MEDICARE-BASED MULTIMORBIDITY INDEX FOR PROJECTING MORBIDITY AND MORTALITY AMONG OLDER ADULTS IN THE U.S

Dr. Whitson is a geriatrician, memory care specialist, and clinical researcher.  Her career is focused on improving care options and resilience for people with multiple chronic conditions.  In particular, she has interest and expertise related to how aging biology and comorbidities impact brain health and risk for Alzheimer's disease. She is co-director of the Duke/UNC Alzheimer's Disease Research Center (Duke/UNC ADRC), which aims to transform dementia care and research in Eastern North Carolina while developing novel preventions and treatment strategies for Alzheimer's disease by identifying aging-related factors across the lifespan that drive risk, progression, or experience of dementia. The Duke/UNC ADRC conducts the Memory and Aging Study, which is tracking brain and cognitive changes in over 400 individuals at risk for dementia in later life.  Dr. Whitson also co-Chairs the Alzheimer's Association's Clinical Practice Guideline panel for the use of blood-based biomarkers in the diagnosis of Alzheimer's disease. As a thought leader in a national collaborative focused on the biomedical aspects of resilience, Dr. Whitson seeks to better understand biological, psychological, and contextual factors that determine how well we "bounce back" after acute health stressors and why our resilience capacity changes with age. Dr. Whitson has contributed to work examining resilience to many types of health stressors, including surgery, dialysis, infection, vascular events, and vision loss - often focused on how these stressors affect the brain.  She has led multiple studies to examine how the aging brain responds to the late-life stressor of vision loss, and she has developed a rehabilitation model to improve independence in older adults living with comorbid impairments in vision and cognition. 

Dr. Cohen's research program includes clinical research relating to aspects of the pathways to functional decline and reilience with aging, geriatric assessment, and cancer and anemia in the elderly.

Pathways to functional decline are being explored through the NIA funded Claude Pepper Older Americans Independence Center, and includes studies of the contributions of age related physiologic change, in particular changes in inflammatory parameters, comorbid diseases and conditions, environment, genetics, and the interactionas among them. Data are derived from several current studies as well as previously collected data sets from the Established Populations for Epidemiologic Studies of the Elderly (EPESE), National Long Term Care Survey, and the Chinese Longevity Study (with Dr. Zeng Yi). Previous work has demonstrated the important contributions of age related inflammation and coagulation activation to functional status. He is Co-PI of the Pepper Center Physical Performance Across the LifeSpan (PALS) study, which is a longitudinal cohort study of community dwelling adults from age 30-90+and includes functional measures and biomarkers on inflammation and metabolism.
 
Geriatric assessment approaches have been studied in a number of randomized and controlled studies and work is now concentrating on the application of Comprehensive Geriatric Assessment tools to the evaluation and treatment of elderly patients with cancer. This is an extension and continuation of a long standing interest in geriatric oncology. Previous studies have elucidated age-related patterns of disease presentation, treatment approaches, clinical trials, survivorship, quality of life, impact of comrobidities and functional outcomes. Dr. Cohen was co-chair, and now member of the Cancer in the Older Adult Committee of the Alliance for Clinical Trials in Oncology (ALLIANCE). A number of active studies and ongoing data bases aree being utilized to address these questions.


Anemia in the older adult is being addressed through an NIA funded U01 consortium (Dr. Cohen Co-PI). the current main study is an observational study followed by a pragmatic treatment trial for anemia in older adults with CHF, in collaboration with the Cardiovascular Research Network (CVRN) of the Health services research network (HSRN) 

Dr. Ukraintseva studies the causes of human aging and the associated decline in whole-body resilience, with the goal of identifying genetic and other factors that drive this decline and contribute to the age-related increase in all-cause mortality risk, ultimately limiting longevity even in individuals without major diseases. She also investigates the “multi-hit” mechanism of Alzheimer’s disease and the complex, including trade‑off–like, relationships between Alzheimer’s disease and cancer. She actively explores the role of infectious diseases and compromised immunity in Alzheimer’s development, as well as the interplay between vaccines and genetic factors, to advance personalized vaccine repurposing for AD prevention. To address these questions, Dr. Ukraintseva and her team analyze large human datasets containing comprehensive information on millions of individuals. She is a PI and key investigator on several NIH-funded grants and has authored more than 150 peer‑reviewed publications, including in major journals such as JAMA, Nature group journals, Stroke, Alzheimer’s & Dementia, and others.

Konstantin G. Arbeev received the M.S. degree in Applied Mathematics from Moscow State University (branch in Ulyanovsk, Russia) in 1995 and the Ph.D. degree in Mathematics and Physics (specialization in Theoretical Foundations of Mathematical Modeling, Numerical Methods and Programming) from Ulyanovsk State University (Russia) in 1999. He was a post-doctoral fellow in Max Planck Institute for Demographic Research in Rostock (Germany) before moving to Duke University in 2004 to work as a Research Scientist and a Senior Research Scientist in the Department of Sociology and the Social Science Research Institute (SSRI).  He is currently an Associate Research Professor in SSRI. Dr. Arbeev's major research interests are related to three interconnected fields of biodemography, biostatistics and genetic epidemiology as pertains to research on aging. The focus of his research is on discovering genetic and non-genetic factors that can affect the process of aging and determine longevity and healthy lifespan. He is interested in both methodological advances in this research area as well as their practical applications to analyses of large-scale longitudinal studies with phenotypic, genetic and, recently, genomic information. Dr. Arbeev authored and co-authored more than 150 peer-reviewed publications in these areas.