INNOVATIONS IN AGING

Aging Institute 2018 Annual Report Aging.UPMC.com 1

Aging Institute 2018 Annual Report “Of molecules, UPMC Senior Services & The University of Pittsburgh mice, and men.”

This trinity aptly summarizes the spectrum of discovery, testing, and life-changing applications that are the promised hallmark of the new Aging Institute of UPMC Senior Services and the University of Pittsburgh. Long recognized nationally as a pioneering force of excellence in geriatric care, the Aging Institute is now investigating the very fundamentals of aging under the leadership of its new director, Toren Finkel, MD, PhD, supported by a multi-million-dollar investment by UPMC and the University of Pittsburgh in new faculty and state-of-the-art research laboratories. In its new role, the Aging Institute will add a focus on the basic science of aging to its work, enabling it to address the entirety of the aging research spectrum. And by illuminating the root cause of the many diseases associated with aging — from cardiovascular disease, cancer, and neurodegenerative disorders — the Institute will begin addressing these diseases in their biological context. 2 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 3

Table of Contents

Aging Institute Connecting to the 8 Initiatives Community 40

Biology of Celebrating Aging Research 12 46 Senior Champions

Innovations Research of the Aging 18 in Research Institute’s Partners 48

Educational Initiatives in Leadership Aging Services 26 62 4 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 5

Steven D. Shapiro, MD, executive vice president, UPMC; Timothy Billiar, MD, Dear Colleagues and Friends, associate medical director, UPMC International and Commercial Services Division; Jeanne Cunicelli, executive vice president, UPMC Enterprises; It’s a rare day that I’m not reminded of what a privilege it is to work as a This charge for the Aging Institute will focus on the identification of biochemical Matthias Kleinz, DVM, PhD, senior director, UPMC Immune Transplant and researcher in the field of aging. If you love science as I do, you know it is pathways and therapies that target the process of aging, with the ultimate Therapy Center; Mark T. Gladwin, MD, Jack D. Myers Professor and Chair, a process both creative and profound. Even when we find ourselves most goal of extending health span and eliminating disease. A major focus of the Department of Medicine, University of Pittsburgh and Director, Pittsburgh challenged, there is still something intrinsically noble in the scientific search new Aging Institute will be the development of new drugs that will enhance Heart, Lung and Blood Vascular Medicine Institute. Christopher P. O’Donnell, for understanding and discovery. our fundamental resilience to age and preventing age-related complications PhD, executive vice chair of academic affairs, Department of Medicine, such as atherosclerosis, lung fibrosis, and neurodegenerative diseases. University of Pittsburgh; Deborah Brodine, president, UPMC Community I’ve come to feel that way even more as recent advancements in the biology Provider Services; Jeffrey A. Romoff, president and chief executive officer of of aging allow me and others in the field to dare to rationally think about ways we Highlights of the Aging Institute Laboratory’s new research agenda in 2018 include: UPMC; Arthur S. Levine, MD, senior vice chancellor for the health sciences can transform the aging process in humans. We are on the cusp of a tremendous and dean of the School of Medicine, University of Pittsburgh; Bruce R. Pitt, PhD, • Construction and opening of the new Aging Institute Laboratory at paradigm shift: By understanding how we age and translating it to new chairman of the Environmental and Occupational Health Department, University Bridgeside Point, featuring state-of-the-art laboratories dedicated to therapies, we have the potential to slow down the aging process and thereby of Pittsburgh; Diane Holder, executive vice president, UPMC, president, UPMC biological discovery in aging prevent, or even stop, a host of age-related complications and diseases. Insurance Services Division, and president and chief executive officer, UPMC • Recruitment of 10 gifted faculty investigators from within the University Health Plan; the deans of the University’s Schools of the Health Sciences: In September of 2017, these advancements led me to become part of the of Pittsburgh and leading institutions across the nation Bernard J. Costello, MD, DMD, School of Dental Medicine; Anthony Delitto, remarkable work of the Aging Institute of UPMC Senior Services and the • Securing more than $4 million in initial research funding from NIH and PhD, PT, FAPTA, School of Health and Rehabilitation Sciences; Donald Burke, MD, University of Pittsburgh. For many years, I served as a researcher at the private support, catalyzed by leadership funding from The Beckwith Institute Graduate School of Public Health; Jacqueline Dunbar-Jacob, PhD, School National Institutes of Health (NIH) in Bethesda, Maryland. It was a wonderful, of Nursing; Patricia Kroboth, PhD, School of Pharmacy; Ann E. Cudd, PhD, fascinating, and challenging place to work, and I’m grateful for the many • Initiation of a new drug discovery program provost and senior vice chancellor, University of Pittsburgh; and Elizabeth M. rewarding experiences I had there. And I am deeply honored that Anne Newman, MD, MPH, has agreed to serve Z. Farmer, PhD, dean of the School of Social Work. But given the explosive new growth occurring in the study of aging, the chance as the Institute’s new clinical director to assure the continued growth of its many In summary, may I say that those of us at the Aging Institute, in all our many to build a research laboratory from the ground up in Pittsburgh — one dedicated legacy programs that promote cross-disciplinary collaboration at the University capacities, recognize that working together we have the power to transform the to solving the chronic diseases of aging as part of the visionary new UPMC of Pittsburgh and UPMC. She also will be involved in the development and lives of older adults and our greater society at large. The year of 2018 has been Immune Transplant and Therapy Center — proved irresistible. It signals that testing of new therapies, joined by Daniel Forman, MD, the new director of ambitious, successful, and satisfying — an exciting portent of the life-changing aging as a field has sufficiently matured to the point that we can now seize the emerging therapeutics for the Institute. With their combined leadership and discoveries we hope to realize through our efforts. opportunity to address human aging in a new way. experience, we are well positioned to soon design and launch our own novel mechanistic trials. Sincerely, Much has happened during my first year here as we seek to continue and build upon the many strengths of the Aging Institute — from its rich and varied We are grateful every day for these new opportunities, made possible through education, community outreach, and practice initiatives focused on creating the counsel, support, and investment of many individuals and offices throughout new models of care for older adults, to its vital role as a convening mechanism for the University of Pittsburgh and UPMC. I would particularly like to extend our Toren Finkel, MD, PhD collaboration among the schools of health sciences at the University of Pittsburgh appreciation to the following: Director, Aging Institute of UPMC Senior Services and the University of Pittsburgh — while adding a new biology of aging research dimension to its mission. Professor of Medicine, Division of Cardiology, School of Medicine, University of Pittsburgh G. Nicholas Beckwith III and Dorothy B. Beckwith Inaugural Chair in Translational Medicine, University of Pittsburgh 6 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 7

“My own journey as a researcher has focused on understanding the reasons that cause loss of mobility in order to prevent disability and optimize health in old age,” notes Dr. Newman, who has led several seminal research studies, including two long-term projects on cardiovascular health and healthy aging Anne B. Newman, MD, MPH body composition. She has followed thousands of participants from the Clinical Director, Aging Institute of UPMC Senior Pittsburgh area for two to three decades to understand the health outcomes Services and the University of Pittsburgh of older adults. She also has conducted clinical trials testing lifestyle and Department Chair, Epidemiology, School of medications to improve health span. Most recently, she identified that the Public Health, University of Pittsburgh predictors on healthy aging include genetic and metabolomic signatures. Katherine M. Detre Endowed Chair, Population Health Sciences “I’m very excited to be part of the next phase of the Aging Institute’s evolution,” Director, Center for Aging and Population Health she says. “We are looking forward to continuing its initiatives in education and Professor, Epidemiology, Medicine, and Clinical training to foster best practice care, as well as its efforts promoting collegial, and Translational Science Institute multidisciplinary collaboration throughout UPMC and the University of Dr. Newman, a leading voice with the Aging Institute since its inception Pittsburgh, such as Research Day. The Institute promises to be a continuing more than a decade ago, now serves as its first clinical director. “With catalyst and community for academicians and researchers who truly care her exceptional knowledge and expertise in understanding what happens about older adults.” biologically as we age and how to maintain function and good health into old age, she is unquestionably the perfect person to lead the Aging Institute’s With the Institute’s new focus on the biology of aging, she also sees new clinical efforts and interventions,” says Dr. Finkel in announcing her appointment. opportunities to optimize health span. “We expect to increasingly look at approaches from a prevention orientation and consider the underlying drivers A renowned researcher in the field of epidemiology and public health, of conditions that require significant integrated health services,” she notes. Dr. Newman served for many years as a distinguished gerontologist and “For example, cardiovascular prevention is critical to optimizing health span. was the first geriatrics fellow at the University of Pittsburgh School of There is a tremendous capacity in older people to recover, respond, and Medicine. During her clinical career, she was staff physician at the highly improve their health, even after serious illness.” regarded UPMC Senior Care-Benedum Geriatrics Center, which offers primary ambulatory care services for older persons with complex problems. She also feels it is important for the Institute to support efforts to ensure that She also established the region’s first teaching nursing home, Canterbury the University’s centers of excellence that support aging remain vibrant and Place (now part of UPMC Senior Communities), as well as Longwood at well-funded. “They strengthen our work as a whole,” she notes. “My hope is Oakmont, a model continuing care community. that working together, we’ll make Pittsburgh the best place to grow old.” 8 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 9

Aging Institute Initiatives Since its inception, the Aging Institute has led collaborative initiatives through a variety of multidisciplinary teams targeting key health problems and wellness initiatives important to older adults. Drawing on the talents and insights of dedicated researchers, scientists, and administrators from the University of Pittsburgh and UPMC, these innovative collaborations have generated new knowledge and actionable solutions — and served as incubators for large-scale, externally funded research such as RAVEN. This year, the Healthy Brain Aging Initiative continued to explore new ways of delaying the e”ects of brain aging. 10 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 11

Healthy Brain Aging Initiative A Study in Contrasts: The Test Group vs. the appeared to get better at learning and memory,” public health significance if we can replicate these of Pittsburgh and his doctoral student Vineet Raghu, in a different way,” says Dr. Cameron.” In addition Is brain aging an inevitable reality that we all must Control Group says Meryl A. Butters, PhD, associate professor findings on a larger scale.” to apply a big data machine learning approach to to a traditional scientist-driven analysis, we’re “When we began the Initiative, we knew from of psychiatry and clinical and translational science this data. His lab specializes in causal inference adding a data-driven analysis that will yield one day face? Are there active steps we can take to Big Data: Bringing New Eyes earlier studies with primates that just being active protect our brains from — or at least delay — the at the University of Pittsburgh, who has led the to the Research Analysis algorithms that learn cause and effect associations statistical connections without imposing any improves brain health, so our clinical study with intrusive effects of aging? cognitive assessment of all participants at the start In 2018, the group turned to across mixed data types and build predictors. presumptive hypotheses.” humans was based on that of the study and its conclusion. Tests focused on Panagiotis (Takis) Benos, PhD, “The world’s top scientists have not yet been able “We will try to show unique associations in the Those questions have shaped the agenda of the basic science work,” says chair these five domains: professor of computational and to successfully find a biomarker for brain health. data by representing every variable as a node in a Aging Institute’s multidisciplinary Healthy Brain Judy L. Cameron, PhD, professor Language abilities systems biology at the University With this approach, we’re looking at the search graph, creating visual connections,” says Dr. Benos. Aging Initiative. Since 2013, its members have of psychiatry and director of the • “By showing what variables directly affect others, focused their efforts on assessing the impact of Pitt Science Outreach program • Visual/spatial abilities physical activity on the brain in hopes of developing it’s possible to build predictive models. This at the University of Pittsburgh. • Attention/processing speed preventative strategies linked to changes in lifestyle. approach will enable us to look at multiple data In all, 25 older adults aged 65-85 were recruited for • Memory/learning The Quest for Biomarkers: scales concurrently and identify the parameters Over the past five years, they have conducted both a human study conducted in 2015–16. • Executive function Proteins and Genes that are most related to the cognitive findings by animal and human studies, including: group and age.” • Test group participants were asked to build up In addition to the cognitive results, the Initiative has intensified its effort to identify biomarkers of The stretching control group improved in all three • Measurements of physical and cardiac fitness to 10-minute periods of moderate exercise, three the improvements they have seen in learning (in the control group) and executive function (in the Strength in Numbers areas — immediate learning, short-term recall, times a day, five days a week. exercise group). Dr. Cameron praised the commitment and diversity • Functional imaging to look at blood flow in the brain and long-term recall. Those results were confirmed of the members of the Initiative, which has grown • Proteomic analysis of the blood proteins and • Control group members were asked to simply by additional tests, demonstrating improvements “We’re trying to determine if increased exercise results in changes to the structure and functional in scale and scope over the last five years. “They gene expression profiling of blood cells stretch three times a day. in learning in the entire control group. activity of the brain, and if we can detect blood biomarkers that reflect these brain changes” represent a remarkable, interdisciplinary range of Both groups were given electronic tablets to explains Abbe N. de Vallejo, PhD, an immunologist at UPMC Children’s Hospital of Pittsburgh, • Neuropsychological and cognitive testing • “The exercise group also demonstrated skills and perspectives — from immunology, sports watch videos demonstrating their assigned who is leading this aspect of the research. “We can’t biopsy a living brain and brain imaging is improvements on multiple cognitive processes, medicine, psychiatry, cognitive neuroscience, In June 2018, the first paper to come out of the workouts, and all engaged in socialization very expensive, so identifying one or more biomarkers - chemicals measured in the blood that particularly in the area of executive function (EF),” biostatistics, and more,” says Dr. Cameron. “Their group’s research — “Association of Hippocampal activities through regular group sessions. reflect changes going on in the brain - corresponding to the cognitive changes would provide notes Dr. Butters. EF is key for complex reasoning, immense expertise has brought incredible cross- Substructure Resting-State Functional Connectivity invaluable insight.” such as problem solving and planning. fertilization to this project and allowed us to With Memory Performance in Older Adults” — Unexpected Findings in Cognitive Function While previous research studies led the Initiative to Of the hundreds of thousands of proteins in the blood, Dr. de Vallejo has identified 87 for analysis achieve what none of us could ever have done was published in the American Journal of Geriatric “These early results are exciting because both expect likely improvements in the exercise test group, that could be expected to show deterioration or improvements that reflect changes in the brain on our own.” Psychiatry. Its findings were based on the group’s learning memory and EF deteriorate with age. But cognitive function analysis results also revealed function in older individuals. They include proteins that have been reported to affect or be linked research that used functional MRI imaging. in this limited study, we instead saw improvement, unexpected changes in the stretching control group. to immune function, inflammation, Alzheimer’s disease, and other age-related diseases. Stephen Smagula, PhD, assistant professor of not deterioration, over a period of six months, in psychiatry at the University of Pittsburgh, served “We were surprised to see improvements among both the control group and exercise group,” says The Initiative first used proteomic analysis (looking at proteins in the blood) to see what changes as the lead author. the members of the stretching control group, who Dr. Butters. “There’s the potential for true major in the proteins correlate to changes in brain structure and function. “The initial results identified certain proteins known to affect muscle function. This first dataset has given us confidence that we’re going in the right direction with the biomarker approach,” notes Dr. de Vallejo. In the coming year, the Initiative will complete the proteomic analysis and plans to analyze its RNA Sequencing (RNA-Seq) results, with the goal of detecting changes in gene expression in the blood. 12 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 13

The Bridgeside Point research building is just a stone’s throw from where steel mills once lit the night sky and fueled the lifeblood of Pittsburgh’s manufacturing economy. Today, this area is part of the region’s booming “eds and meds” economy and the home of the new Aging Institute Laboratory. Here, talented investigators are using sophisticated molecular techniques to answer the fundamental biological Biology of question of what controls how, and why, we age. The answers they yield through their research, says Aging Research Toren Finkel, MD, PhD, the Aging Institute’s new director, have the potential to unlock powerful new approaches to extend our health span — the period of life during which a person remains free from serious illness — by increasing the number of years we remain free of chronic, age-related diseases and conditions. 14 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 15

A Revolutionary New Look at Aging “The bold idea that the Aging Institute will test is energy pathways are involved in the maintenance Immune Transplant and Therapy Center To many, it seemed an impossible undertaking, whether or not those pathways can be treated with of the body’s stem cells. The Aging Institute’s cutting-edge aging research to help patients have longer, healthier lives is a drugs: Can we find medicines that target those but under the leadership of Dr. Toren Finkel, the Over the years, his research has involved both central part of the Immune Transplant and Therapy Center (ITTC), a major $200-million initiative of pathways, just like we have medicines that target gleaming new state-of-the-art Aging Institute animal models and humans, bridging basic science UPMC and the University of Pittsburgh. Its focus is to promote scientific discoveries that will harness other pathways in our body? By essentially slowing Laboratory was successfully designed, constructed, and clinical medicine. His current work at the Aging the power of the human immune system to treat and cure a wide range of diseases. Focused on the or reversing the rate at which we age, we could equipped, and staffed in just over a year’s time. It Institute now explores the relationship between areas of cancer, transplantation, and aging, its ultimate goal is to accelerate the development and potentially prevent a variety of age-related comprises nearly 30,000 square feet of lab and mitochondria, metabolism, and human aging. distribution of life-saving and cost-effective clinical solutions to patients. office space on two floors of Bridgeside Point 1, an diseases. The idea isn’t really to make people live impressive and modern glass-encased building incredibly longer lives, but much healthier lives. “We are heavily invested in the joy of discovery that is part of several University of Pittsburgh Ultimately, the potential impact on human health here and have made considerable progress in the research operations. and quality of life could be staggering.” course of our first year,” says Dr. Finkel. “While we continue our work in basic biology, we are The Aging Institute plans a three-pronged Prior to coming to the Aging Institute, Dr. Finkel increasingly thinking of more practical applications. approach to its research: spent a quarter century working with the National There are already a number of novel drugs that are Institutes of Health (NIH) in Maryland. • It will continue to explore the basic biology of in different parts of our pipeline, and we’re very “Over the last years, researchers have made a great aging, using sophisticated molecular techniques. optimistic that we can move some of these forward into clinical trials within the next several years.” deal of progress trying to understand the basic • It will work to identify novel small molecules mechanisms of why we age, and uncovered some — drugs — to combat the aging process. “In 2019, we’re planning to test whether of the core regulators of the aging process,” says • It will conduct clinical trials to leverage its repurposing biological therapies already-approved Dr. Finkel. “We’ve come to understand that aging is discoveries in the biology of aging to test by the Food and Drug Administration (FDA) that like every other biological process: it’s regulated by new therapies in actual human patients. target the inflammatory cytokine IL-6 can reduce biochemical and genetic controls. While there’s a the symptoms of frailty,” says Dr. Finkel. “If we’re Accelerating New Treatments stochastic nature to it, there’s also a lot of regulation successful, this will be the first trial to rigorously Dr. Finkel’s own research has significantly contributed Pittsburgh’s Bridgeside Point 1 in many places, where we can intervene rationally test the ‘inflamm-aging’ hypothesis of human to the understanding of the aging process. He has research building to change the trajectory. That’s very exciting aging, which theorizes that aging is driven by studied a specific class of enzymes (sirtuins) that because the aging process is fundamental to chronic, low-grade inflammation. so many diseases.” are key regulators in aging and discovered that cellular 16 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 17

Aging Institute Laboratory Inaugural Faculty As part of its research mission, the Aging procedures, and assessments. His leadership in hospitalization to regain function, confidence, During 2018, ten principal investigators were recruited Institute also is helping to train a new generation of the American College of Cardiology, the American and independence. Simultaneously, he is leading to conduct research at the Aging Institute Laboratory. nvestigators in aging through mentoring opportunities Heart Association, the American Geriatrics multiple studies that target biological mechanisms They came from leading institutions from throughout in basic and translational research. Each month, it Society, and the National Institutes of Health have underlying physical decline and novel strategies to the United States, as well as from the University of also hosts a research conference series, network catalyzed relatively more novel holistic approaches remedy them. Body composition, nutrition, and Pittsburgh, and included both established researchers gatherings, progress reports, and a journal club, to patient care, and have even sparked funding inflammation are among the factors considered and gifted early-career faculty. as well as an annual grant writing workshop. initiatives to further grow the field. in this work.

Beibei “Bill” Chen, PhD (University of Pittsburgh) New Supporting Leadership Dr. Forman’s research on older adults at the “I am thrilled to be part of the Aging Institute and Associate Professor of Medicine, Division of at the Institute University of Pittsburgh is multifaceted, extending its work,” says Dr. Forman. “I see it as an exceptional Pulmonary, Allergy, and Critical Care Medicine Daniel Forman, MD from novel approaches of clinical care in older crucible for ideas, insight, and energy among idealistic Director, Small Molecule Therapeutic Center Director of Emerging Therapeutics, adults to cellular and subcellular mechanisms, and dazzling colleagues, which seems certain to Co-Director, Acute Lung Injury Center of Excellence Aging Institute of UPMC Senior all with prevailing goals of enhancing function propel innovation in the care of older adults.” As Research Interests: Studying the molecular Services and the University of and quality of life in older adults. His expertise the Aging Institute’s first director of emerging mechanisms that control inflammation and Pittsburgh in cardiovascular disease and clinical care is therapeutics, he will help organize and lead its cell proliferation via protein ubiquitination Professor of Medicine, complemented by broad expertise in pertinent translational program. (ubiquitin biology) Shihui Liu, MD, PhD (National Institutes of Health) Shiori Sekine, PhD (National Institutes of Health) Division of Cardiology, Associate Professor of Medicine, Division of Assistant Professor of Medicine University of Pittsburgh cellular science. Yvonne Eisele, PhD (Scripps) Infectious Diseases Research Interests: Stress-sensing mechanisms Chair, Section of Geriatric Cardiology, UPMC Assistant Professor of Medicine, Division of Cardiology Soon after arriving to Pittsburgh, Dr. Forman Research Interests: The basic mechanisms of mitochondria proteins, particularly the stress- A cardiologist and geriatrician, Dr. Forman was received funding from the Aging Institute to pursue Research Interests: Delineating the molecular and underlying the pathogenesis of infectious diseases dependent regulation of mitochondrial proteases cellular changes of age-related pathogenic proteins and mitochondrial import machineries recruited to the University of Pittsburgh four years a novel pilot study of nitrite supplementation in seen in Alzheimer’s and Parkinson’s diseases, and Yuan Liu, PhD (University of Pittsburgh) ago from Brigham and Women’s Hospital in Boston older heart failure patients. The study showed that cardiac transthyretin amyloidosis Assistant Professor of Medicine, Division of Yusuke Sekine, PhD (National Institutes of Health) to launch a new geriatric cardiology program that nitrites improved bioenergetics in skeletal muscle Pulmonary, Allergy and Critical Care Diseases Assistant Professor of Medicine Aditi Gurkar, PhD (Scripps) extends from his areas of expertise. That program mitochondria and boosted exercise performance. Research Interests: The role of lysosomal Research Interests: Mechanisms underlying Assistant Professor of Medicine, Division of has flourished and Dr. Forman has advanced as These data have subsequently led to multiple NIH biogenesis in degenerative diseases cellular responses to oxidative, endoplasmic, Geriatric Medicine and metabolic stress a national leader in efforts to broadly integrate studies and an expanding body of work. Research Interests: The role of DNA damage in Ana Mora, MD (University of Pittsburgh) geriatric precepts into specialty medicine in While much of Dr. Forman’s initial research focused aging and age-related pathologies Associate Professor of Medicine, Division of Bokai Zhu, PhD (Baylor) order to better achieve care that responds to the Pulmonary, Allergy and Critical Care Diseases Assistant Professor of Medicine, Division of on older adults with cardiovascular disease, his Gang Li, PhD (Harvard) distinctive needs of older adults. Management of Research Interests: The pathogenesis of idiopathic Endocrinology and Metabolism studies have expanded to include those with and Assistant Professor of Medicine, Division of Cardiology a specific disease process is coupled to expanding pulmonary fibrosis (a fatal and progressive Research Interests: The role of non-circadian without cardiovascular disorders. He is the principal Research Interests: Functional genomics of insights regarding associated frailty, comorbidity, lung disease) rhythms in preventing aging-associated diseases investigator of a cardiac rehabilitation trial that age-related diseases and the use of human cognitive decline, falls, and other healthcare will advance strategies to better enable older genetics as a guide for new drug targets challenges that become pervasive with age and patients who are weakened and debilitated after which commonly confound standard medications, 18 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 19

Innovations A primary goal of the Aging Institute is to foster in Research innovative, pioneering, and multidisciplinary age- related research. Through the Seed Grant program and other initiatives, the Aging Institute is encouraging new and novel research aimed at improving the quality of life and care for older adults. Many of these “seed” projects have gone on to receive additional outside funding, expanding their reach and advancing the development of pioneering insights. 20 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 21

RAVEN: At the Frontline of Care to proactively manage six health conditions that Sharon’s nursing background includes experience “I can’t sing the praises of the RAVEN initiative for Older Adults historically result in hospitalization for older adults, in cardiac, long-term, and hospital-based palliative strongly enough,” adds Vicky. “Our hope is that With two years remaining in Phase II of the such as urinary tract infections, pneumonia, and care, where she often saw nursing home residents CMS sees the full benefits it can offer facilities initiative, RAVEN continues to make a difference. congestive heart failure. “being hospitalized with conditions that probably like ours. It’s inspiring us to look for new ways to For the last six years, UPMC Senior Services and the could have been better managed in place.” continue its impact.” “In addition to integrating the new payment, Aging Institute have spearheaded a groundbreaking, we’ve also expanded our reach and impact to multiphase innovation project known as RAVEN 2017 Seed Grant Update: Early include 35 nursing homes statewide — nearly (Reducing Avoidable Hospitalizations Using Hearing Loss double the number of facilities we worked Evidence-based Interventions for Nursing Facility Identification and Intervention in Older Adults with during Phase I,” says RAVEN co-director Residents). The initiative is designed to improve the Hearing loss can have a significant impact on April Kane, MSW, LSW, of UPMC Community quality and reduce the cost of care for skilled nursing quality of life, but many older adults are unaware Provider Services. home residents enrolled in Medicare and Medicaid. their hearing has been compromised. It can “We’re honored to continue our work in this lead to isolation and depression and even be In 2012, UPMC was one of only seven organizations pioneering program,” says Mary Ann Sander, MHA, misinterpreted as a loss in cognitive function. nationwide to receive a healthcare innovation award MBA, NHA, vice president of Aging and Disability from the Centers for Medicare and Medicaid When Vicky Wittuck, senior vice president of Catherine Palmer, PhD, director Services, UPMC Community Provider Services and Services (CMS). Phase I of RAVEN focused on 18 Brevillier Village and Ball Pavilion’s administrator, of Audiology and Hearing RAVEN co-director. “RAVEN is helping to develop long-term care facilities, bringing nurse practitioners first learned about RAVEN, she immediately knew Aids, UPMC, and associate new models of care that can deliver better health, onsite to support nursing staff, enhanced staff its residents would benefit from the creative, best professor in the departments of improved care, and lower costs for older adults training, and develop customized communication practice offerings. “We serve a very middle income Communication Science and who often have the greatest healthcare needs.” tools to empower staff. The $19 million award population and our facility never could have Disorders in the School of Health featured the introduction of telemedicine, enhanced and Rehabilitation Sciences and RAVEN in Action on the Job afforded the expertise of such an experienced medication review, and pharmacy engagement — nurse practitioner like Sharon,” says Vicky. Otolaryngology in the School of Medicine, Nurse practitioner Sharon Heidecker, MSN, all with the collective goal of reducing avoidable University of Pittsburgh, received a two-year seed FNP-BC, APHPN, was the first staff person hired Sharon says RAVEN’s telemedicine initiative is hospitalizations among nursing home residents. grant from the Aging Institute in 2017 to research for RAVEN in 2012. “It was a very exciting day for key to providing effective and immediate care. GATE: Geriatric Auditory Testing for Everyone. Her Based on the successes of its evidence-based me,” she remembers. “I understood this program “When a resident is having a medical problem, I’m study aims to find the most cost-effective way to innovations, UPMC’s RAVEN initiative received could be a game changer.” In addition to serving as able to evaluate the condition with the RN that very identity hearing loss in seniors early on — before it an additional four-year, $20 million award from the nurse leader for four other RAVEN facilities, day using telemedicine, rather than delaying until has a negative impact on their social, mental, and CMS in 2016. Phase II continues to build on the Sharon works onsite three days a week at Ball the attending physician or I can be there in person. physical well-being. program’s past successes while introducing a Pavilion — the skilled nursing unit of Brevillier new payment model based on a facility’s ability Village in Erie, Pennsylvania. 22 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 23

“It’s mind blowing,” says Dr. Palmer. “Although it “What we are proposing is interventional audiology hope is that this big-picture view will inspire new Jointly funded by the Aging Institute of UPMC A function for B-type lamins in nuclear pore insertion seems unlikely, no one has systematically collected — bringing the audiologist to the patient in order research questions and directions.” Senior Services and the University of Pittsburgh and impacts heart repair and regeneration data on the prevalence of hearing loss in typical to identify hearing loss and provide an immediate the office of Steven B. Shapiro, MD, UPMC senior Bernhard Kühn, MD, scholar, Richard King Mellon “The conference really epitomized the spirit of settings where we find seniors.” solution before it has a negative impact on their lives.” vice president and chief medical and scientific Foundation Institute for Pediatric Research, UPMC collaboration and sharing that is a signature trait officer of UPMC. Children’s Hospital of Pittsburgh; associate professor She and her team conducted hearing screening of the University of Pittsburgh and UPMC,” notes A Day in the Lifespan Conference and director of research in cardiology, Department of tests of nearly 1,000 seniors, seen at an outpatient in vitro and in vivo models of caloric restriction, and Toren Finkel, MD, PhD, director of the Aging The program sought innovative proposals A novel look at the impact of biomedical science Pediatrics, School of Medicine, University of Pittsburgh geriatric clinic and residents of assisted living, on every stage of life from aging biology to mutations that affect sleep, Institute. “By engaging people from diverse demonstrating research collaborations in aging, skilled nursing, and independent living facilities. In May 2018, the Aging Institute was among the cognitive function, and lifespan in animal models. disciplines, and whose research and practice drawing from the full spectrum of disciplines Circulating Autophagy Related 7 (ATG7) Protein as Data also was collected on the willingness of lead sponsors of the “A Day in the Lifespan” areas focus on very different areas within the across the University of Pittsburgh and UPMC a Biomarker of Aging “Our goal was to stimulate a patients to accept and use simple amplifiers. conference at the University of Pittsburgh, which lifespan, we’re able to broaden our insights and — from basic biology, clinical and translational Allison L. Kuipers, PhD, assistant professor of deeper conversation on well- examined the development, influence, and understandings exponentially.” approaches, and epidemiological to psychosocial, epidemiology, Graduate School of Public Health, According to Dr. Palmer, it has been commonly being throughout the spectrum trajectory of biological processes across the health sciences, health policy and health services University of Pittsburgh viewed that patients frequently choose not to of life,” says Yoel Sadovsky, MD, Plans are now underway for a 2019 conference lifespan. Co-sponsoring the event were the Clinical research. Proposals pairing basic science research correct, or amplify, their hearing because of cost executive director of Magee- on epigenetics. Adoption and effectiveness of a health intervention and Translational Science Institute (CTSI) of the with clinical/translational teams were especially and accessibility issues. Her study points to a bigger Womens Research Institute and for hypertension in older adults: a pilot clinical trial University of Pittsburgh and Magee-Womens Editor’s Note: CTSI is part of an NIH-funded nationwide encouraged this year, as were proposals involving problem. “Our data indicates patients simply don’t associate dean, women’s health network which provides the support necessary to bridge Matthew F. Muldoon, MD, MPH, professor of Research Institute. interprofessional collaborations between at least recognize that they have impactful hearing loss,” research and reproductive sciences, University of the gap between innovative approaches to research and medicine, psychology, and epidemiology, School of two different schools within the University of she says. “Untreated hearing has even been The daylong conference, which brought together Pittsburgh. “For example, people tend to think about effective clinical and public health practice, health policy, Medicine, University of Pittsburgh and community engagement in research. Magee- Pittsburgh or UPMC. associated with hospital readmissions. Early academicians and clinicians to create connections pregnancy as largely a woman’s issue, but we now Womens Research Institute is the largest research Novel tools to study mitochondria and identification can lead to better care on all levels.” throughout the world of research, featured an know that what happens at the start of life has 2018 Pilot Seed Grant Recipients institute in the United States dedicated exclusively to postsynaptic densities in aging human brains emphasis on aging and the developmental origin of huge implications on wellness, disease prevention, women’s health research. The Aging Institute awarded the following seed She pointed to studies showing that 60 percent Yi Shi, PhD, assistant professor, Department of Cell health and disease. Presenters included researchers and overall quality of life.” grants in 2018 in support of these projects: of adults 65 and older and 80 percent of those Seed Grant Program 2018: Biology, University of Pittsburgh from the National Institutes of Health (NIH), over 80 have impactful hearing loss — but only “By applying a wide-angle lens to look at the Collaboration in Aging Research Examining the spatio-temporal role of oxidative National Institute on Aging, the Ohio State Prefrontal cortex stimulation: effects on memory 18 percent use hearing aids. research continuum across all phases of life, we were Core to the success of the Aging Institute has been telomere damage on healthspan and lifespan by University, the University of Wisconsin, and the and executive function through slow-wave sleep able to gain a different perspective on the work each its constant emphasis on bringing together the optogenetics Audiologists typically operate well-established University of Pittsburgh. Their topics ranged from Kristine A. Wilckens, PhD, assistant professor, Sleep of us is doing,” adds conference co-developer Daniel best and brightest minds to analyze, research, and Aditi U. Gurkar, PhD, assistant professor, Division of clinics where they wait for patients to come to the developmental origin of health and diseases to and Chronobiology Center, Department of Psychiatry, J. Buysse, MD, core director of participant and develop solutions in the field of aging. Its annual Geriatric Medicine, School of Medicine, University of them. “But these are patients who have self- University of Pittsburgh clinical interactions at CTSI, and professor of seed grant program is a celebration of such Pittsburgh; Aging Institute; Geriatric Research, identified that they have impactful hearing loss,” psychiatry and clinical and translational science, collegial efforts. In 2018, the program’s theme Education, and Clinical Center, VA Pittsburgh says Dr. Palmer. University of Pittsburgh School of Medicine. “Our — Collaboration in Aging Research — exemplified Healthcare System and encouraged that spirit. 24 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 25

12th Annual Research Day on Aging Anne B. Newman, MD, MPH, clinical director Clinical Student - First Place Celebrating Research on Aging: Building of the Aging Institute, Anthony Delitto, PhD, Jessica Graves Collaborations for the Future PT, FAPTA, dean of the School of Health and Rest-activity Rhythm Timing and Depression The Aging Institute’s 12th Annual Research Day Rehabilitation Sciences at the University of Symptom Severity in Dementia Caregivers on Aging was held on December 6, 2018 on the Pittsburgh, and Matthew D. Neal, MD, FACS, Clinical Student - Honorable Mention (tie) campus of the University of Pittsburgh. Roberta G. Simmons assistant professor of Loren Schleiden, MS surgery at the University of Pittsburgh. A signature event of the Aging Institute, Research Geographic Variation in Antidementia Medication Day provides an essential forum for clinicians The poster session at this year’s event featured more Use Among Medicare Part D Beneficiaries with and researchers from UPMC, the University of than 50 presenters on a range of topics. Winners in Alzheimer’s Disease Pittsburgh, Carnegie Mellon University, Duquesne the different categories of submissions included the Basic Student- Honorable Mention Mary Winger, MPH University, Robert Morris University, and other following students, researchers, and clinicians: Amanda Kowalczyk Longitudinal Quadriceps Strength and Fall Injuries in academic institutions to meet, interact, and view Basic Student -First Place (tie) Identifying the Genetic Basis of Longevity in Mammals Medicare Claims: The Health ABC Study posters highlighting the latest in aging research. Abish Pius Using Patterns of Convergent Evolution Clinical Post-Doctoral - First Place This year’s session opened with welcoming AAV Delivery of α-Klotho: Gene Therapy as a Basic Post-Doctoral - First Place Joshua Niznik, PharmD remarks by Toren Finkel, MD, PhD, director of Strategy to Counteract Sarcopenia Diana Alvarez, MD Factors Associated with De-prescribing the Aging Institute of UPMC Senior Services Amrita Sahu, MS Defective Fatty Acid Metabolism Promotes Fibrosis in Antidementia Medications in Older NH Residents and the University of Pittsburgh. Dr. Finkel also Role of α-Klotho in Muscle Progenitor Function the Lung with Severe Dementia joined in a collaborative presentation on the topic and Skeletal Muscle Regeneration of Innovative and Emerging Research in Aging with Basic Post-Doctoral - Honorable Mention Clinical Post-Doctoral - Honorable Mention Hye Jin Hwang, PhD Samaneh Farsijani, MSc, PhD Spatiotemporal Regulation of Fatty Acid Desaturation High Inter-muscular Fat is Associated with Poor in Long-lived Germline-less Animals Mobility Function in Older Adults, Only When Accompanied by Low Muscle Area Basic Faculty -First Place (tie) Aditi Gurkar, PhD Clinical Faculty - First Place Endogenous DNA Damage Plays a Causal Role Gustavo Almeida, PT, PhD in Cardiomyopathy Effect of Changes in Physical Activity on Cartilage Degradation and Inflammation in Knee Osteoarthritis Yusuke Sekine, PhD The Nucleolus Links Acetyl-CoA fluctuation to Clinical Practitioner - First Place p53-mediated Stress Responses Aziza Battle, MA Kane County Living Centers Unit 4a 26 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 27

In hospitals and homes, from clinicians to caregivers, the Aging Institute is educating — and inspiring — audiences on the tremendous physical, mental, and social challenges facing our aging population. It continues to share aging-related insights, knowledge, and findings through its educational training programs, community outreach, literature, and videos aimed at enriching the direct care and treatment of aging adults today and tomorrow — and at helping older adults to not just Educational live longer, but healthier, lives. Initiatives in Aging Services 28 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 29

A Regional Partner on the • Creation of an online video series for caregivers Building on the Institute’s focus on dementia, the Creating a National Model for Caregiving National Geriatrics Workforce Expansion of the Institute’s Help and Referral new videos spotlight typical issues that dementia • Pioneering research on the needs of area caregivers has led to the creation of a groundbreaking new center focused on caregiver research, Enhancement Program Line services caregivers face: Recognizing the dire shortage of skilled geriatric education, and policy • Support outreach efforts to older adults and • Dementia basics — For many caregivers, not specialists and providers in our country, in 2015 the caregivers in underserved communities knowing what to expect when caring for The Aging Institute has long Central to its research agenda awareness about the important role of family U.S. Department of Health and Human Services someone with dementia can lead to unnecessary supported local, statewide, and was the Pittsburgh Regional caregivers in the healthcare system, conduct priority launched the Geriatric Workforce Enhancement Filling the Information Void: tension, misunderstandings, and frustration. national efforts targeting issues Caregivers Survey, led by research in family caregiving, and educate providers Program (GWEP). The three-year, $38.7 million A Video Series for Caregivers UPMC Western Psychiatric Hospital’s clinical related to caregiving. At the Dr. Schulz and Scott R. Beach, and family members so caregivers can more program focused on the development of the health Created in Partnership with the National Geriatrics nurse specialist Marcia Kollar, RN, identifies forefront of these initiatives has PhD, interim director of the effectively care for their loved ones as well care workforce and quality care for older adults Workforce Enhancement Program. common dementia-related behaviors and their been the Institute’s associate University of Pittsburgh’s as themselves. through community-based programs, preparation “My mother resists whenever we try to bathe her — causes, while geriatric psychiatrist Tejal Bhojak, director for education and University Center for Social and of health providers and training opportunities for it’s a battle every time.” “Research and implementation studies from the MD, speaks to the progression of the disease. executive board member, Richard Schulz, PhD, Urban Research. More than 1,000 caregivers healthcare workers. In July 2017, the program was center will provide evidence to guide both practice “Our brother has fallen repeatedly in his home – distinguished service professor of psychiatry at the participated in the survey, which revealed that extended through July 2019. • Dealing with dementia — There are proactive and policy development on how best to support and the injuries keep getting worse.” University of Pittsburgh and a nationally recognized southwestern Pennsylvania significantly exceeds steps caregivers can take to help redirect caregivers and fully integrate them into the health The University of Pittsburgh is one of 44 sites researcher on caregiving and caregivers. the national averages reported by family caregivers “My wife won’t stop asking me the same question, difficult behaviors in individuals with dementia. system,” says Everette James, JD, MBA, director of nationwide receiving GWEP funding — and one of on the stresses and challenges they face. over and over. I’m like a raw nerve.” Cumberland Woods’ Christine Cassesse, life Most recently, Dr. Schulz spearheaded The Caregiver the Health Policy Institute. only four programs focused directly on older adults. enrichment coordinator, aided by a volunteer Project, a two-year, $1 million initiative focused on Results of the Pittsburgh Regional Caregivers It is led by Richard Schulz, PhD, associate director of It’s often the day-to-day details of caring for an “In many ways, the need for a center evolved out of resident, demonstrates how to handle problems making western Pennsylvania — which has one of Survey are at: https://ucsur.pitt.edu/caregiving_ the Aging Institute and the director of the University older adult that can be the most overwhelming. the Aging Institute’s Caregiver Workgroup, which such as restlessness, repetitive behavior, the nation’s oldest populations — a national model project_2017.php of Pittsburgh’s University Center for Social and To support caregivers in their daily efforts — and gave us the opportunity to identify and partner with resistance to care, and wandering. of a “culture of caregiving” by partnering with Urban Research (UCSUR). reinforce that they are not alone — the Aging New center on caregiving research announced researchers and experts across UPMC and the • Eating challenges — Patients with dementia often caregivers, patients, providers, and community Institute has developed a series of six free videos In July 2018, Dr. Schulz was named the director of University of Pittsburgh,” says Dr. Schulz. “We have a Given its long-term expertise in supporting the experience greater difficulty when eating and stakeholders to conduct applied research that as part of the GWEP Initiative. the newly-created Center for Caregiving Research, remarkable depth of expertise that ideally positions needs of older adults, the Aging Institute has drinking, from forgetting to eat to problems would inform policy and practice regionally. Education, and Policy, launched by the University of us to become a national leader in caregiving research collaborated with the University of Pittsburgh over “We completed several new videos this year that recognizing how and what to eat. Speech therapist Pittsburgh Health Policy Institute. It aims to increase and public policy.” the last four years as a GWEP community partner. are designed to build upon the messages of our Audrey Rozell, supervisor of rehab services at In 2018, the Institute continued to connect older 2017 videos exploring caregiving, home safety, UPMC McKeesport, explains proper seating adults and their caregivers to community resources and stress management,” explains Betty Robison, positions, feeding assistance techniques, and — with an additional focus on better educating MSN, RN, gerontology educator for the Institute. helpful tips for drinking fluids for all older adults. “The first videos were very well received, so our primary care providers about the unique needs of The videos are available to interested caregivers goal is to continue to provide practical, supportive, older adults — through these distinct initiatives: and professionals and can be accessed on the and realistic information that caregivers can use Institute’s website. and refer to as needed.” 30 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 31

Help and Referral Line Initiatives referral resource for doctors and other healthcare Reaching Underserved Areas not only within the UPMC system but at healthcare As a GWEP partner, the Aging Institute has expanded providers. “It’s our goal to use this platform to Locally, the GWEP has turned its attention to organizations and community groups statewide,” the capabilities and resources of its Help and Referral receive referrals through EPIC, but also to be able serving underserved areas that have large numbers notes Betty Robison, MSN, RN, gerontology educator Line to connect greater numbers of caregivers and to provide feedback and follow up to the practitioner of lower income, older, frail adults. The goal is to for the Aging Institute. older adults to important community information, on the recommended resources,” explains ensure that seniors in these communities get services, and resources. Additionally, the Institute Melissa Jones, MSN, RN, who joined the Institute recommended health screenings, or assessments, 2018 Highlights is also working to increase awareness and use of in 2018 as a geriatric nurse educator. “Our first during primary care visits. However, most primary Promoting Proactive, Healthy Aging these resources among healthcare providers. accomplishment was getting established as a care doctors — who are on the front lines of treating As conventional medicine increasingly incorporates “SmartText” in EPIC. This phrase provides written older adults — have little to no training in geriatrics. wellness and healing into its scope of care — and as “The call line is critically important to GWEP’s information on our website and the Help and people look for new ways to stay healthier and live Throughout 2018, the Aging Institute worked success. It’s serving as a primary point of entry Referral Line for ease of reference among providers a quality life — the Aging Institute offered its first with GWEP to help support primary care offices for providers as well as their patients and family and their patients.” major conference on integrative medicine for older in the greater McKeesport area through its UPMC members,” says Dr. Schulz. adults in 2018. More than 100 participants attended The full incorporation of the Help and Referral McKeesport Resource Center, as well as through How to Live Longer and Live Better in October, In 2018, the Institute began the process of exploring Line into EPIC will broaden access to resources mailings, personal visits, and social media. featuring keynote remarks by Michael D. Parkinson, the integration of the Help and Referral line into and services related to health maintenance and The Institute is working to assist GWEP to help MD, MPH, FACPM, senior medical director of health The immediate past president of the American • Medical Director Ronald Glick, MD — EPIC — an electronic health record system used by healthcare, which are key focus areas of the GWEP, doctors and other healthcare providers to better and productivity, UPMC Health Plan. College of Preventive Medicine, Dr. Parkinson is a Integrative approaches to managing UPMC and many other healthcare systems — as a adds Dr. Schulz. understand aging issues, and provide geriatric leading national advocate for public health, preventive osteoarthritis training to properly assess and treat older patients. medicine, and consumer-driven health plans. His • Naturopathic Doctor Khara Lucius, ND, FABNO New and Ongoing Educational comments focused on the role of plant-based diets — Supplements and aging as key to longer and healthier living, noting that Programming Psychotherapist Barbara Ivanko, LCSW — research indicates they can reduce diabetes by 91 • Throughout 2018, the educational arm of the Aging Mindfulness techniques for stress reduction percent, heart disease by 80 percent, and cancers Institute made dozens of presentations and launched by 60 percent. He also stressed the importance of Held at Cumberland Woods Village in Allison new initiatives on age-related topicsNeed to help healthcare finding community resources for seniors or caregivers? EDUCATIONAL Call the Aging Institute’s free Help and Referral line at . 30 minutes of moderate physical activity every day professionals, community groups, colleges and 1-866-430-8742 OFFERINGS Park, Pennsylvania, the program also featured two FOR CAREGIVERS AND PROFESSIONALS to reduce injuries and other health risks. universities, caregivers, and older adultsAging.UPMC.com in western therapists from the Center for Integrative Medicine, Aging Institute of UPMC Senior Services and the University of Pittsburgh Pennsylvania and statewide. Direct mail, advertising, The program also featured these staff members who provided shiatsu massage therapy, a form of and social media initiatives helped to build awareness from the UPMC Center for Integrative Medicine Japanese therapy that stimulates acupressure points of the Institute’s robust portfolio of educational and their topics: to promote energy and balance. services. “In addition to our new programs, we’re

seeing renewed interest in our traditional training and AI507802 JAB/LM 10/18 © UPMC 2018 certificate programs, such as Ageless Wisdom™ — 32 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 33

Integrating Geriatric Training in the • Warning signs that something serious may canine members — which emphasized the need Career Ladder at UPMC be happening to educate community members on the need to For many years, the Aging Institute has been secure homes and facilities. The presentation • The role of diet and increased activity in collaborating with UPMC Senior Communities improving brain health was delivered in November 2018 at a two-day to promote the professional development of its training program sponsored by the Fayette County nurses and nurses’ aides through geriatric training. Making a Transition Search and Rescue Team in Hopwood, Pennsylvania. Offered quarterly, Senior Communities staff Making the move into a nursing or personal care Hailing from five states, the participating volunteers members who successfully complete the Institute’s facility can pose painful and unexpected challenges contribute their own time and resources to become Geriatric Nurse Aide Training or Geriatric Resource for older adults. To address these concerns, the certified in search and rescue, as well as bearing Nurse Training program now receive an increase in Aging Institute developed a new program in 2018 the cost and time of training their dogs. compensation, and are eligible for an additional for new residents, which covers topics such as NOTE: The Aging Institute website features a increase after completing an approved project. fitting in, meeting people, making new friends, in such searches. Based on the groundbreaking downloadable worksheet and tips for caregivers of Lighthouse Pointe Village and Cumberland and adapting to a new lifestyle. The program work of Robert J. Koester, PhD (the featured guest adults with dementia with a tendency to wander on Woods Village hosted 2018 geriatric training was introduced at Seneca Hills Village, a UPMC of the Institute in 2017 at a training program on the its Resources for Caregivers page. classes for participating staff from all UPMC Senior Community. subject), the presentation was delivered at UPMC Senior Communities’ facilities. Strategies and Training for Wandering Adults with Magee-Womens Hospital and VOICE PA (formerly Monitoring and Building Brain Health Dementia the PA Culture Change Coalition), which was A new overview program for the general public In 2018, the Aging Institute continued to play a telecast to 25 organizations statewide. To help on brain health in older adults was introduced in leadership role in educating law enforcement and build general public awareness of the subject, 2018 at UPMC McKeesport and the Cranberry first responders to the specialized needs of adults Ms. Robison participated in UPMC Health Plan’s (Pennsylvania) Municipal Building, covering with dementia who wander from their home or Caregiver Teletown Hall, hosted by former such topics as: care facility. Pittsburgh Steeler Charlie Batch.

• The connection between medications A presentation was developed for emergency The Institute also developed additional training and confusion medicine services (EMS) workers, police and fire focused on the specialized challenges faced by professionals, social workers, and others involved rural volunteer search and rescue teams — and its • The impact of too little sleep on brain health 34 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 35

As a community health worker with the University of Pittsburgh in 2011 to pursue a degree specialist with the UPMC Health Plan, where her Gerontology Scholarship Winners UPMC Health Plan, Allegra Wakefield-Flournoy as a physical therapy assistant. With that new team has focused on the benefits of hearing tests There’s an ever-growing need for informed and compassionate professionals in virtually every field to meet the complex challenges facing older works hard to keep members connected to their degree in hand, she went to work at UPMC Sugar and hearing aids in preventing Alzheimer’s disease. adults — from medicine to law, mental health to finance, pharmacy to social work. These professionals are essential advocates and care providers, primary care doctors and help them avoid the Creek Station, a skilled nursing facility operated by Her experiences gave her a new appreciation for who are key to assuring older adults have access to quality care, resources, and support. emergency department. UPMC Senior Communities. Now, after five years the culture of innovation nurtured at UPMC. “With spent working mainly with geriatric patients, she is the graduate certificate in gerontology, I will be “A large percentage of the people I work with The Aging Institute actively encourages full-time UPMC employees in any area to expand their knowledge and understanding of geriatrics by pursuing a graduate certificate in gerontology. “My able to develop programs that will allow our are older adults, and I’ve always been interested awarding $2,500 each year for studies in the University of Pittsburgh’s interdisciplinary Graduate Certificate in Gerontology Program. Offered by appreciation and respect for this population has members to live longer and more rewarding lives,” in better understanding their needs and issues,” the University of Pittsburgh Center for Social and Urban Research and the College of General Studies, the program introduces students to relevant grown over time,” says Ms. Bristow. “Earning my says Ms. Chodor-Papst. says Ms. Wakefield-Flournoy, who is pursuing a and meaningful coursework featuring the latest theories and best practices in the study of aging. certificate will improve my ability to provide graduate certificate in gerontology as an Aging quality, appropriate therapy.” Institute scholarship recipient.

Ms. Wakefield-Flournoy, who helped care for her grandmother, father, and increasingly now Deborah Keyes has seen a lot of changes during her her mother, says her family inspired her to learn 18 years as a dialysis nurse at UPMC Hamot. “When more so she can better help older adults. I first started out, I didn’t see many older patients,” she says. “Now many of them are seniors.” She hopes to apply the credits she earns for the graduate certificate in gerontology toward A desire to better serve her older patients a master’s of social work degree. Victoria Glass prompted her to apply for the Aging Institute’s Service Coordinator UPMC Western Psychiatric Hospital graduate certificate in gerontology scholarship. She 2018 Scholarship Winners Christina Chodor-Papst has completed two classes so far — Nutrition and Renee Bristow Product Development Specialist “Helping others has been a dream of mine since I UPMC Health Plan–Product Development Exercise for Performance and Perspective in Aging. Physical Therapy Assistant can remember. This program is allowing me to get 2017 Scholarship Recipients Allegra Wakefield-Flournoy UPMC Sugar Creek Station “I want to be an advocate for programs that foster the education I need to continue to help others.” Deborah Keyes “It’s nice. The classes I take have professionals Community Health Worker UPMC Health Plan “Working with geriatric patients has been healthy habits and preventive care with the goal Dialysis Nurse of all ages and from a variety of career areas — As a service coordinator at UPMC Western UPMC Hamot occupational therapy, physical therapy, nursing, even rewarding. I want to expand my knowledge and of preventing or postponing physical decline.” “I’ve learned that you need a lot of patience Psychiatric Hospital, Victoria Glass has spent the finance,” she says. “It results in great discussions ability to provide the best possible treatment “I think of myself more as an advocate than a working with older adults, plus good listening After her mother’s devastating stroke at age 63, past two years working closely with patients of all and sharing of diverse perspectives and experiences.” tailored to their specific needs.” student. I’m learning how I can better represent a skills. It’s important to really hear their concerns, Christina Chodor-Papst took on the role of ages, including older adults. “I enjoy every second vulnerable population.” not just lecture them or tell them what you want.” Renee Bristow already had a bachelor’s degree in caregiver for both of her parents. She also juggled of it,” says Ms. Glass, a graduate of the University human relations when she returned to the responsibilities as a product development of Pittsburgh with a bachelor’s degree in social 36 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 37

work. Her goal is to continue building on her quality care for her patients inspired Erika as she i-PEEP: Hands-on, Community-based “We’re thrilled to be a community partner for “This initiative is about learning and working “i-PEEP helped us become more aware of each education and knowledge by pursuing a master’s worked her way up from a certified nurse’s aide to Geriatric Training for Tomorrow’s this project,” says Melissa together to accelerate the use of best team other as professionals and taught us to be more degree in social work after earning her graduate licensed practical nurse to registered nurse. Now, Healthcare Professionals (Missy) Sovak, MSW, LCSW, practices in the home, where we are focusing sensitive to the needs of older adults,” she says. certificate in gerontology. I want to continue my as she pursues a graduate certificate in gerontology, The Aging Institute has long advocated the director of the Living-at-Home efforts to help older adults remain independent.” “You can learn a lot in a classroom but assessing education so I can better serve patients,” she adds. Ms. Williams hopes to set an example for her twin importance of interprofessional care to effectively program. “There’s never been a “Next year, i-PEEP will take a closer look at how older adults in their homes — with healthcare sons. “Sometimes it is not about what is easiest, it address the complex health needs of older adults. greater need for collaborative factors such as poverty, food insecurity, abuse, professionals from other fields — takes learning to is about working hard for something that matters,” The InterProfessional Education Exchange healthcare for aging adults in and crime impact community health,” adds co- a whole new level,” says Kady Yoder, MSW, a she says. Program (i-PEEP), spearheaded by the University their home settings. investigator Pamela E. Toto, PhD, OTR/L, associate University of Pittsburgh graduate with a master’s of Pittsburgh School of Nursing, is helping to “We are broadening access to health assessments professor of occupational degree in social work and certification in gerontology. Inspiring Tomorrow’s prepare the next generation of healthcare among vulnerable older adults while building a therapy in the School of Health Geriatric Professionals professionals to be “interprofessional collaborative “Everyone should do this,” she says. “It was a great workforce of health professionals and Rehabilitation Sciences. “It Each year, the Aging Institute participates in the care ready,” with a special focus on geriatrics. learning experience. I got to see things from a who are better able to identify is allowing us to collaborate Health Career Scholars Academy — a unique different perspective and hear new ideas.” summer program offered to gifted high school Funded through the National Center for and collaboratively manage their across professions and expose students statewide by the University of Pittsburgh. Interprofessional Practice and Education, the health needs,” says Lorraine M. our students to real-life Post-Acute Care Forums Erika Williams, RN Novosel, PhD, CRNP, assistant community-based care.” These talented teenagers travel to Pittsburgh to University of Pittsburgh School of Nursing is one of 16 Understanding How Policies and Politics Impact Care Staff Nurse nursing programs nationwide — and one of only four professor in the School of East Rehabilitation Unit examine critical issues and emerging career Additional support is provided through a Over the past several years, the Aging Institute focused on geriatrics — selected for the National Nursing, coordinator of the opportunities in healthcare. During the 2018 collaboration with the Robert Wood Johnson has partnered with UPMC Community Provider “I learned if I truly want to improve the quality Center’s Accelerating Interprofessional Community- Adult-Gerontology Primary Care program, students choosing the geriatric Foundation, the John A. Hartford Foundation, Services and UPMC Senior Communities to host of care for my patients and conditions for nurses, Based Education and Practice Initiative award. Nurse Practitioner program, and principal concentration received an in-depth look at the Josiah Macy Jr. Foundation, and the Gordon a series of interactive forums designed to build I needed to continue to seek more education investigator for i-PEEP. “ geriatrics and aging from Aging Institute staff The Pitt program pairs professionals and graduate and Betty Moore Foundation. Funding was also awareness, understanding, and conversations and knowledge.” and board members — including many of the students from the University’s schools of Nursing, “We know from experience that provided by Jacqueline Dunbar-Jacob, PhD, within UPMC on major changes impacting the field’s leading researchers and clinicians. Students state’s and nation’s healthcare system, particularly Having worked as a nurse in long-term care Pharmacy, Health and Rehabilitation Sciences, and you can’t ‘go it alone’ as a health dean of Pitt’s School of Nursing and a member explored important issues such as healthy aging, in post-acute care. facilities for nearly a decade, Erika Williams knows Social Work for hands-on learning. Students from care practitioner when working of the Aging Institute general board of directors. memory changes, senior living options, and different disciplines shadow each other on site with older adults,” says co- the ups and downs of her job. “Being able to be What Students Say About i-PEEP Each year, UPMC professionals — from frontline emerging technology, and participated in eye- visits to a rural primary care practice and to the investigator Jennifer Hagerty part of the resident’s life and eventually feel like For Julie Xu, MSW, a Hartford Fellow and recent staff to senior leadership — attend the annual opening hands-on exercises that dramatically residences of older adults participating in the Lingler, PhD, CRNP, professor in family makes everything worth it,” she says. Her graduate from the University of Pittsburgh, the Post-Acute Care (PAC) forums to engage in demonstrate the impact of vision and hearing UPMC Living-at-Home program. the Department of Health and belief that education is key to providing the best i-PEEP program was an eye-opening experience. discussions on key medical, ethical, and legal loss, arthritis, and other forms of disability. Community Systems in the School of Nursing. 38 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 39

issues that are shaping political agendas in Harrisburg effect on skilled nursing facilities and home health and Washington, D.C. agencies. Key speakers included Barbara Gage, PhD, of the Post-Acute Care Center, a national “The goal was to encourage open dialogue and expert on Medicare post-acute care policy issues collaboration around policies that are responsive to and an architect of the IMPACT Act, and policy the needs of the aging population and caregivers.” experts from LeadingAge, the national association says Nicole Fideli, who helped coordinate the for nonprofit providers of aging services. forums and now serves as director of Public Policy and Engagement at UPMC. The 2017 PAC forum featured leaders from the National Hospice and Palliative Care Organization (NHPCO), including President/CEO Edo Banach, JD, with discussions focused on end-of-life care, the importance of advanced directives, and the work of UPMC’s own palliative care program.

The program’s format has proven so popular that in November 2018 the initiative developed a related forum titled “Election Reflection” and brought in state and national policy influencers to discuss The initial PAC forum held in 2015 was inspired by implications of the November election, including the passage of the Improving Medicare Post-Acute its impact on important aging-related issues. Care Transformation (IMPACT) Act of 2014 and its 40 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 41

Sharing knowledge and resources with the community is central to the mission of the Aging Institute. Through this dissemination and outreach, we are building awareness and empowering older adults, their families, and caregivers, providing them with the tools for informed decision-making and access to critical support. Through these and Connecting other e”orts, we are also forging powerful relationships with a host of medical, community, to the public health, legal, advocacy, and faith-based organizations to enlarge the network of expertise Community available for older adults’ lives. 42 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 43

The Aging Institute Help and we get most frequently center around in-home Held at Cumberland Woods Village, the event - and employment. She also explained how to access The Aging Institute at UPMC “We’ve increased our outreach efforts to other Referral Line services so older adults can remain at home Resource Networking in the Care of Older Adults the valuable resources available through the McKeesport community partners, working with the Salvation In 2018, calls to the Aging Institute Help and and their caregivers can get some relief,” says – featured speakers from AARP Pennsylvania and program, including AARP’s Network of Age- In 2018, the Aging Institute’s commitment to Army, area church leaders, and local senior centers,” Referral Line continued to increase — as did the Ms. Edwards. “There’s also a great deal of interest the Allegheny County Health Department. Friendly Communities — an initiative affiliated supporting underserved older adults and their says geriatric nurse educator Ms. Jones, the complexity and diversity of caller questions received. in transportation assistance.” with the World Health Organization’s Age-Friendly caregivers in the nearby Pittsburgh community Aging Institute’s newest staff member. “We’ve Jennifer Blatz, AARP Cities and Communities Program. of McKeesport continued to grow through a also aligned efforts with the 9th Street Clinic in “A big part of the call line’s growth is due to the Both Ms. Edwards, a licensed social worker, and Pennsylvania’s associate state concentrated effort to broaden community McKeesport, a non-profit that provides non- Institute’s increased promotional efforts with her colleague Melissa Jones, MSN, RN, a geriatric director for community Hannah Hardy, program outreach and increase educational programming. emergency basic services to individuals who nurse educator, are the voice of the Help and outreach, discussed AARP’s manager of the chronic doctors, practice managers, and other healthcare cannot afford primary care health insurance.” providers through our partnership over the last Referral Line. “Our professional backgrounds Livable Communities initiative disease prevention program In 2014, the Aging Institute at UPMC McKeesport four years with the national Geriatric Workforce enable us to look at a caller’s problem with very to make neighborhoods, towns, with the Allegheny County Resource Center opened in collaboration with the “We encourage older adults and caregivers to drop Enhancement Program (GWEP),” explains Ronnie different perspectives,” says Ms. Edwards. “That’s cities, and rural areas more Health Department, talked McKeesport Hospital Foundation. According to the in to meet with us to discuss any problems they’re Edwards, MSW, LSW, the Institute’s Aging and a real distinction and value that we offer callers.” age-friendly so older adults can stay in their about the county’s ambitious United States Census Bureau, nearly one in five having and to connect to community resources,” Disability Coordinator (see page 28). “Working communities as they age. The program focuses on and comprehensive Live Well adults living in the city of McKeesport, a suburb says Ms. Jones. “Twice a month, we also offer The service is free and open to anyone, regardless together, we’re creating a centralized regional call helping communities create environments that can Allegheny campaign aimed at improving the health of Pittsburgh, is over the age of 65 - and nearly free educational programs offered by the Aging of location, level of need, or insurance affiliation. line that older adults, caregivers, and healthcare enable older adults to thrive - from transportation and wellness of county residents of all ages. She 40 percent of these adults live on an annual Institute, UPMC, and external organizations.” providers can rely upon for expert help and links And in 2018, for the first time, the Institute offered and social inclusion to housing, communication, encouraged participants to become active partners income of $20,000 or less. to community resources.” opportunities for callers to participate in live chats with the Live Well Allegheny program to sustain and webinars. “Doing so allows us to engage in and grow its successes. Ms. Hardy also provided According to Ms. Edwards, healthcare professionals more extended discussions on a particular topic,” information on county resources of special interest to now comprise 25 percent of all calls. “We’re hearing says Ms. Edwards. “We’re looking forward to doing older adults and their caregivers, ranging from food directly from concerned social workers, nurses, more of them next year.” access (Just Harvest), to fall prevention (Matter of doctors, and case managers who want to discuss Balance and STEADI) and driver safety (CarFit). about a particular patient’s situation to determine Sharing Resources for Older Adults NOTE: Over the summer of 2018, Aging Institute what kinds of community resources are available As part of its efforts to promote awareness of staff received training in Matter of Balance and to help that individual,” she says. the needs of caregivers, in May 2018, the Aging CarFit and began offering classes for interested Institute presented a half-day program focused on Older adults and their spouses — as well as their older adults and caregivers. adult children, concerned friends, and neighbors sharing ideas and resources with caregivers and — make up the balance of callers. “The questions professionals who support older adults in our region. 44 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 45

In 2018, these programs covered a wide range of award-winning program created by the Maine Professor and occupational therapist Pamela E. Toto, and help them complete their project. Plans are in bag deploys in a crash. Many also lack a clear line MOVE UP at UPMC McKeesport topics, including: Health Partnership for Healthy Aging, is designed PhD, OTR/L, School of Health and Rehabilitation place for 2019 to offer Matter of Balance again for of sight, which can lead to an accident. The growing presence of the Aging Institute at UPMC to help seniors overcome their fears and become Sciences at the University of Pittsburgh, is a master McKeesport and Turtle Creek residents as well as McKeesport and its commitment to supporting the • Fraud • Rehabilitation To ensure area seniors “fit” safely in their cars, more active. trainer for the Matter of Balance program. She also other lower income communities with high senior Ms. Jones completed training as a CarFit technician health and wellness needs of vulnerable older adults • Financial planning • Eye health was awarded the 2017 Geriatrics Teacher of the Year populations. “The Aging Institute and its programs This year, Ms. Jones completed coach/facilitator alongside nearly 50 University of Pittsburgh in the community made it the ideal resource to host for care Mindfulness Award by the Pennsylvania Geriatric Society for her are a tremendous resource for our students,” notes • training in Matter of Balance taught by master occupational therapy students in 2018. Training was the first hospital-based site of MOVE UP, The Hospice care contributions to improved care for older adults. Dr. Toto, who also is involved with the Institute’s • • Seniors and research trainers through the Allegheny County Health completed at Senior Communities’ Asbury Heights, Mobility and Vitality Lifestyle Program. “Dr. Toto made a huge impact when she talked to work with the Geriatric Workforce Enhancement • Wandering/lost trials Department. The eight-week, two-hour-long classes located in Pittsburgh’s Mount Lebanon neighborhood. participants at our McKeesport and Turtle Creek Program (see page 28). The national community-based lifestyle research behavior focus on developing coping strategies to address the As a certified CarFit event coordinator and instructor • Medications programs,” says Ms. Jones. “She demonstrated the study is a project of the University of Pittsburgh Nutrition fear of falling, including making changes to reduce fall CarFit: Helping Older Drivers Find a Perfect Fit since 2007, Dr. Toto has championed the program Center for Aging and Population Health’s • • Fall prevention correct way to fall and offered safe strategies on risks and exercising to increase strength and balance. Older drivers often sit too close to the steering locally for more than a decade. “We’re planning to Prevention Research Center, funded by the • Caregiving how to stand up again - something that can be very • Depression and wheel, which increases their injury risk if the air host CarFit community events in McKeesport and In Fall 2018, Ms. Jones introduced Matter of challenging to older adults.” Dennis A. Martin, Centers for Disease Control and Prevention (CDC). • Elder law holiday blues other communities starting in 2019 in collaboration Balance classes at the Aging Institute Resource OTR/L, CHT, occupational therapy program director It is led by epidemiologist Anne B. Newman, MD, Navigating Winter safety with Dr. Toto and her occupational therapy students,” • • Center at UPMC McKeesport, Turtle Creek Senior for UPMC Centers for Rehab Services, also spoke to MPH, clinical director of the Aging Institute. community resources notes Ms. Jones. Center, and at William S. Moorhead Towers in one of the McKeesport classes on how to get up from McKeesport area residents participated in the Additionally, through its relationships with the Oakland, an independent living community serving a fall and shared assistive devices that can help make CarFit, a program created by the American Society program, which targets weight loss and Allegheny County Health Department and individuals with visual or physical challenges. The getting dressed and managing household tasks easier. of Aging in partnership with the Automobile maintenance through the development of healthy the University of Pittsburgh Department of program was met with enthusiastic response by Association of America (AAA), the American The Aging Institute had the opportunity to facilitate eating habits, behavior modification, and self- Occupational Therapy, Aging Institute staff both older adults and caregivers, with requests to Occupational Therapy Association, and AARP, the engagement of three students from the directed exercise (usually walking), with the goal of pursued training and began conducting increase the number of available classes in the uses a 12-point checklist to ensure that older University of Pittsburgh’s School of Engineering reaching 175 minutes of activity a week. Participants programming at UPMC McKeesport and future. A major feature article on the program drivers fit in order to ensure safe driving. Drivers through Matter of Balance. The students used in the 13-month, 32-sesson program ranged in age other locations: appeared in the Pittsburgh Post-Gazette, which has are checked in their vehicles for a clear line of sight, feedback from the participants to modify prototypes from 60 to 75 with a body mass index between also generated increased interest in the program. good foot position, safe distance between chest Matter of Balance: Overcoming Fears and for a fall detection device they were developing 27 and 45. Early indicators of both weight loss and and steering wheel, properly adjusted mirrors and Avoiding Falls “We begin the program by encouraging participants for a class project and poster presentation. The participation in the program is promising. And while steering wheels, and other safety concerns. Particularly if they’ve already experienced a bad to talk about their fears of and experiences with engineering students gained knowledge about the long-term participation isn’t part of the study, many fall, older adults have a fear of falling, which can falling,” says Ms. Jones. “From there we explore ways challenges older adults face especially related to members of the McKeesport MOVE UP program limit their activities and lead to weakness and an to integrate balance exercises into their lives, which vision and hearing impairments and the class are remaining active and involved through the Aging increased risk of falling. Matter of Balance, an can be done while sitting or watching television.” participants were thrilled to engage with students Institute at UPMC McKeesport. 46 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 47

The 2018 Community Champion is the United Way of Southwestern Pennsylvania under the leadership Celebrating of President and Chief Executive Officer, Robert Nelkin. Helping our region’s seniors live healthy lives is one of four core pillars of United Way’s work. To help address the unmet needs of seniors, United Senior Champions Way launched “Open Your Heart to a Senior” in 2012, connecting caring adults with seniors who What began as a dinner in 2009 to recognize need extra assistance to remain safe at home and who would benefit from companionship to combat the 20th anniversary of Seneca Place and the isolation and loneliness. Since then, thousands of genesis of UPMC Senior Communities has The 2018 Grand Champion is Anne B. Newman, MD, seniors and volunteers have developed enriching Richard Schulz, PhD is the 2018 Caregiver marked its tenth year of recognizing remarkable MPH, Distinguished Professor and Chair of the relationships each year, helping seniors prolong Champion. Dr. Schulz is a Distinguished Service Department of Epidemiology and Director of the Professor of Psychiatry and Director of Gerontology individuals and organizations who have created their health, happiness, and independence. Center for Aging and Population Health (CAPH) in Through innovative leadership, financial investment, at the University of Pittsburgh. He is also the a better life for seniors and caregivers living in the Graduate School of Public Health, with a joint volunteerism, public education, and strategic local Associate Director of the Aging Institute of UPMC western Pennsylvania. Since its inception, appointment in the Division of Geriatric Medicine in partnerships, United Way is keeping the time, talent, Senior Services and the University of Pittsburgh. “Celebrating Senior Champions” has presented the School of Medicine at the University of Pittsburgh. and experience of seniors tightly woven into the His work focuses on social-psychological aspects She has also been newly appointed as the Clinical of aging, including the impact of disabling late-life more than $1.1 million in net proceeds to further fabric of our community, making the region stronger, Director of the Aging Institute of UPMC Senior more vibrant, and more economically secure. disease on patients and their families. Funded by charitable care for frail seniors who have outlived Services and the University of Pittsburgh. Dr. Newman the National Institutes of Health for more than their financial resources. UPMC Senior Services plays a critical role in developing the clinical platforms three decades, Dr. Schulz conducts descriptive hosted this signature event on October 18, 2018. needed to translate basic science discoveries into longitudinal and intervention research on diverse population health and patient care. Internationally older populations representing illnesses such as “These honorees play a critical role in developing renowned for her work in the epidemiology of aging, cancer, spinal cord injury, stroke, Alzheimer’s the clinical and human service platforms needed longevity, and disability, Dr. Newman’s research has disease, heart disease, and arthritis. He is a leading defined the impact of apparently subclinical disease contributor to literature on the health effects of to improve the lives of seniors in western on physical, cognitive function, and on the metrics of caregiving. Additionally, Dr. Schulz is exploring Pennsylvania and nationally,” said Deborah healthy aging. She conducts clinical trials to prevent supportive interventions, including technology- Brodine, president of UPMC Community Provider disability using physical activity, weight management, based approaches designed to enhance patient Services. “UPMC Senior Services is proud to and medical therapies. functioning and quality of life of both patients and their relatives. recognize their exemplary work.” 48 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 49

Research of the Aging A recognized pioneer in the field of geriatrics, the University of Pittsburgh remains among the Institute’s Partners foremost institutions of higher learning to lead research focused on improving the care and quality of life of older adults. Through decades of collaborative and multidisciplinary research — conducted by experts in medicine, public health, nursing, social science, psychiatry, epidemiology, and ethics — our University partners have positioned our region at the forefront of aging- related research and innovation. 50 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 51

Centers of Excellence Research Publications Highlights WMLs remained strong 2018 Nov;71:142-148 Snitz BE. Amyloid-beta deposition alone (Aβ+/ American Journal of postsynaptic density, is predictors. Amyloid- [PMCID in process; deposition and suspected ND ) group showed faster Psychiatry. 2018 ;in press associated with resilience Following is a representative sampling that highlights the remarkable range and diversity of aging-related research initiatives undertaken by researchers, β − (A ) deposition and HIP PMID 30138767]. non-Alzheimer decline on tests of verbal [PMC6167138]. to psychosis in Alzheimer’s scientists, and clinicians at the University of Pittsburgh and UPMC that were published in peer-reviewed journals in 2018. β volume were predictors of pathophysiology exhibit and visual memory, disease. Finding: This study Finding: This study death in MCI participants. different cognitive decline executive function, and examined the potential examined whether the Yan Q, Nho K, Del-Aguila Center for Late-Life a Lay Counselor late-life depression. American Journal of The ADRC performs and deposition and brain This study showed the patterns over 12 years in language. The group with modifiable factors that psychotic phenotype in JL, Wang X, Risacher SL, Depression Intervention on Prevention Neuroimage Clinical. Geriatric Psychiatry. promotes research designed structure as predictors presence of more than one the oldest-old without isolated hippocampal might influence the Alzheimer’s disease had a Fan KH, Snitz BE, Prevention and of Major Depression in 2018 Jun 8;19:831-839. 2018;26:7.765-777. to gain an understanding of MCI, dementia and biomarker was a stronger dementia. JAMA- atrophy (Aβ−/ND+ group) functional impact of more rapid cognitive Aizenstein HJ, Mathis CA, Treatment (CLLDPT) Older Adults Living in of the etiology and mortality in the oldest-old. long-term predictor of Neurology. 2018 Jan showed greater decline Finding: Acute, dynamic Finding: The combination Alzheimer’s disease deterioration than in Lopez OL, Demirci FY, Director: Low- and Middle-Income pathogenesis of Alzheimer’s Neurology 2018 May incident dementia than any 1;75(1):88-96 [PMCID: only in tests of visual trajectories of functional of antidepressant pathology, by investigating Alzheimer’s disease Feingold E, Klunk WE, Jordan F. Karp, MD Countries: A Randomized disease (AD) and the 22;90(21): e1920-e1228 biomarker alone. After PMC5833487]. memory. The study imaging metrics in pharmacotherapy and whether sleep measures without psychosis by Saykin AJ, Cruchaga C, The CLLDPT provides a Trial. JAMA Psychiatry. mechanisms underlying the [PMCID: PMC5962915]. adjusting for the risk of concluded that isolated response to a problem-solving therapy moderate the relationship Finding: This study examining alterations in Kamboh MI. Genome-wide research infrastructure to E-pub, ahead of print. cognitive and neurobiological dying, amyloid deposition hippocampal atrophy is pharmacological was not superior Finding: This study tested between A burden and evaluated preclinical the synaptic proteome in association study of brain promote and support changes. It also develops and WMLs were stronger β dissimilar to preclinical AD Finding: The depression in intervention are a valuable to antidepressant the hypothesis that brain cognitive function. biomarkers and cognitive autopsied Alzheimer’s amyloid deposition as investigations that will strategies targeted at predictors of dementia in that only isolated later life (DIL) intervention tool for predicting pharmacotherapy and structural integrity (i.e., Forty-four in nondemented decline in a longitudinal disease cases. The study measured by Pittsburgh improve real world practice effective early diagnoses than HIP volume. The risk memory decline was is effective for preventing treatment response in supportive management. hippocampal (HIP) subjects (age range 64-96) study of the oldest old found that subjects resilient Compound-B (PiB)-PET in the care of older adults and treatments for AD and of dying during follow-up observed over time, as episodes of major late-life depression and Clinically, the rates of volume), white matter underwent PiB-PET (> 80 years) without to psychotic symptoms in imaging. Molecular living with depression other dementias. The was associated with both, compared to memory and depression in older elucidating the mechanism response and stability lesions (WMLs), and imaging and cognitive dementia. The study Alzheimer’s disease had Psychiatry. 2018 Oct and other severe mood publications of the ADRC neurodegeneration, non-memory decline with persons with subsyndromal of pharmacological of response over one amyloid-β (Aβ) deposition, testing. High Aβ burden assessed whether those higher levels of synaptic 25;doi: 10.1038/s41380- and anxiety disorders. It highlight a focus on imaging and amyloid deposition, Aβ accumulation. This symptoms. If replicated, therapies in the context of year observed in both were associated with was associated with poor individuals with A proteins compared to those 018-0246-7). focuses on developing and biomarkers, neuropsychiatric especially in MCI β study confirms previous the DIL intervention may the brain’s functional groups suggest that these long-term (8 years) memory function in those accumulation but without with psychosis and to testing novel medication, characterization including individuals. findings that Aβ deposition Finding: This was the first be effective in older adults architecture. approaches may have increased risk of incident with poorer sleep. This evidence of neuro- unaffected control subjects. psychosocial, and behavioral the provision of high quality, is associated with GWAS on brain amyloid living in low- and clinical utility in these dementia and mortality in Wilckens KA, Tudorascu suggests that better sleep degeneration (ND), as Neuropathologic burden interventions to improve Karp JF, Gao X, Wahed behaviorally characterized long-term cognitive decline. deposition as measured by middle-income countries. chronically suffering 183 cognitively normal and D, Snitz B, Price J, may be protective against assessed by hippocampal predicted less than 20% of mood and cognitive AS, Morse JQ, Rollman BL, samples for genetic and Pittsburgh Compound-B patients. MCI individuals age 80+. Aizenstein H, Lopez OL, the effects of Aβ in volume, or with evidence Krivinko JM, Erickson SL, the variance in psychosis outcomes and reduce the Karim HT, Wang M, Weiner DK, Reynolds CF. postmortem studies, (PiB)-PET imaging HIP, WMLs and amyloid-β Erickson K, Lopresti B, preclinical Alzheimer’s of ND but without Aβ Ding Y, Sun Z, Penzes P, status and did not account disability associated with Andreescu C, Tudorascu Effect of Problem-Solving Alzheimer’s Disease and early stage disease. conducted in several (Aβ) deposition were Laymon C, Minhas D, disease. accumulation (Aβ), show MacDonald ML, Yates, for the synaptic protein late-life depression. D, Butters MA, Karp JF, Therapy Versus Research Center cohorts in the country. Lopez OL, Becker JT, Klunk predictors of incident Mathis C, Buysse D, Klunk specific cognitive decline NA, Ikonomovic MD, level differences between Reynolds CF, Aizenstein Supportive Management (ADRC) Zhao J, Tudorascu DL, We identified multiple Dias A, Azariah F, WE, Mathis C, Price J, dementia, especially in the WE, Cohen AD. Sleep signatures. The study Lopez OL, Sweet RA, groups. The authors HJ. Acute trajectories in Older Adults with Low Director: Oscar Lopez, MD Lopez OL, Cohen AD, independent signals in Anderson SJ, Sequeira Aizenstein HJ, Snitz B, individuals that had the moderates the relationship found that the Aβ+/ND+ Kofler J. Synaptic concluded that the of neural activation Back Pain and Depression Co-Director: William E. Price JC, Mathis CA, the APOE and non-APOE M, Cohen A, Morse JG, Cohen A, Ikonomovic M, three biomarkers present. between amyloid beta and group showed the steepest proteome compensation accumulation of synaptic predict remission to While on Antidepressant Klunk, MD, PhD Aizenstein HJ, Kuller LH, regions (We have also Cuijpers P, Patel V, Chang YF, Kamboh MI, After adjusting for the risk memory recall. decline on cognitive and resilience to psychosis proteins, particularly those pharmacotherapy in Pharmacotherapy. DeKosky ST, Klunk WE, identified a novel locus for Reynolds CF. Effect of Kuller LH. Amyloid of dying, Aβ deposition, Neurobiology of Aging, measures. The amyloid in Alzheimer Disease. that are enriched in the 52 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 53

the attention/processing This study demonstrated orchestrates epidemiologic predicts mortality alone pressure phenotype in the mobility, osteoporosis, speed cognitive domain. the critical role of study and public health research and in combination with a Long Life Family Study. pain, pharmacotherapy, setting on SCD-associated on aging, trains professionals previously published index Journal of Hypertension. resilience, and sarcopenia. Snitz, B.E., Wang, T., risk for progression in population research of comorbidity. 2018 Jan;36(1):43- The division also has NIH Cloonan, Y.K., Jacobsen, and underscores the methodology, and conducts 53. doi: 10.1097/ support for a Cancer and E., Chang, C.C.H., Hughes, Jacob ME, Marron MM, importance of community outreach with H.0000000000001514. Aging Center, an Older T.F., Kamboh, M.I. and Boudreau RM, Odden MC, consideration of study a goal of keeping older PubMed PMID: 28837423; Americans Independence Ganguli, M. Risk of Arnold AM, Newman AB. setting when evaluating adults healthy. PubMed Central PMCID: Center (Pepper), and several progression from Age, Race, and Gender the utility of SCD as a risk PMC5893936. NIH-funded research training subjective cognitive Sanders JL, Arnold AM, Factors in Incident marker for AD / cognitive grants. decline to mild cognitive Boudreau RM, Hirsch CH, Disability. Journals of Finding: The Long Life decline. This is one of the impairment: The role of Kizer JR, Kaplan RC, Gerontology Series A: Family Study is a major Gurkar AU, Robinson A, first direct comparisons of study setting. Alzheimer’s Cappola AR, Cushman M, Biomedical Sciences and ongoing study of families Yuxiang, et al. clinical outcomes between & Dementia. 2018;14 (6): Jacob ME, Kritchevsky SB, Medical Sciences. 2018 with longevity. This report Dysregulation of DAF-16/ two divergent study 734-742. Newman AB. Association Jan 16;73(2):194-197. doi: suggests that blood FOXO3-mediated stress settings addressing this of biomarker and 10.1093/gerona/glx194. pressure may be one responses accelerate Finding: This study hypothesis. physiologic indices with PubMed PMID: 29045556; specific pathway to oxidative DNA damage compared risk for clinical Center for Aging and mortality in older adults: PubMed Central PMCID: longevity in certain families. induced aging. Redox progression associated Population Health Cardiovascular Health PMC5861898. Biology. In press. with subjective cognitive Division of Director: Anne B. Study. Journals of decline (SCD) (vs. control) Finding: Rates of disability Geriatric Medicine Finding: Physiologic DNA Newman, MD, MPH Gerontology Series A: from two study settings: by various definitions are Director: Neil M. damage is thought to The Center for Aging and Biomedical Sciences and the ADRC vs. a population- useful for planning future Resnick, MD drive cell fate-decisions Population Health (formerly Medical Sciences. 2018 based cohort in small studies. This report from Designated a National Center such as senescence or the Center for Healthy Apr 12. doi: 10.1093/ town communities the Cardiovascular Health of Excellence by the John A. apoptosis, which in turn, Aging) generates new gerona/ gly075. [Epub around Pittsburgh, Study (CHS) provides such Hartford Foundation, the are believed to drive solutions to the challenges ahead of print] PubMed the Monongahela- rates by age, race, and sex. University of Pittsburgh’s aging and age-related of an aging society through PMID: 29659743. PubMed Youghiogheny Health Division of Geriatric Medicine pathologies. However, population-based research Central PMCID: In Process Marron MM, Singh J, Aging Team (MYHAT). The is committed to excellence Dr. Gurkar and colleagues that promotes healthy aging, by Journal. Boudreau RM, Christensen hazard ratio for incident in geriatric research, clinical found that, in mice, longevity, and prevention of K, Cosentino S, Feitosa mild cognitive impairment Finding: This report from care, and training. Its research endogenous DNA damage disability. Supported in part MF, Minster RL, Perls T, in individuals with SCD the CHS All Stars Study includes the biology of aging, induces activation of the by the Centers for Disease Schupf N, Sebastiani P, was higher in the memory (R01 AG023629, Newman cancer, dementia, depression, DAF-16/FOXO3A stress Control and Prevention’s Ukraintseva S, Wojczynski clinic than in a general PI) shows how an index of falls, frailty, heart disease, response pathway. In the (CDC) Prevention Research MK, Newman AB. A non-specific population. blood biomarkers of aging incontinence, infections, short term, this response Centers Program, the Center novel healthy blood 54 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 55

is protective. Since such falls, and frailty. It also brain plays the dominant pharmacotherapy for older differences, they concluded Greenspan SL. Identifying Greenspan SL, Singer A, osteoporosis following a its authors to summarize of complex older CVD Xia Y, Pu H, Leak RK, Shi Y, synthetic tPA can safely activation cannot be supports broadening the role and one in which it adults reduces ADRs by that those in the HELP sarcopenia in female Vujevich K, et al. first fracture. the key components of patients. Its publication in Mu H, Hu X, Lu Z, Foley protect or repair white sustained, however, it scope of HF management does not. These findings 21% and serious ADRs by program had 17% fewer long-term care residents: Implementing a fracture such a program and the one of the field’s premier LM, Hitchens TK, Dixon matter by promoting Jump RLP, Gaur W, Katz results in functional to include greater should facilitate 35%. Healthcare systems readmissions than those A comparison of current liaison service open model steps needed to adapt journals adds further CE, Bennett MVL, Chen J. communication across MJ, Crnich CJ, Sloane P, decline and death. Thus, emphasis on nutrition development of enhanced should consider deploying who were not. guidelines. Journal of the of care utilizing a cloud- them to the LTC setting; credence to its message: a Tissue plasminogen nerve fiber tracts, leading Nace D on behalf of the response to DNA damage, and other approaches to behavioral therapy for the more pharmacists to American Geriatrics based tool. Osteoporosis they also provided a geriatric domain (i.e., activator promotes white to improved long-term Sanders JL, Arnold AM, Infection Advisory rather than the damage preserve lean mass as an first phenotype and more reduce ADRs and Society. 2018; 66:316-20. International. 2018; sample policy template multimorbidity) must matter integrity and adaptive behavior. These Newman AB. Association Committee for AMDA-The itself, seems to drive additional target. targeted pharmacologic associated costs. 29:953-960. and a list of free resources transform CVD practice. functional recovery in a results suggest that of biomarker and Finding: Although Society of Post-Acute and organismal aging. treatment for the second. to support such efforts. murine model of traumatic tPA could be useful in Clarkson B, Griffiths D, Rubin FH, Bellon J, physiologic indices with sarcopenia-the loss of Finding: Half of women Long-Term Care Medicine. Geriatric Research The article is among the brain injury. Proceedings of promoting recovery after Forman DE, Santanasto AJ, Resnick NM. Do brain Gray SL, Hart LA, Perera S, Bilderback A, Urda K, mortality in older adults. muscle mass and and 25% of men 50 will Template for an antibiotic Education and Clinical ≥ top 5 downloaded from the the National Academy of TBI in patients. Boudreau RM, et. al. Impact structural abnormalities Hanlon JT. Meta-analysis Inouye SK. Effect of the Cardiovascular Health capacity--impairs function fracture, but <25% receive stewardship policy for Center (GRECC) JAMDA website. Sciences of the United of incident heart failure on differentiate separate of interventions to reduce Hospital Elder Life Program Study. J Gerontology: and independence of older appropriate secondary post-acute and long-term Director: Steven Graham, Cai M, Zhang W, Weng Z, States of America. 2018 body composition over forms of urgency urinary adverse drug reactions in (HELP) on risk of 30-day Series A. 2018: gly075. adults, there is a lack of prevention. In this care settings. Journal of Forman DE, Maurer MS, MD, PhD Stetler RA, Jiang X, Shi Y, Sep 25;115(39):E9230- time in the Health, Aging, incontinence? Neurourolgy older adults. Journal of the readmission. Journal of the consensus on how to innovative quality the American Medical Boyd C, et. al. The GRECC is funded by the Gao Y, Chen J. Promoting Finding: A new biomarker E9238. doi: 10.1073/ and Body Composition and Urodynamics. 2018 American Geriatrics American Geriatrics define it. The 3 most improvement project, a Directors Association. Multimorbidity in older Department of Veterans Neurovascular Recovery in index-which included pnas.1810693115. Study population. [epub ahead of print]. Society. 2018; 66:282–288. Society. 2018; 66: 145-149. accepted definitions- nurse practitioner-led 2017; 18: 913-20. adults with cardiovascular Affairs and provides an Aged Mice after Ischemic Cystatin C, IGF-1, IGFBP-3, Circulation Heart Failure. from NIH, the European Fracture Liaison Service disease. Journal of the integrated program of basic Finding: Tissue Stroke - Prophylactic Finding: Urge incontinence Finding: Older adults take Finding: In 2002, Dr. Rubin IL-6, NT-Pro BNP, and Finding: Owing to the 2017; 10 (9):e003915. Working Group, and (FLS) was implemented in American College of biomedical, clinical, and plasminogen activator Effect of Omega-3 Poly- is the most common and more drugs than younger implemented Dr. Inouye’s DHEAS-was independently increase in multidrug SARC-F- are based on data 3 healthcare systems. It Cardiology. 2018; 71: health services research; (tPA) is used in stroke unsaturated Fatty Acids. Finding: Obesity is linked refractory type of geriatric individuals, and are more HELP program at UPMC associated with mortality, resistance and Clostridium from community-dwelling increased bone density 2149-61. education of trainees and patients to break up blood Aging and Disease. 2017 to heart failure (HF) but incontinence, and it is apt to suffer adverse drug Shadyside, a community even after adjusting for an difficile infections, in 2017 elders; none used data testing from 21% to 93% practitioners; and clinical clots, but there are Oct 1;8(5):531-545. doi: the association has not associated with non- reactions (ADR). teaching hospital. Although organ system-based CMS required all long-term Finding: Although from long-term care (p < 0.001), vitamin D demonstration projects conflicting reports about its 10.14336/AD.2017.0520. accounted for age-related suppressible bladder Pharmacists can reduce HELP is effective in physiologic index of care (LTC) facilities to comorbidity is common residents. This study assessments from 25 to designed to advance potential therapeutic eCollection 2017 Oct. changes in lean body mass. contractions. Using the use of potentially reducing the incidence of comorbidity. Because both establish an antibiotic with aging, current CVD compared the 3 criteria in 84% (p < 0.001), knowledge regarding the benefit and safety for PMID:28966799. This analysis of healthy neuroimaging to assess problematic medications delirium, its efficacy in indices substantially stewardship program. diagnosis and management 141 such residents. prescription of calcium/ care of the elderly, with an victims of traumatic brain older adults over 6 years brain structure, function, but it is less clear whether reducing readmissions is attenuate the age effect on Yet experience with such focus primarily on the Finding: Omega-3 Fifty-one met at least one vitamin D from 36% to emphasis on stroke. Its injury (TBI). In this study, revealed that, despite an and connectivity, however, this input can reduce unclear. Thus, Dr. Rubin mortality, these indices programs is largely limited heart. This review polyunsaturated fatty acids definition but concordance 93% (p < 0.001), and research focus includes electrophysiological, increase in obesity, those Drs. Clarkson, Griffiths, and ADRs. This meta-analysis and colleagues identified may prove useful in to academic or hospital recommends incorporating (o-3PUFAs) are the active between definitions was prescription of specific neuronal-cell death in anatomical, and behavioral who develop HF suffer loss Resnick have found that UI by Drs. Gray, Perera, and readmissions of all older targeting and assessing the settings. To address this multimorbidity into clinical ingredients of fish oils low and only 2 residents osteoporosis treatment stroke, gene therapy in measures of recovery of lean mass that exceeds may comprise at least two Hanlon found that, patients discharged from impact of interventions to gap, leaders in geriatrics decision making, highlights and have been shown to met all 3 definitions. from 20 to 54% cerebrovascular disease, were performed on mice the amount due to aging. separate phenotypes, even regardless of the setting Shadyside. Using alter the trajectory of aging. and infectious disease critical knowledge gaps, improve recovery from Clearly, development of (p < 0.001). An FLS model depression in the elderly, after TBI. The findings The loss likely increases the in neurologically normal or type of intervention, administrative data to reviewed the formal and clarifies research stroke in young adult Kotlarczyk MP, Perera S, better diagnostic criteria can effectively address polypharmacy in long-term suggested that natural or risks of functional decline, elders: one in which the optimizing adjust for group literature and expertise of priorities to optimize care Nace DA, Resnick NM, is needed. care, and end-of-life care. 56 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 57

rodents. This study back pain (CLBP) tend to 10.1044/2017_ Mental Illness doi:10.1007/s40501-018- M, Ruiz A, Williams J, investigated whether be nonspecific and costly, AJSLP-16-0196. Research, Education, 0145-1. Mayeux R, Lopez OL, Sibille o-3PUFA-enriched fish and lead to unsatisfactory PMID:29497754. and Clinical Centers EL, Kamboh MI, Devlin B, Finding: This narrative oil is effective in aged outcomes. This study (MIRECC) Sweet RAC. Genetic Risk Finding: Semantic feature review provides an mice. Mice treated with demonstrated the Site Director: Gretchen L. for Schizophrenia and analysis (SFA) is a overview of recent o-3PUFA-enriched fish oil association of individual Haas, PhD Psychosis in Alzheimer common treatment for recommendations improved long-term stroke pain-causing conditions in The Mental Illness Research, Disease. Molecular aphasia, a language and empirical findings histological and behavioral the periphery (e.g., Education and Clinical Psychiatry. 2018; 23(4), impairment, following regarding the management outcomes and evidence of osteoarthritis) and in the Centers (MIRECC) were 963-972. doi: 10.1038/ stroke. This study of insomnia in older enhanced post-stroke brain central nervous system established by Congress with mp.2017.81. investigated how adulthood. Cognitive repair processes. Since (e.g., insomnia, the goal of researching the practice-related variables Behavioral Therapy for Finding: Dr. DeMichele- stroke is a disease of the fibromyalgia) to key causes and treatments of affected word-finding Insomnia (CBT-I) continues Sweet and colleagues elderly, these results treatment outcomes – pain mental disorders and using outcomes in 17 patients to be empirically supported demonstrate that the risk suggest that o-3PUFA- severity and self-reported education to put new undergoing intensive SFA and is the recommended for psychotic symptoms enriched fish oil treatment and performance-based knowledge into routine treatment. Findings first-line intervention for (delusions and/or may improve recovery in physical function. Treating clinical practice in the indicated that the number insomnia in older adults. hallucinations) in elderly patients with stroke. these specific conditions Veterans Administration. of semantic features Other nonpharmacological individuals with may impact outcomes and Specialized mental health Weiner DK, Gentili A, patients generated during interventions such as Alzheimer’s disease health care utilization. centers of excellence (MH Coffey-Vega K, Morone N, naming trials was more mindfulness-based is reduced in those CoE) are an essential Rossi M, Perera S. Gravier ML, Dickey MW, strongly related to therapies, light therapy, individuals carrying component of the VA’s Biopsychosocial Profiles Hula WD, Evans WS, treatment response and physical activity common genetic variations response to meeting the and Functional Correlates Owens RL, Winans-Mitrik than other factors such interventions also show that otherwise increase the mental health needs in Older Adults with RL, Doyle PJ. What Matters as number of trials, total promise in the treatment risk for schizophrenia. This of veterans. Chronic Low Back Pain: A in Semantic Feature treatment time, and of insomnia in older provides an opportunity to Preliminary Study. Pain Analysis: Practice-Related number of trials per hour. Tighe, C, & Bramoweth, adulthood. identify possible biologic Medicine. 2018 Apr 16. doi: Predictors of Treatment These results suggest AD. Recent Developments pathways (i.e. pathways DeMichele-Sweet MAA, 10.1093/pm/pny065. Response in Aphasia. how refinements in in the Management of affected by these genetic Weamer EA, Klei L, Vrana [Epub ahead of print] American Journal of rehabilitation protocols Insomnia in Later Life. variations) that may be DR, Hollingshead DJ, PMID:29672748. Speech-Language may reduce word finding Current Treatment targeted in efforts to Seltman HJ, Sims R, Foroud Pathology. 2018 Mar problems in patients Options in Psychiatry. develop medications to Finding: Current T, Hernandez I, Moreno- 1;27(1S):438-453. doi: after stroke. 2018; 5 (2), 195-210. treat or prevent these treatments for chronic low Grau S, Tárraga L, Boada 58 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 59

disturbing symptoms in Kotlarczyk MP, Perera S, European Working Group Secondary Data Analysis 0.60 to 0.68 in terms of Using regression modeling, 336-342. DOI: 10.1212/ conclusion that slowing 2018 Jun 19. PubMed that the blunted active area of research at the Singapore Chinese elderly Alzheimer’s Nace DA, Resnick NM, on Sarcopenia in Older of Women in Long-Term correlation with ADL and the study examined L.0000000000004153. gait can serve as an PMID: 30031267; transcription responses the Hillman Cancer Center. Health Study. International disease patients. Greenspan SL. Identifying People (EWGSOP) and Care Using Item Response from 22% to 36% in terms cross-sectional indicator of dementia risk. PubMed Central PMCID: to oxidant stress in these This preclinical study Journal of Cancer. 2018 Finding: This study Sarcopenia in Female two sets of evidence- Theory. The Gerontologist. of proportion of explained associations between PMC6076207. repair deficient animals examined how combining a Jun 1;142(11):2234-2243. Pittsburgh Claude D. examined the association University of Long-Term Care Residents: based guidelines from the 2018; 58(4): e197-e204. variability by frailty. As WMH volume and COMT rather than direct DNA ATR kinase inhibitor with doi: 10.1002/ijc.31251. Pepper Older between slowing gait and Pittsburgh Cancer Finding: How DNA A Comparison of Current Foundation for the National DOI: 10.1093/geront/ only older women were Val158Met genotype in a damage seems to be the ionizing radiation (IR) Epub 2018 Jan 25. Americans cognitive impairment in a Center Genome damage and repair Guidelines. Journal of Institutes of Health (FNIH) gnx033. included, further study cohort of older adults. MPS cause of premature aging. caused complete immunity PubMed PMID: 29318605; Independence Center cohort of older adults Stability Program modulate the aging process American Geriatrics Sarcopenia Project, as well with a larger and more was found to be present in to colon cancer cells in a PubMed Central PMCID: Director: Susan L. Finding: Using item (n=175). Participants were Patricia Opresko, PhD and is an active area of Vendetti FP, Karukonda P, Society. 2018; 66(2): as by the SARC-F generalizable sample is 42.3% of the sample. mouse model. They show PMC5893405. Greenspan, MD response theory, this study assessed for gait speed Ben Van Houten, PhD, research. This study shows Clump DA, Teo T, Lalonde 316-320. DOI: 10.1111/ questionnaire. The study needed before definitive Ultimately, WMH had a that while IR increases the Balance disorders in older explored the psychometric over fourteen years and co-leaders. how the loss of a critical R, Nugent K, Ballew M, Finding: Is telomere length jgs.15213. found that the prevalence recommendations can be direct relation with MPS, expression of a tumor cell people are common, characteristics and gray matter volume (via Advancing the understanding, DNA repair protein, ERCC1, Kiesel BF, Beumer JH, a predictor of cancer? This of sarcopenia ranges from made for NHPPT. and while COMT was not marker that allows immune disabling, and often Finding: This study potential improvements MRI) at years ten or eleven. diagnosis, and treatment in the nematode, early in Sarkar SN, Conrads TP, study examined telomere 4.3-32.6%. Only two out associated with MPS, it did evasion, the ATR inhibitor complex. A concentrated, conducted cross-sectional of the Nursing Home Rosso AL, Bohnen NI, Cognitive status was then of cancer through basic, life turns on an oxidative O’Connor MJ, Ferris RL, lengths in peripheral blood of the one-hundred and modify the effect of WMH helped to ameliorate this multidisciplinary effort is secondary analyses Physical Performance Test Launer LI, Aizenstein HJ, adjudicated at year translational, clinical, stress response network, Tran PT, Delgoffe GM, cells from 26,540 forty-one participants on MPS. These findings effect. Mice were found not needed to understand its of long-term care (NHPPT), an instrument Yaffe K, Rosano C. Vascular fourteen. Gait was and population-based under the control of Bakkenist CJ. ATR kinase individuals prior to the would be considered suggest that MPS has a only to clear the tumor causes and consequences — communities in Pittsburgh, developed using classical and Dopaminergic calculated by using research programs DAF-16 . However, this inhibitor AZD6738 onset of any overt disease, sarcopenic under all three primarily vascular origin in cells, but were found to and to develop innovative Pennsylvania with the methods to measure Contributors to Mild Bayesian slopes, with activation is lost with age potentiates CD8+ of which 654 developed diagnostic guidelines. older adults and that Gurkar AU, Robinson AR, be immunized to further treatments. The team of aims of establishing the function among nursing Parkinsonian Signs in higher values indicating and these nematodes Tcell-dependent antitumor lung cancer. The patients’ The criterions set by the dopaminergic networks Cui Y, Li X, Allani SK, tumor challenges. Orally investigators at the Claude D. prevalence of sarcopenia in home residents. Older Adults. Neurology. greater decline, while displayed overall shorter activity following radiation. average age was 73 years. EWGSOP and FNIH have may have a role in resilience Webster A, Muravia M, active ATR inhibitors are Pepper Older Americans long-term care populations Researchers already knew 2017; 90(3): e223-e229. gray matter volume was life span, and premature Journal of Clinical The results showed that little overlap among older to vascular pathology. Fallahi M, Weissbach H, currently being translated Independence Center offers and examining different that NHPPT had good DOI: 10.1212/ normalized to intracranial functional decline. Analysis Investigation. 2018 Aug longer telomere length was women living in long-term Robbins PD, Wang Y, Kelley into the clinic here in complementary expertise, guideline and self-report psychometric properties L.0000000000004842. Rosso AL, Verghese J, volume, with lower of mice with the same 31;128(9):3926-3940. doi: associated with a greater care communities. The EE, Croix CMS, Pittsburgh. outstanding research systems. One-hundred from an item response Metti AL, Boudreau RM, volumes indicating greater DNA repair deficiency 10.1172/JCI96519. Epub risk for developing lung SARC-F questionnaire, Niedernhofer LJ, Gill MS. productivity, and ongoing and forty-one women theory perspective but Finding: In this study, Aizenstein HJ, Kritchevsky atrophy. Ultimately, the showed activation of the 2018 Aug 13. PubMed Yuan JM, Beckman KB, adenocarcinoma, but not while a useful and simple Dysregulation of DAF-16/ studies to address this sixty-five years and older acknowledged the researchers examined S, Harris T, Yaffe K, study found that an homologous transcription PMID: 29952768; Wang R, Bull C, Adams- squamous cell carcinoma. tool, has comparatively low FOXO3A-mediated stress problem. The center brings were assessed based on possibility of further associations between mild Satterfield S, Studenski S, association between factor, FOXO3A early in PubMed Central PMCID: Haduch J, Huang JY, Jin A, These data are important sensitivity for identifying responses accelerates together faculty from five appendicular lean muscle improvement. For example, Parkinsonian signs (MPS) Rosano C. Slowing Gait slowing gait and cognitive life, which declined with PMC6118586. Opresko P, Newman AB, because they suggest those with sarcopenia. oxidative DNA damage schools within the University mass, hand grip strength, making sit-to-stand and and the dopaminergic and Risk for Cognitive decline is supported by a age. This decrease in Zheng YL, Fenech M, Koh telomere length may induced aging. Redox Finding: Cancer of Pittsburgh: medicine, and gait speed. Sarcopenia Perera S, Nace DA, Resnick sweater items harder and indicator catechol-O- Impairment: The shared neural substrate activity caused an increase WP. Leukocyte telomere help inform about risk of Biology. 2018 Sep; Immunotherapy, the nursing, public health, allied status was determined NM, Greenspan SL. The dialing a phone easier methyltransferase (COMT) Hippocampus as a that includes a low volume in oxidant stress and length in relation to risk of specific cancer types, 18:191-199. doi: 10.1016/j. subject of the 2018 Nobel health, and engineering. based on consensus Nursing Home Physical improves concurrent and white matter Shared Neural Substrate. right hippocampus. These premature aging in the lung adenocarcinoma and they offer clues into redox.2018.06.005. Epub Prize in medicine is an guidelines from the Performance Test: A validity of the NHPPT from hyperintensities (WMH). Neurology. 2017; 89(4): results support the mice. These data indicate incidence: Findings from the role that telomeres 60 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 61

play in developing lung of health care professionals A randomized trial of a care were higher in the epidemic. The authors Finding: This review adenocarcinoma. Cells offers care for patients with family-support intervention intervention group, and noted that balanced synthesized evidence with longer telomeres life-limiting illnesses, and in intensive care units. the length of ICU stay was attention to the morbidity from randomized clinical can undergo more cell provides comfort and support New England Journal of shorter in the intervention and mortality related to trials of palliative care divisions prior to arrest, to those patients and their Medicine. 2018 Jun group, when compared to opioid addiction and the interventions in heart increasing the likelihood families. The following 21:378(25):2365-2375. usual care. morbidity and adverse failure. The authors found of acquiring genetic publications are relevant effects on function and that the evidence base, Findings: This stepped Schenker Y, Merlin JS, Quill mutations or chromosomal to today’s trend of focusing quality of life related to while promising, was still wedge, cluster-randomized TE. Use of palliative care changes than allow bypass on patients’ desires for undertreatment of pain in in its infancy. Additional trial involved 1420 patients earlier in the disease of growth arrest, and care at the end of life and serious illness are needed. high-quality studies are at high risk of death and course in the context switching on telomere the importance of needed, in particular their surrogates in five of the opioid epidemic: Kavalieratos D, Gelfman LP, maintenance pathways communicating clearly with regards to primary intensive care units. The educational, research, and Tycon LE, Riegel B, that enable unlimited with the patient and palliative care interventions study found that a policy issues. Journal of Bekelman DB, Ikejani DZ, cell divisions. physician or clinician. to address unmet needs multicomponent family- the American Medical Goldstein N, Kimmel SE, earlier and throughout UPMC Palliative and White DB, Angus DC, support intervention Association. 2018 Sep Bakitas MA, Arnold RM. the illness course. Supportive Institute Shields AM, delivered by the 4:320(9):871-872. Palliative care in heart (PSI) Buddadhumaruk P, Pidro C, interprofessional ICU team failure: rationale, evidence, Findings: This article Director: Robert Paner C, Chaitin E, Chang did not affect surrogates’ and future priorities. highlighted important Arnold, MD CH, Pike F, Weissfeld L, psychological symptoms Journal of the American educational, research, and The PSI was established to Kahn JM, Darby JM, when compared to usual College of Cardiology. policy challenges related to improve the quality of life Kowinsky A, Martin S, care, but ratings of the 2017 Oct 10;70(15):1919- use of palliative care earlier of patients whose diseases Arnold RM: PARTNER quality of communication 1930. doi: 10.1016/j. in the disease course in the are no longer responsive to Investigators and the patient- and jacc.2017.08.036. context of the opioid curative treatments. Its team family-centeredness of 62 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 63

Administrative Sta™ Bridgeside Point Susan L. Greenspan, MD Neil M. Resnick, MD Associate Director, Clinical and Associate Director, Aging Institute of UPMC Phone: Kirsten Schwoegl, CRA Translational Research Senior Services and the University of Pittsburgh Administrative Director 1-866-430-8742 Aging Institute of UPMC Senior Services Chief, Division of Geriatric Medicine Website: Daniel Stump and the University of Pittsburgh and Gerontology Aging.UPMC.com Academic Administrator Director, Osteoporosis Prevention Thomas P. Detre Professor of Medicine and Treatment Center Director, John A. Hartford Foundation Tari Deiss Toren Finkel, MD, PhD Program Director/Principal Investigator, Center of Financial Assistant/Purchasing Director, Aging Institute of UPMC Senior Pittsburgh Claude D. Pepper Older Americans Excellence in Geriatric Medicine Independence Center School of Medicine Services and the University of Pittsburgh Joy Hart Director, Bone Health University of Pittsburgh Professor of Medicine, Division of Cardiology, Senior Administrative Coordinator School of Medicine, University of Pittsburgh Magee-Womens Hospital of UPMC Executive Committee Professor of Medicine, School of Medicine, Charles F. Reynolds III, MD G. Nicholas Beckwith III and Dorothy B. Immediate Past Director, Aging Institute of Beckwith Chair in Translational Medicine, Robert Arnold, MD University of Pittsburgh UPMC Senior Services and University University of Pittsburgh/UPMC Medical Director, UPMC Palliative and Professor in Clinical and Translational of Pittsburgh Supportive Institute Science Institute Charles F. Reynolds III, MD Distinguished Professor of Psychiatry Director, Institute for Doctor-Patient UPMC Endowed Professor in Geriatric Immediate Past Director, Aging Institute of Taafoi S. Kamara, MPH Communication Psychiatry, Emeritus UPMC Senior Services and University Administrative Director of Pittsburgh Chief, Section of Palliative Care and University of Pittsburgh Medical Ethics Aging Institute of UPMC Senior Services Distinguished Professor of Psychiatry Leo H. Criep Chair in Patient Care and the University of Pittsburgh UPMC Endowed Professor in Geriatric Edmund M. Ricci, PhD, MLitt Associate Director, Evaluation Sciences Psychiatry, Emeritus Professor of Medicine, School of Medicine, Anne B. Newman, MD, MPH University of Pittsburgh Aging Institute of UPMC Senior Services and University of Pittsburgh Clinical Director, Aging Institute of UPMC the University of Pittsburgh Deborah S. Brodine, MHA, MBA Senior Services and the University of Pittsburgh Deborah S. Brodine, MHA, MBA Professor & Director Emeritus, Evaluation President, UPMC Community Chair, Department of Epidemiology President, UPMC Community Provider Services Institute for Public Health Provider Services Katherine M. Detre Endowed Chair of Graduate School of Public Health Leadership Mary Ann Sander, MHA, MBA, NHA Population Health Sciences Toren Finkel, MD, PhD University of Pittsburgh Vice President Director, Center for Aging and Population Health Director, Aging Institute of UPMC Senior Professor of Epidemiology, Medicine, and Aging and Disability Services Services and the University of Pittsburgh Loren Roth, MD, MPH Clinical and Translational Science UPMC Community Provider Services Professor of Medicine, Division of Cardiology, Associate Senior Vice Chancellor for Clinical Graduate School of Public Health School of Medicine, University of Pittsburgh Policy and Planning, Health Sciences Taafoi S. Kamara, MPH University of Pittsburgh University of Pittsburgh Administrative Director G. Nicholas Beckwith III and Dorothy B. Beckwith Chair in Translational Medicine, Distinguished Service Professor of Psychiatry, University of Pittsburgh Betty Robison, MSN, RN-BC University of Pittsburgh/UPMC Gerontology Educator Senior Advisor, Quality, UPMC Health Plan Daniel E. Forman, MD Professor of Health Policy and Management, Melissa Jones, MSN, RN Director of Emerging Therapeutics, Aging Graduate School of Public Health, Geriatric Nurse Educator Institute of UPMC Senior Services and the Secondary Apt. University of Pittsburgh Ronnie Edwards, MSW, LSW Chair, Section of Geriatric Cardiology Aging and Disability Coordinator Professor of Medicine University of Pittsburgh School of Medicine Peggy Edinger Administrative Coordinator 64 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh Aging.UPMC.com 65

Mary Ann Sander, MHA, MBA, NHA Robert Arnold, MD Toren Finkel, MD, PhD Diane Holder Rick Morycz, PhD Daniel Rosen, PhD Vice President, Aging and Medical Director, UPMC Palliative and Director, Aging Institute of UPMC Senior Executive Vice President, UPMC Associate Professor of Psychiatry, Medicine, and David E. Epperson Associate Professor of Disability Services Supportive Institute Services and the University of Pittsburgh President, Insurance Services Division Social Work Social Work UPMC Community Provider Services Director, Institute for Doctor-Patient Professor of Medicine, Division of Cardiology, President and CEO, UPMC Health Plan University of Pittsburgh School of Medicine University of Pittsburgh Communication School of Medicine, University of Pittsburgh Geriatric Services, Western Psychiatric Institute Richard Schulz, PhD Chief, Section of Palliative Care and G. Nicholas Beckwith III and Dorothy B. A. Everette James, JD, MBA and Clinic Loren Roth, MD, MPH Associate Director, Education Medical Ethics Beckwith Chair in Translational Medicine, Associate Vice Chancellor for Health Policy Associate Senior Vice Chancellor Aging Institute of UPMC Senior Services and Leo H. Criep Chair in Patient Care University of Pittsburgh/UPMC and Planning Anne B. Newman, MD, MPH for Clinical Policy and Planning, Health Sciences the University of Pittsburgh Professor of Medicine, School of Medicine, Executive Director, Health Policy Institute Clinical Director, Aging Institute of UPMC Senior Distinguished Service Professor of Psychiatry University of Pittsburgh Daniel E. Forman, MD M. Allen Pond Professor of Health Policy Services and the University of Pittsburgh University of Pittsburgh Professor, Epidemiology, Sociology, Psychology, Director of Emerging Therapeutics, and Management Chair, Department of Epidemiology Distinguished Service Professor of Psychiatry, Aging Institute of UPMC Senior Services Community Health, Nursing, Health and Graduate School of Public Health Katherine M. Detre Endowed Chair of Population University of Pittsburgh Michael Boninger, MD and the University of Pittsburgh Rehabilitation Sciences University of Pittsburgh Health Sciences Senior Advisor, Quality, UPMC Health Plan Senior Medical Director for Post-Acute Care, Chair, Section of Geriatric Cardiology School of Medicine UPMC Health Services Division Director, Center for Aging and Population Health Professor of Health Policy and Management, Professor of Medicine Program Director, Gerontology, University Vice President for Medical Affairs, UPMC Taafoi S. Kamara, MPH Professor of Epidemiology, Medicine, and Clinical Graduate School of Public Health, Secondary Center for Social and Urban Research Director Community Provider Services University of Pittsburgh School of Medicine Administrative Director and Translational Science Appointment. University of Pittsburgh Professor and UPMC Endowed Vice Chair for Aging Institute of UPMC Senior Services Graduate School of Public Health Lawrence Frolik, JD, LLM and the University of Pittsburgh Mary Ann Sander, MHA, MBA, NHA Director, Geriatric Education Center Research, Department of Physical Medicine John E. Murray Faculty Scholar University of Pittsburgh Vice President of Pennsylvania & Rehabilitation Professor of Law Carrie Leana, PhD Neil M. Resnick, MD Aging and Disability Services Director, Center for Caregiving Research, George H. Love Professor of Organizations Education and Policy, University of Pittsburgh Jennifer Brach, PhD, PT School of Law Associate Director, Aging Institute of UPMC UPMC Community Provider Services Associate Professor, Department of Physical University of Pittsburgh and Management Senior Services and the University of Pittsburgh Bennett Van Houten, PhD Therapy, School of Health and Rehabilitation Professor of Business Administration, Medicine, Chief, Division of Geriatric Medicine Richard Schulz, PhD Associate Director, Basic Science Research Sciences, University of Pittsburgh Susan L. Greenspan, MD and Public & International Affairs and Gerontology Associate Director, Education Aging Institute of UPMC Senior Services and Associate Director, Clinical and Director, Center for Healthcare Management, Thomas P. Detre Professor of Medicine Aging Institute of UPMC Senior Services and the Deborah S. Brodine, MHA, MBA Translational Research University of Pittsburgh the University of Pittsburgh Katz School of Business, University Director, John A. Hartford Foundation Center of President, UPMC Community Provider Services Richard M. Cyert Professor of Aging Institute of UPMC Senior Services and of Pittsburgh Excellence in Geriatric Medicine Distinguished Service Professor of Psychiatry the University of Pittsburgh Professor, Epidemiology, Sociology, Psychology, Molecular Oncology Anthony Delitto, PhD, PT, FAPTA John Lovelace, MS, MSIS School of Medicine Department of Pharmacology and Director, Osteoporosis Prevention and Community Health, Nursing, Health and Professor and Dean, School of Health and Treatment Center President, UPMC for You, Inc. University of Pittsburgh Rehabilitation Sciences Chemical Biology Rehabilitation Sciences, University of Pittsburgh Program Director/Principal Investigator, President, Government Programs and School of Medicine Graduate Faculty in Molecular Biophysics and Individual Advantage Charles F. Reynolds III, MD Structural Biology (MBSB) at the University of Jacqueline Dunbar-Jacobs, PhD, RN, FAAN Pittsburgh Claude D. Pepper Older Americans Immediate Past Director, Aging Institute of Program Director, Gerontology, University Center Independence Center Pittsburgh and Carnegie Mellon University Distinguished Service Professor and Dean, Susan C. Martin, MSN, RN UPMC Senior Services and University for Social and Urban Research Director Co-Leader, Program of Molecular and Cellular School of Nursing Director, Bone Health Senior Director, Clinical Improvement/Patient of Pittsburgh University of Pittsburgh Cancer Biology Professor, Psychology, Epidemiology & Magee-Womens Hospital of UPMC Safety Department Distinguished Professor of Psychiatry Director, Geriatric Education Center University of Pittsburgh Cancer Institute Occupational Therapy Professor of Medicine, School of Medicine, Wolff Center at UPMC UPMC Endowed Professor in Geriatric of Pennsylvania University of Pittsburgh Psychiatry, Emeritus Director, Center for Caregiving Research, Aging Institute Board of Directors Rafael Engel, PhD, MSW Professor in Clinical and Translational Tami Minnier, RN, MSN, FACHE University of Pittsburgh Education and Policy, University of Pittsburgh Associate Professor Science Institute Chief Quality Officer Fabrisia Ambrosio, PhD, MPT Coordinator, Gerontology Certificate Program UPMC Edmund M. Ricci, PhD, MLitt Elizabeth Skidmore, PhD, OTR/L, FAOTA Associate Professor and Research Scientist Principal Investigator, John A. Hartford Executive Director Associate Director, Evaluation Sciences Chair and Associate Professor, Department of Occupational Therapy, School of Health and Department of Physical Medicine Practicum Partnership Program in Beckwith Institute for Innovation in Patient Care Aging Institute of UPMC Senior Services and the and Rehabilitation Aging Education University of Pittsburgh Rehabilitation Sciences, University of Pittsburgh School of Medicine, University of Pittsburgh School of Social Work Professor & Director Emeritus, Evaluation Director of Rehabilitation for UPMC University of Pittsburgh Institute for Public Health International Graduate School of Public Health University of Pittsburgh 66 Aging Institute • 2018 Annual Report - UPMC Senior Services & the University of Pittsburgh

Joshua Thorpe, PhD, MPH Panagiotis (Takis) Benos, PhD Donna L. Korol, PhD Steven Smagula, PhD Associate Professor Associate Professor of Computational and Associate Professor, Biology Assistant Professor, Psychiatry Department of Pharmacy and Therapeutics Systems Biology, Biomedical Informatics Syracuse University University of Pittsburgh School of Pharmacy Director, Center for Translational Bioinformatics University of Pittsburgh Director, Molecular Systems Modeling (MSM) Anne B. Newman, MD, MPH Richard Jay Smeyne, PhD Health Equity Research and Promotion Director, Joint CMU-Pitt PhD Program in Clinical Director, Aging Institute of UPMC Senior Professor and Head of the Parkinson’s Disease Services and the University of Pittsburgh Program in the Department of Neuroscience Department of Veterans Affairs Computational Biology University of Pittsburgh Chair, Department of Epidemiology Thomas Jefferson University Bennett Van Houten, PhD Katherine M. Detre Endowed Chair of Population Associate Director, Basic Science Research Meryl A. Butters, PhD Health Sciences Abbe N. de Vallejo, PhD Associate Professor of Psychiatry Director, Center for Aging and Population Health Associate Professor of Pediatrics Aging Institute of UPMC Senior Services and the and Immunology University of Pittsburgh University of Pittsburgh Professor of Epidemiology, Medicine, and Clinical School of Medicine, University of Pittsburgh Richard M. Cyert Professor of Molecular Oncology and Translational Science Judy Cameron, PhD Graduate School of Public Health Associate Professor, Division of Department of Pharmacology and Pediatric Rheumatology Chemical Biology Professor of Psychiatry University of Pittsburgh Children’s Hospital of Pittsburgh of UPMC Graduate Faculty in Molecular Biophysics and Director of Science Outreach Structural Biology (MBSB) at the University of Director of Working For Kids: Building Skills Vineet K. Raghu Director, Flow Cytometry Core I Facility Pittsburgh and Carnegie Mellon University University of Pittsburgh PhD Candidate in Computer Science Rangos Research Center University of Pittsburgh Faculty, University of Pittsburgh Cancer Institute Co-Leader, Program of Molecular and Cellular Kirk I. Erickson, PhD Cancer Biology Investigator, Pittsburgh Claude D. Pepper Older Assistant Professor Charles F. Reynolds III, MD University of Pittsburgh Cancer Institute Americans Independence Center Department of Psychology Immediate Past Director, Aging Faculty, McGowan Institute for Helene Weinraub, MPH University of Pittsburgh Institute of UPMC Senior Services and Regenerative Medicine Vice President, Medicare, University of Pittsburgh UPMC Health Plan Tamer S. Ibrahim, PhD Distinguished Professor of Psychiatry Peter Wipf, PhD Associate Professor, Bioengineering Department UPMC Endowed Professor in Geriatric Distinguished University Professor of Chemistry Robert Weyant, DMD, DrPH University of Pittsburgh Psychiatry, Emeritus University of Pittsburgh Associate Dean University of Pittsburgh Dental Public Health and Community Outreach John M. Jakicic, PhD Michael J. Zigmond, PhD Distinguished Professor and Chair School of Dental Medicine Caterina Rosano, MD, MPH Professor of Neurology Department of Health and Physical Activity University of Pittsburgh Professor of Epidemiology University of Pittsburgh Director, Physical Activity and Weight Graduate School of Public Health Management Research Center University of Pittsburgh Healthy Brain Aging Initiative University of Pittsburgh Howard Aizenstein, MD, PhD Andrea Rosso, PhD, MPH Charles F. Reynolds III and Ellen G. Detlefsen Taafoi S. Kamara, MPH Assistant Professor, Epidemiology Endowed Chair in Geriatric Psychiatry and Administrative Director Assistant Professor, Clinical and Translational Professor of Bioengineering and Aging Institute of UPMC Senior Services and Science Institute Clinical and Translational Science the University of Pittsburgh University of Pittsburgh Fabrisia Ambrosio, PhD, MPT Associate Professor and Research Scientist Department of Physical Medicine and Rehabilitation School of Medicine, University of Pittsburgh Director of Rehabilitation for UPMC International INNOVATIONS IN AGING

Aging Institute 2018 Annual Report

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