Center for Demography of Health and Aging (CDHA)

2022. Corinne Engelman. Identification of Gene–Environment Interactions in Cognitive Decline During the Preclinical Stage of Alzheimer’s.

The overall objective of this proposal is to use the life-course approach, combined with a novel Alzheimer’s disease (AD) modeling strategy and rich Health and Retirement Study (HRS) and Wisconsin Registry for Alzheimer’s Prevention (WRAP) data, to identify potential interactions between social and behavioral factors, biomarkers, and genetic variants influencing cognitive aging during the preclinical stage of AD. Findings from this research will provide preliminary data for an NIH R01 application to the NIA to evaluate these candidate interactions in other NIA-funded datasets we have access to through collaborators, including expanding this research to African Americans recruited by WRAP, who were targeted in a later phase of WRAP and have just undergone genome-wide genotyping, HRS, and the Washington Heights-Inwood Community Aging Project (WHICAP).

Priority Research Areas: Biology, Genetics and Demography of Aging

2022. Lauren Schmitz. Assessing Measures of Biological Age in a Low-Income Context: The Malawi Longitudinal Study of Families and Health.

This pilot supports in-depth research on the creation and evaluation of biological (or phenotypic) aging measures in a low-income countries (LIC) context. This project has two aims: (1) construct measures of biological age (BA) in the Malawi Longitudinal Study of Families and Health (MLSFH) and test whether they are stronger predictors of age-related disease than chronological age (CA) and (2) compare BA measures and related findings with results from high-income countries (HICs) to evaluate the context-dependence of biological aging measures. This project includes the analysis of pilot data for an R01 resubmission or submission of a new R01 as well as collaborative research opportunities for students that are interested in working with the MLSFH data.

Priority Research Areas: Biology, Genetics and Demography of Aging

2022. Qiongshi Lu. Polygenic Gene-environment Interaction Analysis for Human Complex Traits.

This study will assess the interaction between genetics and education reform (i.e., a well-known natural experiment on compulsory schooling age reform) in the UK. This project will explore two recent statistical advances as alternative approaches to estimating gene-environment interaction (GxE). This project will pursue the following two aims: (1) estimate GxE using genetic variants associated with trait variability (vQTL) and variance polygenic scores (vPGS) and (2) estimate polygenic GxE interaction using genetic correlation analysis. The analysis conducted in this project will benefit the method paper describing the PIGEON approach and will lead to at least one other manuscript on GxE analysis.

Priority Research Areas: Biology, Genetics and Demography of Aging

2022. Rebecca Myerson. Informing Health Insurance Policy to Improve Lung Cancer Screening.

This project aims to: (1) compare the effect of nearly-universal access to Medicare insurance coverage on lung cancer screening by race, sex, and ethnicity to evaluate the impact on disparities and (2) document the characteristics of screened Medicare patients who lack documentation of shared decision-making, including race, sex, and ethnicity. The findings will inform coverage policy as well as policy related to shared decision-making to improve access to lung cancer screening among older adults, women, and racial/ethnic minorities. As such, the project will increase the evidence base to improve diagnosis and make health care more accessible and equitable. Furthermore, this research will open new horizons for R01-level work on shared decision-making policy, including Medicare’s recent shared decision-making mandates for two other conditions.

Priority Research Areas: Population, Economic and Health Forecasting

2022. Wei Xu. Uncovering the Impact of Birth Place on Mid-Life All-Cause and Cause-Specific Mortality.

This project aims to provide new evidence of the contribution of early life geographic context to variation in mid-life mortality in the US and potential mechanisms through which the contribution may be realized. Specifically, this project seeks to: (1) determine the magnitude of contribution of birth place to mid-life mortality, (2) determine the influence of birth place on patterns of mid-life cause-specific mortality, and (3) uncover mechanisms linking birth place and mid-life mortality by focusing early life exposures to epidemiologic and socioeconomic contexts and residential mobility. Findings will inform policy interventions aimed at reducing mid-life mortality inequalities.

Priority Research Areas: Population, Economic and Health Forecasting

2021. Eric Grodsky. The Nation’s High School Class of 1972 at Retirement: Education and Cognitive Aging Among Mid-Cohort Baby Boomers.

The research team will collect data from the ~14,500 sample members of the precursor to High School and Beyond, the National Longitudinal Study of the High School Class of 1972. Born mainly in 1953-55, sample members are now in their mid to late 60s. This proposed project would collect, analyze and disseminate data about their current cognition and life circumstances as well as their physiological status as indicated by whole blood, plasma, serum, and other biomarkers. The project has four aims:

1. Estimate the effects of education from adolescence forward
2. Assess the role of different aspects of education in producing racial and ethnic disparities in cognitive functioning and impairment in the transition from midlife to older ages
3. Assess the role of different aspects of education in the relationship between physiology and ADRD captured in blood- and saliva-based biomarkers as individuals transition from midlife to older ages
4. Prepare for distribution the resulting database and associated documentation and metadata to facilitate scholarship on the factors that affect cognitive functioning and cognitive impairment.

Priority Research Areas: Cognitive Aging and the Demography of Dementia

2021. Jessica Cao. Post-acute Care Access and Disparities among ACO Medicare Beneficiaries during the COVID-19 Pandemic.

This pilot project aims to gauge the changes and disparities in post-acute care (PAC) access among Medicare beneficiaries in the UW Health system, a local Medicare Accountable Care Organization (ACO), during the COVID-19 pandemic. Results from this pilot project will be used as the baseline for R01- level studies regarding the effects of the pandemic on PAC utilizations, health outcomes and subsequent health care utilizations and costs among Medicare beneficiaries. The ultimate goal is to make recommendations to the local ACO and beyond on how to improve equitable care access and quality of care for older adults.

Priority Research Areas: Health Trends and Disparities

2021. John Eason. Frailty, Aging, and Cancer Survival.

The goal of this project is to investigate the role of frailty/aging at the individual level and community level factors in pancreatic ductal adenocarcinoma survival. In addition to measuring the effect of community disadvantage (e.g. poverty and unemployment), researchers will examine how/if the presence of healthcare organizations in a community mitigate the effect of disadvantage incidence and survival. Eason and colleagues will investigate the role of individual level determinants of health disparities, but will also investigate how access to health care may alleviate cancer survival disparities.

Priority Research Areas: Effects of Interventions on Population Health

2021. Kristen Litzelman. “Jumping through A New Set of Hoops Each Time” – Conceptualization and Assessment of Socioeconomic Disparities in Caregivers’ Access to Resources.

In order to advance research and intervention efforts focused on resource use among caregivers, this project will conceptualize the process of accessing resources and assess socioeconomic disparities in resource use. The researchers will draw on previous theoretical and conceptual models to frame this work. The project’s overarching hypothesis is that service use is driven not only by need, but by caregivers’ existing resources of time, money, and emotional energy, compounded by sequential challenges in the systems navigation process. Conceptualizing this process and assessing how socioeconomic factors are linked to service utilization is a critical first step to understanding disparities in resource allocation and identifying targets for intervention

Priority Research Areas: Health Trends and Disparities

2021. Lauren Schmitz and Valentina Duque (University of Sydney). The Impact of Early Life Exposure to Extreme Weather and Temperature Shocks on Late Life Cardiovascular and Cognitive Health: Evidence from the Longitudinal Aging Study in India (LAS).

This project will contribute to our understanding of how early life conditions affect aging patterns in developing countries. Specifically, since agriculture remains the main source of income for a large fraction of households in these contexts, we will focus on two shocks that largely affect their economic, health, and psychological wellbeing: 1) the occurrence of adverse weather and temperature shocks, and 2) policies aimed at reducing food insecurity, poverty, and promoting economic growth. Understanding life course impacts of extreme weather patterns on aging outcomes is particularly imperative in the modern climate era; the number of record high temperatures and intense rainfall events has been increasing globally and these trends are expected to continue to rise over the next few decades.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Jason Fletcher. Deploying Machine Learning Tools to Predict Mortality Outcomes in the General Population.

Utilizing machine learning to predict mortality outcomes at the population level has thus far proven a tough nut to crack: the existing small samples sizes too small, the large samples lacking the proper type of data. This project aims to find the middle ground between these extremes by linking large population-based data from the National Longitudinal Mortality Study and the American Community Survey (ACS) to data from the National Death Index (NDI) and Medicare claims. Utilizing these linkages, the researchers will look for interactions that lead to mortality, and create risk scores based off of these interactions.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Jooyoung Kong. Adverse Childhood Experiences and Physiological, Affective, and Cardiovascular Reactivity to Family Caregiving Stress.

Longer life spans have helped advent the “sandwich generation” – middle-aged adults who find themselves caring for their children and their own aging parents. This position, stressful for anyone, may be especially stressful for adults who had Adverse Childhood Experiences (ACEs) while growing up. Primarily using the data from the Midlife in the United States (MIDUS) study, this project will explore how caregiving adults with ACES in their histories respond and react to daily stressors.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. Judith Simcox. Improving Biomarkers of Metabolic Disease in African American Populations.

Studies have shown that the most widely used clinical markers for diabetes — HDL, LDL, and triglycerides — are not accurate predictors of the disease in African-Americans. This pilot project will examine the promise of two potential alternatives in African-American females: C reactive protein and arachidonic acid containing lipids. African Americans are 60% more likely than Caucasians to have diabetes and twice as likely to die from diabetes-related complications. With better diagnostic tools, healthcare professionals have a better chance of bringing about positive health care outcomes.

Priority Research Areas: Biology, Genetics and Demography of Aging

2020. Philipp Koellinger. Understanding Socio-economic Influences on Health and Longevity.

Scientists have already discovered that low socio-economic status (SES) is linked to an array of physical and mental health conditions and reduced longevity, but the mechanisms behind these correlations have proven elusive thus far. If they could be discovered, scientists may be able to predict and prevent some of the poor outcomes associated with low SES. This project will utilize the over 500,000 genomic samples within the UK Biobank to complete analyses.

Priority Research Areas: Determinants of Health, Well-Being and Longevity

2020. ZhengZheng Tang. Investigating the Interactions between Inflammatory Biomarkers and Gut Microbiome in the Wisconsin Longitudinal Study.

Persistent inflammation has emerged as a consistent marker of aging and aging-related diseases. This pilot project seeks to investigate the connection between these inflamed biomarkers and changes in the gut microbiome among older adults, using the Wisconsin Longitudinal Study, a rich longitudinal data source that has tracked individuals from the 1957 high school class throughout Wisconsin.

Priority Research Areas: Biology, Genetics and Demography of Aging