Making the best days of our lives last longer
How UF is enhancing physical and cognitive abilities that decline with age
Dr. Marco Pahor is fighting a war on aging. Don’t get him wrong, though. Pahor, director of the UF Institute on Aging, doesn’t want to keep us from aging; he just wants to help us grow old — not gracefully — but actively.
“We want to prevent physical and cognitive decline and expand active life expectancy,” Pahor said of the interdisciplinary team of scientists, clinicians and researchers at the institute dedicated to unlocking the secrets of aging.
Marco Pahor, MD, director, Institute on Aging
Maria Belen Farias
The Institute on Aging has plenty of weapons in its research and clinical arsenal to support the university’s plan to become a national leader in the understanding of the aging process and diseases and conditions associated with growing older.
One of those weapons is its new home in the Clinical and Translational Research Building. The $45 million, 120,000-square-foot complex, which opened earlier this year, serves as a hub for activity that will speed scientific discoveries to patients by bringing together researchers from a range of disciplines. In addition to the Institute on Aging, the building houses the Clinical and Translational Science Institute and an array of other research departments and clinical programs, as well as state-of-the-art conference, training and reception areas.
Almost 40,000 square feet of the CTRB is dedicated to the Institute on Aging, which was funded under the American Recovery and Reinvestment Act of 2009 through a $15 million grant from the National Institutes of Health.
Scientists and physicians with the Institute on Aging are dedicated to achieving a better understanding of the biological mechanisms of aging and how we can maintain or enhance our physical and cognitive abilities.
Almost 40,000 square feet of the CTRB is dedicated to the Institute on Aging.
Maria Belen Farias
Here is a sample of the projects that will lead to new discoveries:
LIFE Study
Researchers from the Institute on Aging utilize the Health Promotion Center’s 200-foot indoor walking track for the LIFE Study to examine the effects of physical activity as they relate to aging. The HPC also features ballet-style bars for balance exercises, resistance training equipment and classroom space for health education group meetings.
Maria Belen Farias
Statistics from the Centers for Disease Control and Prevention show that Americans are living longer, with life expectancy continuing to increase from 78.6 in 2009 to 78.7 in 2010. In fact, life expectancy rose in just one year — from 78.6 in 2009 to 78.7 in 2010. To provide the keys to ensuring the years we gain are high quality and fruitful, the National Institute on Aging is funding a nationwide study to see whether behavioral and lifestyle interventions can help older adults retain their independence.
UF is the coordinating center for the Lifestyle Interventions and Independence for Elders (LIFE) Study and one of eight field sites. The phase 3 randomized control trial of 1,600 people ages 70 to 89 who are at risk of mobility disability is the largest study ever conducted on older adults comparing two lifestyle interventions — a physical activity program and a program of health education — to see which is more effective in maintaining mobility in older adults.
Researchers are examining the effects of physical activity on a number of factors, including cognitive function, serious fall injuries, disability in basic activities of daily living, cardiovascular events and hospitalization and nursing home admission. They will also examine quality-of-life measures such as depression symptoms, sleep quality, stress and satisfaction with life.
The four-year study concluded in November, and the results will be presented next spring. So far, the news is encouraging. The LIFE-Pilot study has shown that older sedentary adults can engage in active physical activity and that there are long-term positive effects of physical activity interventions on major mobility disability.
Learn more about the LIFE Study
Living with pain
For some, part of growing old is living with pain, and one area of research encompassed by CTSI is the newly formed Pain Research and Intervention Center of Excellence (PRICE). With strong support from the Institute on Aging and the UF Health Science Center, PRICE serves as the professional home for scientists, clinicians and trainees dedicated to improved understanding and treatment of pain. Under the direction of Roger Fillingim, PhD, a professor at the UF College of Dentistry, PRICE is focused on research to reduce pain-related suffering that afflicts about 100 million people in the U.S.
Healthy weight management
Dr. Stephen Anton, chief of clinical research in the department of aging and geriatric research at the College of Medicine, focuses his efforts on helping older overweight people increase and improve their mobility and eat a healthy diet. The obstacles are sometimes daunting. The participants in his study live in an environment that encourages the consumption of highly palatable foods that are high in fat and sugar and where they likely will not engage in physical activity throughout the day.
“As individuals engage in sedentary lifestyles and age, it becomes progressively more challenging to engage in a physical activity or an exercise regimen,” explained Anton, who leads the clinical research core for the Cognitive Aging and Memory Program as well as the Claude D. Pepper Older Americans Independence Center.
Someone who tries to go from being sedentary to becoming active often tends to overdo it. That can lead to injury or excessive soreness, quickly taking them from being highly motivated to very discouraged.
Still, there are many who recognize the stakes and meet the challenges. Through the results these people achieve, Anton and his fellow researchers have learned how great a difference these positive changes in lifestyle can make in people’s lives.
“We’ve seen when people engage in a progressive exercise program combined with a healthy diet they’re able to achieve many valuable changes in health-related quality of life,” Anton said. “Physically and cognitively they’re able to function at a high level. They feel better emotionally. Then those changes are reflected in the biology as well. So those are all encouraging changes. They see that when they do it, these types of outcomes are possible.”
Pepper Center
After its initial NIH grant in 2007 that established the Claude D. Pepper Older Americans Independence Center, the Institute on Aging was awarded in 2012 a multimillion-dollar, five-year grant that is expected to total $5.2 million in renewed support of the Pepper Center.
The Center focuses on understanding age-related muscle loss from different perspectives, and the potential role of skeletal muscle as a key target for therapies to counteract age-related damage to the body. The center also aims to train the next generation of academic and research leaders in the field of aging.
UF is one of 15 institutions in the nation to receive the award, which is named for the late Claude D. Pepper, a U.S. senator-turned-representative from Florida. Pepper advocated for the rights of the elderly.
Expanding its reach
Late last year, UF officially opened a new research and education center in Orlando that includes a 4,200-square-foot unit that gives the Institute on Aging the ability to reach beyond Gainesville to recruit study participants.
The UF Research and Academic Center at Lake Nona allows the Institute on Aging to involve larger numbers of people from a wider geographical radius, improving the quality of the resulting research data and the soundness of the study findings.
Five tips for doctors when caring for older patients
Provided by Donnie Batie, MD ’79, a geriatric specialist in Baton Rouge, La.
-
When caring for geriatric patients, remember they move much more slowly than young people, and mobility is important as they age.
-
It’s important to help them embrace having a caregiver — ideally someone who comes with them to their visits and oversees their care.
-
Encourage them to bring their medication everywhere they go.
-
Be sure to address cognitive impairments. As patients age, these impairments should be expected and addressed by both you and the patient.
-
Address end-of-life issues — make sure they express their wishes to the appropriate people. Examples of these issues are wills and life support.
Who will care for the aging population?
The UF College of Medicine and UF Health are working
hard to ensure the aging population is not ignored.
Under the leadership of Laurence Solberg, MD, the IOA is launching initiatives that will improve the quality of care for older adults within the UF Health system and surrounding communities.
Maria Belen Farias
“As the Baby Boomer generation expands the geriatric population, we are looking for different approaches to help them achieve healthy aging and care for them with respect and dignity,” said Laurence M. Solberg, MD, who was recently appointed chief of the division of geriatric medicine at the college.
With added services such as a geriatric consult service and the new Institute on Aging facility, UF Health continues to improve the quality of care for older adults.
In fact, UF Health Shands Hospital, which ranks among the nation’s 50 top hospitals in adult medical specialties according to U.S. News & World Report, is pioneering a new model of geriatric care.
“We are leading the nation in our effort to develop the embedded geriatrician,” Solberg said. “We have initiated this new model in the surgical intensive care units where the geriatrician rounds with the ICU teams, manages the chronic and acute medical issues of adults over 65 and educates the surgical teams about delirium and potentially inappropriate medications in the elderly.”
There are plans to duplicate the success of the embedded geriatrician in the emergency department, which will allow geriatricians to assist in the immediate assessment of older adults and avoid hospitalization.
Sorting out changes in the brain
People spend a lifetime building memories only to slowly watch them fade away with age.
It has become an accepted part of growing old. But does it really have to be?
Dr. Ronald Cohen doesn’t think so. As director of the UF Cognitive Aging and Memory Clinical Translational Research Program, Cohen has focused his research for many years on brain-related effects of diseases and conditions such as cardiovascular disease, HIV, hepatitis C and obesity.
When Cohen began looking at vascular dementia, which is caused by problems in the supply of blood to the brain, it quickly became clear to him that researchers needed to look back in time to earlier stages before people were no longer functionally independent. Cohen received grant money from the National Institutes of Health to look at vascular disease and other risk factors as well.
Ronald Cohen, PhD, is the director of the UF Cognitive Aging and Memory Clinical Translational Research Program and a professor of aging and geriatric research within the UF College of Medicine. His research interests include clinical and experimental neuropsychology, cognitive and clinical neuroscience and neuropsychology of attention.
Maria Belen Farias
As people age they often experience various comorbid conditions like heart disease that can set the stage for changes in the brain. As Cohen notes, not everyone who develops brain changes with aging has Alzheimer’s disease. There are other reasons why these changes can occur.
“Increasingly what became very clear was the process of aging, and things that go along with aging are really multi-dimensional,” said Cohen, who came to UF in July 2012 from Brown University. “There are a lot of different comorbidities and factors. So the broader phenomena of what is healthy and non-healthy brain aging became sort of a central theme in a lot of my research.”
While almost everyone experiences comorbid conditions such as blood pressure or vascular disease or diabetes, Cohen explained, there are many people who are quite healthy throughout their lives. Researchers are trying to answer many questions about what happens to the aging brain when these conditions exist or do not exist.
“What is normal aging? These are the kind of questions that we’re trying to sort out,” Cohen said. “We’re trying to understand the bases for age-related brain changes and age-related cognitive change.”
Cohen’s program is supported by the McKnight Brain Research Foundation and complements the ongoing basic science, clinical and translational research at the UF Institute on Aging and the McKnight Brain Institute of UF.
“Age-related decline in cognitive function — including changes in attention, memory, learning, executive function and language — is real and varies widely from one individual to the next, substantially influencing the quality of life, the character of personal relationships and the capacity for making informed decisions,” said J. Lee Dockery, MD, a trustee of the McKnight Brain Foundation and former interim dean and executive associate dean of the College of Medicine. “For these reason, age-related cognitive decline demands our attention and a continued, concerted research effort.”
