Epidemiologic Research

Dynamics of Health, Aging, and Body Composition (Health ABC, NIA N01AG62101), PI: Anne Newman MD MPH. Two field center, observational cohort study focusing on prevention of weight change, sarcopenia and disability in older adults ongoing since 1996.
The Health, Aging and Body Composition Study is an interdisciplinary study focused on risk factors for the decline of function in healthier older persons, particularly change in body composition with age.  The study was designed to address differences in onset of functional limitation, disability and longevity between older men and women as well as between Blacks and Whites.

 

https://healthabc.nia.nih.gov/

 

  • Vitamin D, falls, fractures, and function in community- dwelling older adults (NIA R01AG029364/ WFUHS11200/Kritchevsky), PI: Jane Cauley DrPH. The goal of the project is to advance our understanding of the role of Vitamin D in function and bone health by measuring circulating 25(OH) D and parathyroid hormone levels in archived samples from the Health ABC study in a cohort of black and white, well-functioning, community-dwelling men and women aged 70-79.
  • Peripheral Nerve Function Decline in an Aged Cohort (NIA R01AG028050), PI: Elsa Strotmeyer PhD MPH. This study will determine the declines in peripheral sensory and motor nerve function over seven years in older white and black adults in the Health, Aging and Body Composition (Health ABC) Study cohort, the risk factors for these declines, and if the rate of decline is prospectively related to rate of recurrent falls and a decline in self-reported walking ability over two years.
  • Peripheral nerve decline: an underappreciated cause of injurious falls (NIA R01AG028050), PI: Elsa Strotmeyer PhD MPH. This renewal ancillary study to the Health Aging Body Composition Study (Health ABC) is designed to define for the first time the clinical outcomes of poor peripheral nerve function including fall injuries requiring medical care, fractures, medical utilization, expenditures, and mortality in older adults.
  • Novel Brain Neuroimaging Markers of Age-Related Mobility Impairment (Healthy Brain Project, NIA K23AG028966), PI: Caterina Rosano MD MPH. The study aims are to identify the earliest structural white matter (WM) and gray matter (GM) changes associated with unexplained age-related mobility impairment, to examine the spatial and temporal relationship of WM and GM subclinical abnormalities in mobility-related areas, and to identify the possible causes and risk factors of such brain abnormalities.
  • Brain Anatomical Correlates of Mobility Control in the Oldest Old (NINDS R01AG029232), PI: Caterina Rosano MD MPH. This longitudinal epidemiological research project will investigate the association of focal brain magnetic resonance imaging (MRI) abnormalities with changes over time in age-related mobility impairment that are not associated with specific neurological diseases, such as strokes or Parkinson’s disease.
  • Resilience to Mobility Impairment: Neural Correlates and Protective Factors (NIA R01AG037451), PI: Caterina Rosano MD MPH. This is a longitudinal neuroepidemiological study to identify the brain characteristics and risk factors of older adults who have maintained good mobility in the face of substantial structural brain abnormalities.
  • Racial Disparities in Older Adults: Impact of Medicare Part D (NIA R01AG034056), PI: Joseph Hanlon PharmD MS. The long-term objective of this study is to reduce racial disparities in health outcomes by examining the impact of this policy intervention of increasing prescription drug coverage among the elderly.
  • Impact of Medicare Part D on Racial Disparities in Diabetes Treatment and Outcome (AHRQ R01HS017695), PI: Julie Donohue PhD. The long-term objective of this study is to reduce racial/ethnic disparities in health by examining the impact of changes in insurance coverage among the elderly.
  •  End of Life in the Very Old (NINR R01NR012459), PIs: Steven Albert PhD MSPH, June Lunney PhD. The goal of the proposed study is to provide information on a broad- based sample of elders aged 85+ in order to improve care at the end of life in advanced age. We propose to continue follow- up of participants in the Health ABC over an additional 3 years.

 

Cardiovascular Health Study (CHS, NHLBI N01HC85082), PI: Lewis Kuller MD DrPH. CHS is a four field center, observational cohort study currently in year 30 examining the incidence and natural history of coronary heart disease and stroke, dementia, physical function, and mortality.

The Cardiovascular Health Study (CHS) was initiated by the National Heart, Lung and Blood Institute (NHLBI) in 1987 to determine the risk factors for development and progression of cardiovascular disease (CVD) in older adults, with an emphasis on subclinical measures. The study recruited 5,888 adults aged 65 or older at entry in four U.S. communities and conducted extensive annual clinical exams between 1989-1999 along with semi-annual phone calls, events adjudication, and subsequent data analyses and publications. Additional data were collected by studies ancillary to CHS. With the exception of annual clinic visits, these activities are still ongoing.

 

 

https://chs-nhlbi.org/CHSOverview

 

  • Exceptional Aging: 12 Year Trajectories to Function (CHS All Stars, NIA R01AG023629), PI: Anne Newman MD MPH. This study of functional aging, or disability-free survival, examines the long-term survivors of the Cardiovascular Health Study to determine the likelihood of maintaining function, identify the trajectories that distinguish those destined to do well, and define the importance, independence and interactions of physiologic predictors of function.
  • CHS Events Follow Up Study (U Wash U01HL080295), PI: Lewis Kuller MD DrPH. This study designed to continue events follow-up for the Cardiovascular Health Study for cardiovascular and cerebrovascular morbidity and mortality.
  • Predictors of Alzheimer’s Disease in Mild Cognitive Impairment (CHS Memory, NIA R01AG020098), PI: Lewis Kuller MD DrPH. This is a longitudinal ancillary study of at- risk individuals who have been identified from the Cardiovascular Health Study based on the presence of mild cognitive impairment to determine the possibility of identification of those with the highest risk to develop Alzheimer’s disease.
  • Predictors of Alzheimer’s Disease in Mild Cognitive Impairment (CHS Memory II, NIA R01AG020098), PI: Oscar Lopez MD. The goals of this study are to examine the natural history of AD in the Pittsburgh CHS Memory I study, from a normal cognitive state to dementia onset, with especial emphasis on the transitional phase Mild Cognitive Impairment, including repeat MRI and cognitive testing.
  • The Sleep Heart Health Study (NHLBI U01HL077813), PI: Anne B. Newman MD MPH. This is a longitudinal multi-center cohort study including the CHS cohort that began in 1994 to determine the cardiovascular consequences of sleep disordered breathing including mortality and morbidity follow-up of the cohort.
  • Does Kidney Function Determine Aging Success (NIA R01AG027002), PI: Linda Fried MD MPH. This grant is an ancillary study to the Cardiovascular Health Study to evaluate whether kidney function predicts successful aging and changes in risk factors associated with successful aging.

 

Clinical Trial/Observational Study of Women’s Health Initiative (WHI, NHLBI N01WH32112), PI: Lewis Kuller MD DrPH. Regional center extension follow up of clinical events in participants from both the clinical trial and observational study arms of WHI examining the primary outcomes of post-menopausal women including cardiovascular disease, osteoporotic fractures and female cancers, as well as dementia.
The Women’s Health Initiative (WHI) is a long-term national health study that has focused on strategies for preventing heart disease, breast and colorectal cancer, and osteoporotic fractures in postmenopausal women. These chronic diseases are the major causes of death, disability, and frailty in older women of all races and socioeconomic backgrounds.

 

https://www.whi.org/about/SitePages/About%20WHI.aspx

 

  • Hormone Therapy, Estrogen Metabolism and Risk in WHI (NHLBI N01WH74320), PI: Lewis Kuller MD DrPH. This contract has been awarded under a program to maximize the scientific yield from the biologic resource and associated participant exposure and outcome data in the Women’s Health Initiative (WHI), with the objective to elucidate whether differences in estrogen metabolism in untreated women and women on estrogen therapy determine risk of hip fracture and breast cancer.
  • Women’s Health Initiative – The Memory Study (WHIMS, WFU N01WH44221), PI: Lewis Kuller MD DrPH. This is a subcontract for participation in an ancillary study to the Women’s Health Initiative focusing on dementia, mild cognitive impairment, and global cognitive function in women who participated in the estrogen + progesterone or estrogen-alone hormone treatment trials. The purpose is to determine if taking hormones prevents dementia or slows the decline of cognitive function.
  • Biochemical Antecedents of Fracture in Minority Women (NHLBI N01WH74318), PI: Jane Cauley DrPH. This study is designed to maximize the scientific yield from the biologic resource and associated participant exposure and outcome data in the Women’s Health Initiative (WHI), through improved understanding of the biochemical factors that predict the risk of fracture in minority women and to test whether these factors are independent of other risk factors such as body weight, smoking, and physical activity.
  • Anemia and Its Relationship with Sarcopenia and Mortality (U AZ Y481844), PI: Jane Cauley DrPH. This is a subcontract for participation in an ancillary study to the Women’s Health Initiative focusing on anemia. Measurements of body composition are examined in order to investigate the association of anemia with skeletal muscle loss.
  • Estradiol, Cytokines and Bone Turnover: Effect on Fracture (NIAMS R01AR052105), PI: Jane Cauley DrPH. This is a case-cohort study of sex steroid hormones, Vitamin D, cytokines and bone turnover in relationship to hip fracture in two cohorts (SOF and WHI).
Study of Osteoporotic Fractures (SOF, NIA R01AG027576), PI: Jane Cauley DrPH. Conducted at four clinical centers, this is a twenty year observation cohort of originally 9,704 women focused on osteoporotic fractures and successful aging.

The multi-center Study of Osteoporotic Fractures (SOF) has 20 years of prospective data about osteoporosis that has served as the basis for many findings about osteoporosis and aging in women ≥ age 65. In addition to adjudication of fractures, SOF has tracked cases of incident breast cancer, and total and cause-specific mortality. The data include serial measures of bone mineral density, measurements of sex and calcitropic hormones, tests of strength and function, cognitive exams, sleep measurements, use of medication, health habits and much more. Most data are available in the current release.

 

https://sofonline.epi-ucsf.org/interface/

 

  • Health Decline in Aged Caregivers: An Epidemiologic Study (BU 442407160), PI: Jane Cauley DrPH. This is an ancillary study to the Study of Osteoporotic Fractures comparing change in physical health between caregivers and non-caregivers and comparing the effects of factors directly and indirectly associated with caregiving on change in physical health.
  • Change in Sleep and Cognition in Older Women (Cal Pac Med Ctr 2803212), PI: Jane Cauley DrPH. This is an ancillary study to the Study of Osteoporotic Fractures as a clinical site for collection of data and health outcomes for a project focusing on the longitudinal relationships of sleep and cognitive function in older women.

 

Osteoporotic Fractures in Men (MrOS) (NIAMS U01 AR045654), PI: Jane Cauley DrPH. Six clinical center observational cohort study focused on identifying potentially modifiable risk factors for osteoporotic fractures, neuromuscular function and falls in older men.

MrOS, a research study funded by the National Institutes of Health, began in 2000. Six clinical centers in the United States, located in Birmingham, AL; Minneapolis, MN; Palo Alto, CA; the Monogohela Valley near Pittsburgh, PA; Portland, OR; and San Diego, CA recruited 5,994 men at the baseline visit (2000 -2002). The baseline examination included the assessment of risk factors for fractures and other conditions, including neuromuscular, visual and cognitive function tests; bone mineral density (BMD); x-rays of the spine; QCT scans of the hip and spine and the collection of biospecimens.

https://mrosdata.sfcc-cpmc.net/

Study of Women’s Health Across the Nations (SWAN, NIA U01AG012553), PI: Karen Matthews PhD. The Study of Women’s Health Across the Nation (SWAN) is a multicenter, multiethnic, community based longitudinal study designed to characterize the biological, symptomatic and psychosocial changes that occur during the menopausal transition and the effects of these changes on women’s health during and after the transition.

The Study of Women’s Health Across the Nation (SWAN) is a multi-site longitudinal, epidemiologic study designed to examine the health of women during their middle years. The study examines the physical, biological, psychological and social changes during this transitional period.

 

http://www.swanstudy.org/

 

  • Hip Strength Across the Menopausal Transition (NIA R01AG026463), PI: Jane Cauley DrPH. This is an ancillary study to the Study of Women’s Health Across the Nation (SWAN), using archived hip DXA scans and data collected annually from the SWAN cohort to analyze measures of hip geometry and strength.
(NIA U01AG023744), PI: Anne Newman MD MPH. Exceptionally long lived and healthy older adults and their families will be examined to determine the combined genetic and environmental factors contributing to longevity in families at 4 field centers in the US and Europe.
The goal of the LONG LIFE Family Study (LLFS) is to answer an important question:  Why do some people and their families live very long lives? LLFS is a unique international project that is studying families who have several members reaching a very old age.  Families from the United States and Denmark will help us learn why some people live until a very old age and why some families maintain their health far longer than the average family. By sharing information about your life and family with us, you can help improve the health of future generations, including your own children and grandchildren.  What we learn from this study also can help older people in the future maintain their health and well-being.

https://longlifefamilystudy.wustl.edu/LLFS/Home.html

 

 

(NIAMS P60AR054731), PI: Jane Cauley DrPH. The Osteoarthritis Initiative (OAI) is a multi-center, longitudinal, prospective observational study of knee osteoarthritis to facilitate the scientific evaluation of biomarkers for osteoarthritis as potential surrogate endpoints for disease onset and progression.

The Osteoarthritis Initiative (OAI) is a multi-center, longitudinal, prospective observational study of knee osteoarthritis (OA). The overall aim of the OAI is to develop a public domain research resource to facilitate the scientific evaluation of biomarkers for osteoarthritis as potential surrogate endpoints for disease onset and progression.

https://oai.epi-ucsf.org/datarelease/default.asp

(NIA U01AG029824), PI: Anne Newman MD MPH. This is a randomized double-blind placebo-controlled trial of aspirin in primary prevention in healthy elderly people aged 65/70 years and over, designed to determine whether low dose aspirin will extend the duration of disability- free life in an aging population. The study will examine whether the potential benefits of this drug (particularly the prevention of heart disease, stroke and vascular dementia) outweigh the risks of severe bleeding in this age group.

ASPREE is the largest primary prevention aspirin study ever undertaken in healthy older people. It will determine whether daily low-dose aspirin prevents or delays the onset of age-related illness such as cardiovascular disease (heart attack and stroke), dementia, depression and certain cancers and if the benefits outweigh the risks, such as bleeding.

https://aspree.org/aus/

(U01 AG050499), PI: Anne Newman MD MPH. This randomized clinical trial will test the ability of anti-inflammatory interventions for preventing major mobility disability by improving or preserving walking ability. Specifically, in this trial we test the efficacy vs. placebo of the angiotensin receptor blocker losartan and omega-3 polyunsaturated fatty acids in the form of fish oil, alone and in combination.

ENRGISE addresses critical public health issues regarding mobility disability prevention. We test the anti-inflammatory effects of widely available inexpensive interventions and their impact on mobility in a highly vulnerable population of older adults at risk of mobility disability.

https://www.enrgisestudy.org/

(NIA 2U01AG022376), PI: Anne Newman MD MPH. LIFE is a Phase 3, single-masked multicenter randomized controlled trial to compare a moderate-intensity physical activity program to a successful aging health education program in sedentary older persons who are at risk of disability. The trial will provide definitive evidence regarding whether physical activity is effective and practical for preventing major mobility disability.

Based upon promising results from a pilot study among 424 sedentary older adults who were randomized to a physical activity intervention or a successful aging health education intervention, a Phase 3 multi-center randomized controlled trial is being conducted to compare a moderate-intensity physical activity program to a successful aging health education program in 1,600 sedentary older adults who are followed for an average of 2.7 years.

The primary aim is to assess the long-term effects of the proposed interventions on the primary outcome of major mobility disability, defined as inability to walk 400 m.

Secondary aims focus on assessing the relative effects of the interventions on the following outcomes: cognitive function; serious fall injuries; persistent mobility disability; the combined outcome of major mobility disability or death; disability in activities of daily living; cardiovascular and pulmonary events; and cost-effectiveness.

Tertiary aims relate to assessing the relative effects of the interventions on (a) the combined outcome of mild cognitive impairment or dementia and (b) physical performance within pre-specified subgroups defined on the basis of race, gender and baseline physical performance.

The proposed trial will provide definitive evidence regarding whether lifestyle modification interventions are effective and practical for preventing major mobility disability. Eight sites around the country participate in the LIFE study.

https://www.thelifestudy.org/public/index.cfm

(NIA RC2AG036594), PI: Anne Newman MD MPH. We hypothesize that decreased skeletal muscle mitochondrial capacity to generate energy plays a pivotal role in age-associated decline in mobility. To test this hypothesis, an interdisciplinary team will lead assessments and analyses of components of the ‘energetics system’ from muscle oxygen delivery to the energy efficiency of walking. These assessments include phosphorous spectroscopy for in-vivo muscle ATP generation, muscle biopsies with measurements of mitochondrial content and function, blood flow to the legs with exercise, and energy utilization during walking.

Study of Energy and Aging (SEA) is a cross-sectional, observational study of 38 men and women ages 70-89 years with a wide range of mobility, examined in 2011. To lay the foundations for future longitudinal studies of energy production, disability, and fatigue, SEA tested several novel measurements of mitochondrial function, in-vivo ATP production, and other standard myocellular features for correlations with mobility, exertional fatigue during walking, and leg muscle strength and mass and establish their intra-subject reproducibility. SEA also aimed to develop standardized procedures and quality control of these measurements for use in future longitudinal and multi-center studies, and SEA created a unique resource of muscle biopsy tissue in well-characterized elderly people. All subject recruitment and data collection occurred at the clinical center at the University of Pittsburgh. Nancy Glynn, PhD, an RCDC member is Co-Investigator on this trial.

PI: Anne Newman MD MPH. Our goal is to establish a longitudinal cohort study in India to define the prevalence, incidence and risk factors for disability and age-related disease and in the population of older adults (50+) in the Andhra Pradesh region near Hyderabad.
The increase in the older population is most rapid in developing countries and in the oldest old. There is a need for more detailed data on the prevalence and causes of disability in these countries and also an opportunity to better understand the causes and consequences of disease by examining cross-cultural differences. The Indian population is not well described, but evidence suggests that the current demographic transition provides a unique opportunity to better understand the potential for future disability. Our goal is to establish a longitudinal cohort study in India to define the prevalence, incidence and risk factors for disability and age-related disease in the population of older adults (60+) in the Telangana region near Hyderabad.

http://sharefoundations.org/Projects/MILES/index.htm

 

(NIA 1U01AG030644), PI: Jane Cauley DrPH. The Testosterone trial is a randomized trial in hypogonadal men designed to test whether testosterone treatment results in improved physical and sexual function and vitality in older men, with secondary endpoints of cognition and coronary calcification.

The Testosterone Trial is a clinical research trial to determine if testosterone treatment of men aged 65 and older will help their walking, vitality, sexual function, memory, bone density, blood count, and cardiovascular risk. This trial, called The Testosterone Trial, or TTrial, will be conducted in 800 men in 12 cities across the United States. The overall goal of The Testosterone Trial is to test the hypothesis that testosterone treatment, compared to placebo treatment, of men who are 65 years or older and have unequivocally low serum testosterone concentrations will improve their physical function, sexual function, vitality, cognitive function, and low hemoglobin concentration, as well as decrease risk factors for cardiovascular and diabetes. Dr. Greenspan is a co-investigator in this trial along with the site-PI, Dr. Jane Cauley. Many of the outcomes, including the Bone Trial will be a rich source of data for our investigators.

(NIA 5P01AG025204), PI: William Klunk MD PhD, Co-I Oscar Lopez MD and Lewis Kuller MD DrPH. The overall objective of this proposal is to define amyloid deposition in early phases of AD and aid in the characterization of PIB as a surrogate marker of amyloid deposition by examining PIB retention and other metabolic and structural makers. Two of the three studies that are part of this program project grant will continue follow up of participants in the GEM Study who underwent PiB imaging in the final year of the trial.
(NIA R03AG025076), PI: Caterina Rosano MD MPH. The goal of this project is to identify and quantify specific neuroimaging markers of Alzheimer Disease (AD) using an automated brain MRI reading technique, the automated labeling pathway (ALP).
(NHLBI R01HL70301), PI: Anne Newman MD MPH. As an ancillary study to the Look AHEAD Study, this research is designed to determine the efficacy of a weight loss program in reducing sleep disordered breathing (SDB) in obese type 2 diabetics with obstructive sleep apnea (OSA), identify sources of variability in SDB associated with weight loss, and examine the role of SDB in mediating changes in blood pressure associated with weight loss.

(NIAMS 1RC1AR058162), PI: Jane Cauley DrPH. This proposed study will provide the research community with novel understanding toward the etiology of osteoporosis, especially in older men. It also opens a new opportunity for prevention and/or treatment of osteoporosis and osteoporotic fractures among at-risk populations.

(NIDDK 5R01DK089028), PI: Caterina Rosano MD MPH. Brain changes are common in persons with Type 1 Diabetes (T1D) and they are strikingly similar to abnormalities observed in older adults. We propose to characterize the nature of accelerated brain aging in T1D (cerebral perfusion, neural activation and micro-structure level) and identify their determinants.
(CDC NCCDPHP 1U48DP002657), PI: Steven Albert PhD MSPH. This study is a randomized controlled trial involving the Pennsylvania Department of Aging’s Healthy Steps and Healthy Steps in Motion programs to examine their effect on risk of falls over 12 months.
(Novartis CZOL446H2301), PI: Jane Cauley DrPH. This is a multicenter, double-blind, randomized, placebo- controlled study to evaluate the safety and efficacy of zoledronic acid in the treatment of osteoporosis in postmenopausal women taking calcium and vitamin D.

University of Pittsburgh
Center for Aging and Population Health
130 N Bellefield Ave
Pittsburgh, PA 15213

 CHA@edc.pitt.edu