Duke Pepper OAIC Leadership and Structure

The Leadership and Administrative Core (LAC) provides the scientific leadership and administrative infrastructure to create a robust environment for aging and geriatrics research in our theme:
To understand and optimize reserve and resilience

The Leadership and Administrative Core promotes the development of early investigators with interests in aging and geriatrics research and ensures the coordination, integration, funding, and translation of research within the Duke OAIC, a mission that supports our ultimate goal of improving the independence of older adults.

Core Leader:

Kenneth Schmader, MD
Professor of Medicine in the Division of Geriatrics

Dr Schmader’s primary area of research is herpes zoster and postherpetic neuralgia (PHN) and vaccines in older adults. He conducts pre-clinical, epidemiological and intervention studies of zoster and PHN, particularly with the zoster and influenza vaccines. He is involved with other adult vaccine development in older adults. With colleagues in the Division of Infectious Diseases, Dr. Schmader investigates other infections in older adults. Another major research focus is adverse drug reactions, medication prescribing and pharmacoepidemiology in the elderly. The objective of this work is to reduce adverse drug reactions, improve inappropriate prescribing and determine drug use patterns in older adults.

EXTERNAL ADVISORY BOARD:

• Karen Bandeen Roche, PhD Chair, Johns Hopkins Pepper OIAC

• George Kuchel, MD University of Connecticut

• Neil Alexander, MD Michigan Pepper OAIC

The Research Education Component (REC) recognizes that training in aging research faces several unique challenges, including difficulties recruiting geriatricians into research careers and a lack of training in the principles of aging research by other medical disciplines.

The objective of the Research Education Component is to develop the next generation of researchers who will become leaders in integrating basic science and clinical insights into innovative interventions promoting reserve and resilience in late life.  Every two years the REC releases a request for proposals and funds up to three promising Duke early-career investigators with Pepper Career Development Awards.

Core Leaders:

Cathleen Colón-Emeric, MD, MHS
Professor of Medicine and Chief of the Division of Geriatrics

Current research focuses on the epidemiology, prediction, and prevention of osteoporotic fractures in elderly persons, and in improving the quality of care delivered to residents in skilled nursing facilities. Ongoing projects include a large, administrative database study of osteoporosis screening in men, a randomized trial of different staff education strategies to improve fall prevention in nursing homes, and several clinical demonstration projects. In 2017, Dr Colón-Emeric received the Clinical Sciences Research Mentoring Award from the Department of Medicine, and in 2018 she was appointed Associate Dean for Research Mentoring for the School of Medicine.

Kimberly Johnson, MD
Professor of Medicine in the Division of Geriatrics

Dr Johnson leads the Duke Center for REsearch to AdvanCe Healthcare Equity (REACH), where researchers study the effect of a clinician communication coaching intervention—teaching empathic skills and eliciting participatory behaviors—on the quality of communication in cardiology encounters with African American patients; test the use of a mobile app for African American patients receiving palliative care in the ICU and their families to self-report needs, obtain information about patient/family needs, and access decisional support; and develop and pilot test an implicit bias training intervention for providers.

The overall objective of the Pilot/Exploratory Studies Core (PESC) of the Duke OAIC is to conduct pilot studies that inform the selection, design, and conduct of subsequent larger, hypothesis-driven research in our theme: To understand and optimize reserve and resilience. 

The Pilot/Exploratory Studies Core emphasizes physiological reserve at the cell/tissue/organ level, which we hypothesize is a key contributor to resilience at the whole person level.  Every two years the PESC releases a request for proposals and funds up to four Pepper Pilot Study Awards to Duke investigators to conduct innovative aging research in reserve and resilience.

Core Leaders:

Heather E. Whitson, MD, MHS
Professor of Medicine (Geriatrics) & Ophthalmology
Director, Duke Aging Center

Dr. Whitson’s research is focused on improving care and health outcomes for people with multiple chronic conditions. In particular, she has interest and expertise related to the link between changes in the eye and brain (e.g., Why do cognitive and brain changes occur in the context of late-life vision loss? Is Alzheimer’s Disease associated with distinctive changes in the retina, and could such changes help diagnose Alzheimer’s early in its course?). She has developed a novel rehabilitation model for people with co-existing cognitive deficits, and is part of an inter-disciplinary team seeking to improve peri-operative outcomes for frail or at-risk seniors who must undergo surgery. 

William E. Kraus, MD
Richard and Pat Johnson University Professor of Medicine
Director of Clinical Translation, DMPI

One focus of my group’s work is to understand the cellular signaling mechanisms underlying the normal adaptive responses of skeletal muscle to physiologic stimuli, such as occur in exercise conditioning, and to understand the abnormal maladaptive responses that occur in response to pathophysiologic stimuli, such as occur in congestive heart failure, aging and prolonged exposure to microgravity. Recently we have begun to investigate interactions of genes and lifestyle interventions on cardiometabolic outcomes. We have experience with clinical lifestyle intervention studies, particularly the contributions of genetic variants to interventions responses. We call this Lifestyle Medicopharmacogenetics. Dr Kraus served as President of the American College of Sports Medicine for the 2019-2020 term.

Molecular profiling can uniquely discover biomarkers, and predict and monitor traits and processes to understand and optimize reserve and resilience

The goal of the Molecular Measures Core (MMC) is to promote an understanding of the means to optimize whole person reserve and resilience through analyses of molecular factors indicative of cellular and tissue level ability to withstand and recover from stressors. The Molecular Measures Core complements the whole person level analyses offered through the Health and Mobility Measures Core and is inter-dependent with the Analysis Core, which is responsible for statistical analysis and modeling of data generated by the Health and Mobility Measures Core and Molecular Measures Core.

The Molecular Measures Core has extensive molecular profiling capabilities including among others, inflammatory, metabolic, tissue matrix, genetic and genomic analyses. The Molecular Measures Core operates in the DMPI Metabolomics Lab and has capabilities to expand and adapt existing core capabilities to facilitate the many needs of the novel investigator-initiated research projects affiliated with our Duke OAIC.

In addition to providing ongoing collaboration and support to the Pepper Career Development Awardees and the Pepper Pilot Study Awardees, the MMC contributes to externally funded projects such as the MURDOCK Study, The Dunedin Study, CALERIE, EPESE, and DDYNAMO.

CORE LEADERS

Virginia Byers Kraus, MD, PhD
Mary Bernheim Distinguished Professor of Medicine, Adjunct Professor of Pathology and Orthopaedics
Founding member: Duke Molecular Physiology Institute
My career has focused on discovery and validation of biomarkers of ageing and arthritis. I am trained as a molecular biologist and rheumatologist. I have been in charge for over 10 years of overseeing the inflammatory markers and metabolomics work for the aging related Pepper Center projects at Duke. This has led to a close working relationship with the collaborating researchers making up the Duke OAIC Pepper Research team.

James Bain, PhD
Associate Professor of Medicine
Founding member: Duke Molecular Physiology Institute
I focus on small-molecule phenotyping via mass spectrometry. Since its founding in 2003, our Metabolomics Laboratory has maintained a strong focus on diabetes, obesity, cardiovascular disease, and related conditions. We are especially interested in the perturbations in metabolic homeostasis that can occur early and late in the lifespan. In more than ten years of our close collaboration with the Duke OAIC Pepper Center, we have enjoyed working closely with early-career gerontologists and clinical geriatricians on their research projects.

The Health and Mobility Measures Core serves as the central resource for Center investigators seeking advice, training, laboratory access, and equipment for valid, sensitive, and reliable measures. The Health and Mobility Measures Core provides highly integrated, customized support to investigators supported by our Research Education Component, Pilot/Exploratory Studies Core, Externally Funded Projects, and the larger Duke Community engaged by the Duke Older Americans Independence Center.

The HMC aims to provide:

1. Expertise and Consultation: To provide centralized expertise available for consultation on the measurement of reserve and resilience
2. Development and Standardization: To develop measurement protocols and train personnel in administration and data collection
3. Innovation and Standardization: To identify gaps in resiliency measures and develop or adapt innovative new measurement approaches across the adult lifespan for related outcomes

CORE LEADERS

Katherine S. Hall, PhD
Associate Professor of Medicine in the Division of Geriatrics, Duke Pepper Scholar, and Investigator in Durham VA GRECC

My research is focused on developing evidence-based physical activity interventions for older adults with an eye to preserving functional independence and quality of life. I am particularly interested in developing exercise programs to promote physical and psychological well-being among older veterans with posttraumatic stress disorder (PTSD).

Amy Pastva, PT, MA, PhD, CHSE
Assistant Professor of Physical Therapy, Medicine, Cell Biology, and Population Health Sciences

Dr. Pastva’s research focuses on care transition and physical rehabilitative interventions for medically-complex and older adult populations, especially those with living with cardiovascular and pulmonary diseases and/or surviving critical illness.

The Analysis Core provides specialized expertise developing design, collecting and managing data, and providing and developing analytic methodology. The Analysis Core promotes novel lines of research by developing new methods specifically targeted to detect and measure reserve and resilience. Finally, the Analysis Core supports training objectives by developing fellow and faculty understanding of biostatistics and research methodology—critical areas of the research enterprise that are typically a knowledge gap in basic, translational, and clinical researchers.

The Analysis Core works closely with other components of the Duke OIAC to achieve shared goals. The Analysis Core collaborates with the two Resource Cores (Molecular Measures Core (MMC) and Health and Mobility Measures Core (HMC)) to manage the data and perform planned analyses. The Analysis Core collaborates within the OAIC investigators to direct study design and analysis, insuring that studies are properly powered and able to address their research questions, and, is positioned to expand these studies to evaluate additional or emerging hypotheses, including those that support methodologic investigations in statistical science, a unique goal of this Core.

CORE LEADERS

Sarah Peskoe
Professor of Biostatistics & Bioinformatics