Pittsburgh Claude D. Pepper Pittsburgh Claude D. Pepper Older Americans Independence Older Americans Independence

CenterCenter

May 2013

Mission StructureActivities

Accomplishments

Pittsburgh OAIC Mission Pittsburgh OAIC Mission

Promote independence in older adults through Promote independence in older adults through multidisciplinary research on mobility, balance and aging.multidisciplinary research on mobility, balance and aging.

Our long term goal is to develop new preventive and Our long term goal is to develop new preventive and therapeutic interventions to promote balance and mobility, therapeutic interventions to promote balance and mobility, reduce falls and prevent fall injuries.reduce falls and prevent fall injuries.

Our research ranges from molecules to societies but focuses Our research ranges from molecules to societies but focuses on human studies of mechanisms and clinical on human studies of mechanisms and clinical interventions.interventions.

Goals for our second five yearsGoals for our second five years

1) 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 StructureThe Pittsburgh OAIC StructureResearch Resource cores Research Resource cores

Clinical/Population Research CoreClinical/Population Research Core

Technology CoreTechnology Core

Data Management and Analysis CoreData Management and Analysis Core

Research Career Development CoreResearch Career Development Core

Pilot/Exploratory Studies CorePilot/Exploratory Studies Core

Leadership/Administrative CoreLeadership/Administrative Core

We promote research through support for We promote research through support for Novel multidisciplinary pilot studies that can lead to new independent research Novel multidisciplinary pilot studies that can lead to new independent research

Innovative and useful new research resourcesInnovative and useful new research resources

Career development for high potential young investigators at every level Career development for high potential young investigators at every level

Spontaneous topically oriented work groupsSpontaneous topically oriented work groups

Seminars and retreats to develop new initiativesSeminars and retreats to develop new initiatives

New partnerships with other programs New partnerships with other programs

Leadership Team Leadership Team Studenski P30 PI, Core Leader LAC and PEC (Medicine, SPH, Allied Health, Studenski P30 PI, Core Leader LAC and PEC (Medicine, SPH, Allied Health, Nursing)Nursing)

Newman P30 coPI, (SPH, Medicine)Newman P30 coPI, (SPH, Medicine)

Greenspan Core Director RCDC (Medicine)Greenspan Core Director RCDC (Medicine)

Rosano Core Director, Clinical and Population Research Core (SPH)Rosano Core Director, Clinical and Population Research Core (SPH)Albert CPRC co-I for Registry and Advisory Board (SPH) Albert CPRC co-I for Registry and Advisory Board (SPH)

Goodpaster Core Director Tech Core (Medicine)Goodpaster Core Director Tech Core (Medicine)Aizenstein co-I for neuroimaging (Medicine, Engineering)Aizenstein co-I for neuroimaging (Medicine, Engineering)Sparto co-I for biomechanics (Allied Health) Sparto co-I for biomechanics (Allied Health)

Perera Core Director DMAC (Medicine)Perera Core Director DMAC (Medicine)Rubio co-Core Director DMAC (Medicine)Rubio co-Core Director DMAC (Medicine)

Human Mobility and BalanceClinical and Biomechanical

CNSSensory integration, Motor controlCognition, AttentionAffect, Anxiety, Experience, Pain

SensoryVisionVestibularSomatosensation

EffectorsMuscle EnduranceBones and Joints

Animal and in vitro models: genetics and epigenetics, vascular injury, degenerative processessignal transmission, growth and repair processes

Consequences: falls, injury, disability, utilization

InterventionsPreventionTreatmentSystems of Care

The Pittsburgh Pepper CenterThe Pittsburgh Pepper Center

Mechanisms

Clinical and Population Research Core Clinical and Population Research Core (CPRC)(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, NHISCommunity 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 CenterThe 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 CoreTechnology CoreGoal: Provides access and expertise to

complex tools and methods relevant to mobility and balance

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 metabolism- Goodpaster

Core supports over half of Pepper pilot studies

Has or is supporting over 30 independently funded studies

FORCE PLATES

RT SIGNAL

RT BUTTON

SAFETY HARNESS

EAR INSERT

Data Management and Analysis Core in Data Management and Analysis Core in partnership with the Pitt CTSIpartnership 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 CoreResearch 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 Recent RCDC members

** funded as pepper scholar ** received RCDC pilot funds 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”

LACLAC• 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 CorePilot/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

AccomplishmentsAccomplishments

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-presetNew Independent Funding 2010-preset

Albert: CDC falls prevention in Pa.Albert: CDC falls prevention in Pa. DeVallejo: Immunity and health agingDeVallejo: Immunity and health aging Fisher: Insulin-like signaling on muscle in C ElegansFisher: Insulin-like signaling on muscle in C Elegans Goodpaster: Skeletal muscle lipid and insulin resistance in aging R01 renewal Goodpaster: Skeletal muscle lipid and insulin resistance in aging R01 renewal Handler: R01 Adverse drug events in nursing homesHandler: R01 Adverse drug events in nursing homes Hanlon: R01 antihypertensives and geriatric syndromesHanlon: R01 antihypertensives and geriatric syndromes Huard: R21 Muscle Stem Cell aging in a mouse model of premature agingHuard: R21 Muscle Stem Cell aging in a mouse model of premature aging Loughlin: R03 vibrotactile feedbackLoughlin: R03 vibrotactile feedback Morone R01 Effectiveness of a Mind Body Program for Older Adults with chronic low Morone R01 Effectiveness of a Mind Body Program for Older Adults with chronic low

back painback pain Newman: R01 CHS allstars renewal, CDC Healthy Aging renewalNewman: R01 CHS allstars renewal, CDC Healthy Aging renewal Redfern: R01 postural control and attention renewalRedfern: R01 postural control and attention renewal Rosano: R01 Resilience to mobility impairment, R01 imaging in accelerated aging of Rosano: R01 Resilience to mobility impairment, R01 imaging in accelerated aging of

DM, U13 CNS mobility 3 year conference grantDM, U13 CNS mobility 3 year conference grant Schlenk: R01 promoting PA in Older adults with comorbiditySchlenk: R01 promoting PA in Older adults with comorbidity Studenski: sarcopenia FNIH and U13 conference grant Studenski: sarcopenia FNIH and U13 conference grant

Building Bridges to our peers in the Biology Building Bridges to our peers in the Biology of Aging of Aging

• P01 on DNA repair and NF kB score 13P01 on DNA repair and NF kB score 13• Bret Goodpaster leads multidisciplinary group Bret Goodpaster leads multidisciplinary group

promoting collaborations around translational promoting collaborations around translational biology of aging seminar biology of aging seminar

• UPMC has committed to 600k in pilot funding UPMC has committed to 600k in pilot funding • Recent Pepper pilots promoting further bridge Recent Pepper pilots promoting further bridge

building building

Leadership TransitionLeadership 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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