F, Phibbs C, Lavori P. A Controlled Trial of Inpatient and Outpatient Geriatric Evaluation and Management. NEJM 346(12): 905-912, 2002.
- Cohen HJ, Harris T, Pieper CF. Coagulation and Activation of Inflammatory Pathways in the Development of Functional Decline and Mortality in the Elderly. American Journal of Medicine 114(3): 180-187, 2003.
- Schmader EK, Hanlon JT, Pieper CF, Sloane R, Ruby CM, Twersky J, Francis SD, Branch LG, Lindblad CI, Artz M, Weinberger M, Feussner JR, and Cohen HJ: Effects of Geriatric Evaluation and Management on Adverse Drug Reactions and Suboptimal Prescribing in the Frail Elderly. Amer J Med 116:394-401, 2004.
- Rao AV, Hsieh F, Feussner JR, and Cohen HJ: Geriatric Evaluation and Management Units in the Care of the Frail Elderly Cancer Patient. Journal of Gerontology: Medical Sciences, 60A:6:798-803, 2005.
- Phibbs CS, Holty JC, Goldstein MK, Garber AM, Wang Y, Feussner JR, and Cohen HJ: The Effect of Geriatrics Evaluation and Management on Nursing Home Use and Health Care Costs: Results From a Randomized Trial. Medical Care, 44:1, 2006.
- Whitson HE, Purser JL, Cohen HJ.Frailty thy name is…phrailty? JGerontol A Biol Sci Jul;62(7), 2007. PMCID: PMC2648133
- Purser JL, Kuchibhatla MN, Miranda ML, Blazer DG, Cohen HJ, Fillenbaum GG. Geographical segregation and IL-6: a marker of chronic inflammation in older adults. Biomarkers Med; 2(4): 335-348, 2008. PMCID: PMC2719974
- Morey MC, Snyder DC, Sloane R, Cohen HJ, Hartman TJ, Miller P, Mitchell DC, Demark-Wahnefried W. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors. JAMA; 301: 1883-1891, 2009. PMCID: PMC2752421.
- Whitson HE, Sanders LL, Pieper CF, Morey MC, Oddone EZ, Gold DT, Cohen HJ. Correlation between Symptoms and Function in Older Adults with Comorbidity. J Am Geriatr Soc; 57: 676-682, 2009. PMCID: PMC2674624.
- Hurria A, Cirrincione CT, Muss HB, Kornblith AB, Barry W, Artz AS, Schmieder L, Ansari R, Tew WP, Weckstein D, Kirshner J, Togawa K, Hansen K, Katheria V, Stone R, Galinsky I, Postiglione J, Cohen HJ. Implementing a geriatric assessment in cooperative group clinical cancer trials: J Clin Oncol. 1;29(10):1290-1296,2011. PMCID: PMC3083997.
- Huffman K, Pieper C, Kraus V, Kraus WE, Fillenbaum G, Cohen HJ. Relations of a Marker of Endothelial Activation (s-VCAM) to function and Mortality in Community Dwelling Older Adults. Journal of Gerontology; 66(12):1369-1375, 2011. PMCID: PMC3210955.
- Lum H, Sloane R, Huffman KM, Kraus VB, Thompson DK, Kraus WE, Bain JR, Stevens RD, Pieper CF, Taylor GA, Newgard CB, Cohen HJ, Morey MC. Plasma acylcarnitines are associated with physical performance in elderly men. J Gerontol A Biol Sci Med Sci. 66(5) 548-53 2011. PMCID: PMC3074959