Each year, CHABLIS funds a select number of projects that advance the center’s mission of examining how demographic and economic factors influence individual healthy aging behaviors (HABs) and outcomes across the life course. You may learn more about the 2021–2022 and 2020–2021 pilot projects below, or learn how to apply for pilot funding here.
System Testing Patient-report Periodontal Data Prediction of Mental/other Health
The project will develop an innovative analytic system that enhances understanding of how race and Medicaid coverage (as an indicator of low income/assets) may be a structural driver of higher risk of PD and not performing PHABs such as PC (e.g., flossing, professional gum treatment, dental visits), which, in turn, may be associated with higher risk of systemic diseases like cognitive impairment (CI). The analytic system will be used by Early-Stage Investigators who aim to collaborate on oral/systemic health and health care research.
Adaptive Assessment of Cognition and Metacognition in Aging
The project has two major goals. The first is to build the first-ever computerized adaptive test to measure global cognitive ability in older adults. This instrument should increase measurement precision and efficiency compared to current gold-standard measures (e.g., MoCA), significantly improving cognitive assessment for basic research and healthcare applications. The second goal is to further develop a measure of metacognitive awareness – or personal insight into one’s own cognitive ability. Metacognitive awareness varies across individuals and can differ from overall cognitive ability. A lack of awareness (“anosognosia”) in the cognitively impaired has been related to risky decisions and behaviors (e.g., financial, or medical decision making, dangerous driving), but these links and how social factors may play a role have been under explored in cognitively normal older adults.
Examining Geriatric Assessment, Androgen Deprivation and Biomarkers in Prostate Cancer Treatment
The project’s goals are to improve risk assessment for adverse outcomes (such as healthcare utilization, disability, cardiovascular disease, and cognitive impairment) and optimize the health of older adults with mHSPC needing androgen deprivation. A 2020 Survivorship Research in Prostate Cancer (SuRECaP) working group identified significant knowledge gaps in understanding ADT/ARSI-related toxicity biomarkers, especially among minorities. To address these gaps, we propose a 12-month observational cohort study of vulnerability and adverse events in a sample of n=30 predominantly minority mHSPC patients ≥65 years old planning to undergo ADT/ARSI treatment. Participants will be recruited from the UChicago Cancer Center Network (Hyde Park, Ingalls, and Orland Park). Baseline assessments will include CARG scores, 7-day wrist accelerometry, and initial body composition by wearable bioimpedance analysis (BIA). Serious adverse events will be reported weekly over 12 months.
Language Use within the AD/ADRD Care Networks of Latino Older Adults: A Pilot Test of New NSHAP
The project seeks to enhance the “important matters” social network name generator, used by the National, Social Life, Health, and Aging Project (NSHAP), to explore language use within AD/ADRD care networks. NSHAP is a longitudinal study focused on social relationships, physical and mental health, cognitive, sensory, and motor function, and medication use of older adults. Although it amassed a rich set of data in English and Spanish, and interviewed respondents in four rounds (2005, 2010, 2015 and 2021), few NSHAP studies have examined the health and social lives of Latinos. Moreover, NSHAP data collection protocols have not used visual network representations, and recent methodological developments indicate that such visualizations could reduce respondent burden and assist the network data collection of family caregivers. Network visualizations could facilitate the collection of culturally and linguistically sensitive data. Results may reveal enhancements that could be made to the NSHAP instrument or other similar studies.
Environment Exposures: Behavioral, Social, and Health impacts on older US Adults in the National Social Life, Health, and Aging Project
The project goal is to test feasibility of remote collection of direct indoor pollution assessment (airborne and organic compounds), collection of address histories from respondents to aid longer term/life course assessment of exposures, and measurement of airway function (nose and lung) will generate high quality longitudinal indoor pollution data. It is known that air pollution plays a major role in the process of healthy aging, being associated with both physical health and key healthy aging behaviors (mobility, exercise to name two examples). Because of that, our study will be pivotal to understanding and improving the process of healthy aging. Additionally, this pilot project will generate critical practical information setting the foundation for a R01 level project that will collect pollutant exposure data on the entire NSHAP cohort and be useful for other major aging studies.
Characterizing Fatigability, Fatigue, and Activity in Hospitalized Older Adults
This project will to measure fatigability, fatigue, and activity levels in older adults during hospitalization and after hospital discharge. The data for this proposal will help advance our scientific and clinical understanding of fatigue, which as a common symptom in older adults is a high priority scientific area of the NIA. Fatigability is an innovative approach to addressing the symptom of fatigue, and in this proposal I will expand the scientific and clinical application of fatigability to hospitalized older adults with multifactorial fatigue, and longitudinally (hospitalization to post-discharge), both of which have been identified as important to advancing fatigue research. The data collected, analyses conducted, and protocols generated are necessary for and designed to setup future work, specifically longitudinal studies and trials, investigating the effect of hospital-based interventions on fatigability and functional outcomes after hospital discharge.
Assessing Health and Burden Among Caregivers of Older Adults at High Risk for Hospitalization
Dr. Kareti’s pilot project has three main goals: to develop practical strategies for identifying and recruiting caregivers of older adults at high risk of hospitalization (OHH), use cognitive interviewing techniques to gain insight about the experiences of caregivers of OHH and refine survey instruments, and to enhance our understanding of their baseline well-being and support needs.
- Principal Investigator: Sanjana Kareti, MD (email@example.com)
Sleep Disturbance and Depressive Symptoms in People Living with Mild Dementia: The mechanistic role of cortisol
An estimated 6.2 million Americans are affected by Alzheimer’s Disease and Related Dementias and the number is projected to grow to almost 12 million by 2040. Distressing symptoms such as sleep disturbance and depression are commonly reported in people living with mild dementia or mild cognitive impairment (PLwMD). Dr. Dong is investigating the cross-sectional and longitudinal association between sleep disturbances, depressive symptoms, and cognitive decline, and also examining the interrelationships among sleep disturbances, cortisol levels, and depression in PLwMD.
Piloting the Mind Over Matter Program for Urinary and Bowel Incontinence in Chicago
‘Mind Over Matter: Healthy Bowels, Healthy Bladder (MOM),’ is a community-based behavioral modification workshop for urinary and bowel incontinence. Dr. Iyer (urogynecology) and Dr. Thompson (geriatrics) are piloting the MOM program at 2 south side Chicago locations to improve urinary and bowel incontinence in older women with this community-based intervention focused on healthy aging behaviors.
The Effect of the Doctor-Patient Relationship on Advance Care Planning and End of Life Care
Improving advance care planning (ACP) and end of life (EOL) care is an important part of efforts to improve population health for those aging in America. Tate investigates how the physician-patient relationship and trust in physicians, as demonstrated by the Comprehensive Care Physician (CCP) Program, may have impact ACP and EOL care delivery among patients who face additional socioeconomic and psychosocial barriers.
Developing a Longitudinal Measurement Metric and Risk Prediction Model to Identify Medicare Patients at High Risk of Hospitalization with Persistent Cost-related Medication Nonadherence (CRN) and Improve Insurance Coverage
There is a growing body of evidence in recent years that even after the implementation of Medicare Part D, cost-related medication non-adherence (CRN) has persisted, or even worsened, among the sickest Medicare patients, including those with multiple chronic conditions, depression, and stroke survivors. Zhang’s pilot aims to develop a new measurement metric of persistent, transient, and intermittent CRN over time and create a risk prediction model using a wide range of predictors for persistent and transient CRN. Identifying such patients will enable more effective policy intervention in terms of targeting and costs, improve access to health care and insurance coverage, and ultimately improve health outcomes for millions of Medicare beneficiaries who struggle to pay for critically important medications.
Universal Early Screening For Alzheimer’s Disease and Related Dementia (ADRD) Via Automated Deep Pattern Discovery in Past Medical Encounters
A barrier to accurate screening for ADRD or cognitive impairment signaling early stage AD is the limitation of current diagnostic and prognostic modalities. Chattopadhyay’s pilot project aims to design a reliable screening tool for ADRD up to 10 years in the future, enabled by novel learning algorithms that analyze deep comorbidity patterns emerging in the longitudinal history of past medical encourages of individual patients.
Sensory Health Trajectories Among Older Adults in the U.S.
A growing area of research recognizes the significance of declines in olfactory functioning in predicting numerous age-related health conditions and the importance of identification of factors that contribute to the impairment of olfaction. Goldman is using data from the National Social Life, Health and Aging Project (NSHAP) to examine how structural features and dynamics of older adults’ social networks and neighborhoods shape trajectories of olfactory functioning.
Circadian Biology of the Endocannabinoid System in Aging
Although the literature shows that aging is associated with well-documented alterations in the circadian system, including reduced exposure to both external and internal synchronizing agents, the impact of circadian misalignment on cardometabolic (CM) rate risk among older adults is unknown. Hanlon is studying whether the 24-hour profile in circulating endocannibinoids (eCBs), which aid in modulation of appetite, glucose metabolism, and reward driven eating, is modified in older adults when compared to middle aged adults. Hanlon further seeks to study whether a dietary intervention may impact eCB rhythm and CM risk.
Comparison of Hospital-Associated Disability (HAD) in Elderly Hospitalized Patients Before and During COVID-19 Pandemic
For older adults, the effects of hospitalization superimposed on the normal effects of aging can be a powerful accelerator of that path and result HAD. The COVID-19 pandemic is also likely to increase the risk for development of HAD in hospitalized patients with and without COVID-19. Martinez’s work will examine the prevalence of HAD among hospitalized older adults during the pandemic and study the the effectiveness of the implementation of a clinical decision support tool that guides physical therapy (PT) referral decisions on appropriateness of PT in context of the pandemic.
Using 24-hour Ambulatory Blood Pressure Monitoring (ABPN) to Examine Association Between Blood Pressure Phenotypes and Cognitive Impairment among African Americans
Prior studies using 24-hour ambulatory blood pressure (BP) monitoring (ABPM) found that associations between specific BP phenotypes and increased small vessel cerebrovascular disease was linked with cognitive impairment. However, African Americans were largely excluded from these studies. Price aims to understand the prevalence of BP phenotypes among a sample of African American older adults, and determine if these phenotypes are associated with cognitive impairment in this population.
Health Care Spending, Mortality and the Macroeconomic and Distributional Effects of Health Inequality at Older Ages
In existing work, Kaplan and colleagues have analyzed the joint economic and health implications of different polices by integrating an expanded SIR model of virus spread into a macroeconomic model with realistic income and wealth inequality, as well as occupational and sectoral heterogeneity. However, this work has so far not considered the role of age as a dimension of heterogeneity. The aim of this pilot project is to fill this gap by expanding both the epidemiological and economic blocks of the model to include older people.
The Rise and Consequences of Alternative Work Arrangements for the Aging Workforce
Koustas’ recent work has found rates of self-employment and gig work to be higher among older workers. As gig workers will not obtain health insurance through their gig employer, documenting whether they obtain health care coverage for themselves and their dependents through other means is important for contextualizing the welfare implications of gig work and for understanding the labor supply of gig workers. The aims of this pilot project are to clean and process new data elements, and to explore and develop new research designs to answer questions around gig work and health insurance in the United States.
The Significance of Race, Skin Color, and Discrimination for Health and Aging
Perceived discrimination, especially ethnoracial discrimination, is a significant predictor of the incidence and/or severity of a variety of health outcomes. However, most studies that focus on perceptions of discrimination between-groups fail to define what is meant by ‘racism,’ and rarely consider alternative measures of ‘race’ beyond dichotomous self-identification measures. Monk’s prior research shows that disparities in socioeconomic status among blacks associated with their skin tone rival or exceed SES disparities between blacks and whites as a whole. This pilot study uses innovative measures of skin color, perceived discrimination, and ethnoracial identity to examine their role in shaping health and aging among older adults.
Impact of Pharmacogenetics in a High Utilizer Program for Older Adults at Increased Risk of Hospitalization
Progress in pharmacogenomics (PGx) has led to identification of genetic variants that impact response or toxicity for hundreds of drugs. To address barriers to implementation, O’Donnell has developed a genomic prescribing system (GPS), which incorporates preemptive PGx test results and translates patient-specific genotypes into concise, real-time guidance integrated into the University of Chicago Medical Center’s (UCM) EPIC electronic health record. This pilot will evaluate whether the Comprehensive Care Physician (CCP) Program, designed to improve care for older adults at increased risk of hospitalization by giving them a physician who will care for them in and out of the hospital, may provide a stronger setting in which to assess the effect of the GPS system for PGx.