Pittsburgh OAIC Overview - Claude D Pepper Older Americans

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Pittsburgh Claude D. Pepper
Older Americans
Independence Center
May 2013
Mission
Structure
Activities
Accomplishments
Pittsburgh OAIC Mission
Promote independence in older adults through
multidisciplinary research on mobility, balance and aging.
Our long term goal is to develop new preventive and
therapeutic interventions to promote balance and mobility,
reduce falls and prevent fall injuries.
Our research ranges from molecules to societies but focuses
on human studies of mechanisms and clinical
interventions.
Goals for our second five years
1) increase understanding of central nervous system alterations that,
with aging, affect sensorimotor function and cause problems with
balance and mobility
2) make progress toward a better understanding of how cellular injury
and repair in multiple organ systems may affect balance and
mobility in older persons and how these mechanisms can be
targeted for interventions that promote mobility and balance
3) develop new imaging and biomechanical techniques for
assessing mobility and balance in ecological conditions, such
as during weight bearing activities
4) produce a cadre of new independently funded investigators that
are able to lead multidisciplinary teams to study mobility and
balance in older persons from a multidisciplinary perspective.
The Pittsburgh OAIC Structure
Research Resource cores
Clinical/Population Research Core
Technology Core
Data Management and Analysis Core
Research Career Development Core
Pilot/Exploratory Studies Core
Leadership/Administrative Core
We promote research through support for
Novel multidisciplinary pilot studies that can lead to new independent research
Innovative and useful new research resources
Career development for high potential young investigators at every level
Spontaneous topically oriented work groups
Seminars and retreats to develop new initiatives
New partnerships with other programs
Leadership Team
Studenski P30 PI, Core Leader LAC and PEC (Medicine, SPH, Allied
Health, Nursing)
Newman P30 coPI, (SPH, Medicine)
Greenspan Core Director RCDC (Medicine)
Rosano Core Director, Clinical and Population Research Core (SPH)
Albert CPRC co-I for Registry and Advisory Board (SPH)
Goodpaster Core Director Tech Core (Medicine)
Aizenstein co-I for neuroimaging (Medicine, Engineering)
Sparto co-I for biomechanics (Allied Health)
Perera Core Director DMAC (Medicine)
Rubio co-Core Director DMAC (Medicine)
The Pittsburgh Pepper Center
Human Mobility and Balance
Clinical and Biomechanical
Mechanisms
Sensory
CNS
Effectors
Vision
Vestibular
Somatosensation
Sensory integration,
Motor control
Cognition, Attention
Affect, Anxiety,
Experience, Pain
Muscle
Endurance
Bones and
Joints
Animal and in
vitro models:
genetics and epigenetics,
vascular injury,
degenerative processes
signal transmission, growth
and repair processes
Interventions
Prevention
Treatment
Systems of Care
Consequences: falls, injury, disability, utilization
Clinical and Population Research Core
(CPRC)
Goal: promote human studies research in older populations
Primary recruitment: searchable Research Registry of over 2500 older
volunteers- used by over 50 independent studies
Secondary data analysis:
Participating studies: ongoing or completed studies willing to
consider additional data collection and/or analyses
Public Use Datasets: MCBS, NHIS
Community input and feedback:
Community Advisory Board
CDC Center for Healthy Aging
Long Term Care Network
Partnership with CTSI community core
Clinical Measure expertise and development
The SMART Center
• SMART Center (Senior Mobility and Aging Research and
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Training): 5000 sq ft with 180 foot oval track, 4 exam and
interview rooms, dedicated areas for gait and strength
assessment, conference room, offices and work spaces
Interventions: exercise
Clinical assessments
Low tech resources (gait mats, dynamometers,
accelerometers…)
Collaboration with the Center for Aging and Public
Health to support the LIFE study (Newman)
Technology Core
Goal: Provides access and expertise to
complex tools and methods relevant to
mobility and balance
RT SIGNAL
Human Movement Analysis Laboratory:
Cham
Medical Virtual Reality Center: Sparto
Jordan Balance Disorders Center: Furman
Magnetic Resonance Imaging Center:
Aizenstein, Erikson
Near infrared spectroscopy-Huppert
Body composition/energy metabolismGoodpaster
Core supports over half of Pepper pilot
studies
Has or is supporting over 30 independently
funded studies
EAR INSERT
SAFETY
HARNESS
RT BUTTON
FORCE
PLATES
Data Management and Analysis Core in
partnership with the Pitt CTSI
Data management
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Development of forms and databases
Development of data dictionaries and codebooks
Train project staff on data quality
Data entry
Entry verification and data editing
Tracking
Data manipulation and archiving
Confidentiality and security of data
• NEW: data warehouse for merging long term care data sources
Analysis
• Methodological and statistical consultations
• Data analysis
• Psychometric evaluation
• Signal processing and interpretation
DMAC provides preaward statistical planning to 10-20 proposals per year,
has or is supporting most pilot studies and over 50 funded grants
Research Career Development Core
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Novice
Pepper Scholar
Transition to Independence (K awardees)
Visiting Scholars
• Biweekly seminar series: driven by trainees-
works in progress(grants, manuscripts),
toolboxes
• Small pilot program exclusively for RCDC
members
Recent RCDC members
* funded as pepper scholar ** received RCDC pilot funds
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* ** Erikson (PhD Psychologist): R01 “Influence of Physical Activity and
Weight Loss on brain plasticity”
* **Hile (PhD Physical Therapist): Komen Foundation “Balance after
neurotoxic chemotherapy”
* ** Marcum (Pharm D) LRP “Medication adherence during care transitions”
* ** Nadkarni: (MD PhD geriatrician) Hartford Foundation “Effect of multiple
neuropathologies on dual task performance”
** Coen (PhD Exercise physiologist) K08 “Ceramide Mediated Oxidative
Stress in Muscle Loss with Aging and Disuse".
* ** Huppert (PhD engineering) 2 R01s related to NIRS development
*Schneider (PhD Physical Therapist) K99/R00, PCORI “rehab approaches to
lumbar stenosis”
* ** VanLonden (MD geriatrics) KL2 (CTSI) “Effect of aromatase inhibitors on
physical and cognitive function”
*Campbell (PhD nursing) F31 “Executive function and falls after stroke”
*Jain (MD PhD Neurology) K23 “Autonomic dysfunction in Parkinsons
disease”
*Ambrosio (PhD Physical Therapy) K01 “Electrical Stimulation reverses the
effect of age on skeletal muscle regeneration”
LAC
• Seminars: highlighting work of potential
partners
• Retreats: used to develop and advance
multidisciplinary topical workgroups
• Workgroups
 Neuroimaging applications for movement
 Energetics
 Neural adaptation/motor learning
 Building Pepper Research in Vulnerable Populations “LTC”
 Emerging Core: Translational Biology of Aging
Pilot/Exploratory Studies Core
• Preliminary studies by senior and junior investigators,
preference for multidisciplinary teams, engaging new
with established Pepper Investigators
• Supplements to ongoing studies
• Innovative techniques and methods
• Structures for promotion, review, award and monitoring
• Recent focus on supporting progress of workgroups and
new partnerships
Accomplishments
Publications: 325 citations in PubMed, 191 from
2010-present
New funding: 16 new externally funded research
grants since 2010, of which 4 are career awards
Clinical trials: Newman: LIFE-M and ASPREE,
Albert: CDC falls, Erikson: obesity, exercise and
the brain, Handler: AHRQ adverse drug events
in LTC
New Independent Funding 2010-preset
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Albert: CDC falls prevention in Pa.
DeVallejo: Immunity and health aging
Fisher: Insulin-like signaling on muscle in C Elegans
Goodpaster: Skeletal muscle lipid and insulin resistance in aging R01
renewal
Handler: R01 Adverse drug events in nursing homes
Hanlon: R01 antihypertensives and geriatric syndromes
Huard: R21 Muscle Stem Cell aging in a mouse model of premature aging
Loughlin: R03 vibrotactile feedback
Morone R01 Effectiveness of a Mind Body Program for Older Adults with
chronic low back pain
Newman: R01 CHS allstars renewal, CDC Healthy Aging renewal
Redfern: R01 postural control and attention renewal
Rosano: R01 Resilience to mobility impairment, R01 imaging in accelerated
aging of DM, U13 CNS mobility 3 year conference grant
Schlenk: R01 promoting PA in Older adults with comorbidity
Studenski: sarcopenia FNIH and U13 conference grant
Building Bridges to our peers in the Biology
of Aging
• P01 on DNA repair and NF kB score 13
• Bret Goodpaster leads multidisciplinary group
promoting collaborations around translational
biology of aging seminar
• UPMC has committed to 600k in pilot funding
• Recent Pepper pilots promoting further bridge
building
Leadership Transition
Susan Greenspan will take over PI role
during 2013
Anne Newman will remain active and
highly involved co-PI
Thank You!!
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