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 • • • • 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 • • • • • • • • 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 • • • • 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 • • • • • • • • • • • * ** 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 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!! Questions Comments