Duke University

CPHA at Duke University is a highly interdisciplinary environment for developing faculty and students who study aging. CPHA fosters important research breakthroughs, particularly in the overlapping areas of biodemography (biological and biomedical demography of aging), life course analyses, and intergenerational studies, including the transmission of health and longevity.

Research Themes
Determinants of health, well-being and longevity; Consequences of U.S. and global aging; Population, economic and health forecasting; Health trends and disparities; Disability, health care and long-term care; Cognitive aging and the demography of dementia; Biology, genetics and demography of aging; Population, economic and health forecasting; Economics of aging; Innovations in data collection and measurement in aging research; Determinants of health and aging across social species.

Pilot Projects

  • 2022. Terrie Moffitt . Psychological and mental health determinants of COVID-19 vaccine hesitancy and vaccine resistance.

    This pilot aims to deliver a comprehensive psychological description of groups who differed in their vaccine intentions in the months just before vaccines became available to them utilizing a cohort on all 1037 births (1972-1973) in one city from the Dunedin Study in New Zealand. Public health professionals aspire to tailor pro-vaccination messaging to the values, motives, lifestyles, and background of people who are hesitant or resistant toward vaccination. This tailoring has called for a “marketing approach” to messaging. However, there is a wide social gap between highly-educated public health professionals and most unvaccinated citizens, who tend to be secondary-school educated, or less. This gap impedes effective messaging. For example, prior US surveys report that unvaccinated individuals tend to be Republicans, or southerners, or not college graduates, but these are crude proxies for people’s actual beliefs, attitudes, preferences, cognitive abilities, and motivations. This pilot harnesses psychologically rich prospective data from a 5-decade longitudinal cohort study to provide insights about the personal psychologies associated with vaccine-hesitance and vaccine-resistance, and whether those personal psychologies emerged early in life and are longstanding. Dunedin cohort members have reported whether they definitely or probably intended to be vaccinated ; definitely or probably did not intend to be vaccinated, or did not know enough to decide. The pilot will compare these 3 groups on prospective antecedents of vaccine intentions, including: (1) adverse childhood experiences; (2) adolescent personality and locus of control over health; (3) cognitive abilities and health knowledge and comprehension of health concepts; and (4) detailed mental disorder histories.

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


  • 2022. Elizabeth Gifford . Characterizing Accelerated Aging in Veterans of the Gulf War using Epigenetic Biomarkers.

    Gulf War illness (GWI) is a chronic multisymptom illness (CMI) like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome. GWI affects an estimated 25-32% of veterans who were deployed in support of the first Gulf War (1990-91) who continue to experience a host of persistent and reoccurring symptoms (e.g., fatigue, pain, rashes, and gastrointestinal issues) that cannot be explained by other diagnosed medical conditions. An unanswered question for Gulf War veterans is whether or not individuals who experience GWI are also at- risk for experiencing accelerated aging as evidenced by older “epigenetic clocks” and younger age of onset for various chronic conditions. The overarching aim of this pilot is to leverage rich data collected on Gulf War era veterans including self-reported survey data, GWAS (genome wide association study) data, and electronic medical records to create generalizable knowledge regarding aging and disease progression. Specifically, utilizing the Gulf War Era Cohort and Biorepository data repository, this pilot will develop four estimates of epigenetic physiologic age for participants of the Gulf War Era Cohort and Biorepository in support of testing the following hypotheses: (1) Epigenetic age estimates will be higher in Veterans with GWI compared to those without GWI; (2) Epigenetic age estimates will be higher in Veterans with chronic health conditions compared to those without chronic health conditions; (3) Epigenetic age estimates will be higher in Veterans with psychosocial stress, as measured by post-traumatic stress disorder (PTSD).

     

    Priority Research Areas: Biology, Genetics and Demography of Aging, Health Trends and Disparities


  • 2022. Tyson Brown . Structural Racism and Trajectories of Disease and Disability in Later Life.

    Health inequities along racial lines are broad and deep. Black Americans have a greater prevalence and severity of an array of illnesses, including chronic diseases and disability. While the vast majority of research on racial inequalities in health has focused on the role of individual-level factors such as socioeconomic resources (e.g., education, insurance, income, and wealth), a nascent line of research has begun to examine how health inequities are shaped by contextual factors stemming from structural racism (SR)—i.e., systemic racial exclusion from power, resources, opportunities, and well-being due to societal policies, practices, ideologies and institutions. Prior research has not examined whether racialized socioeconomic inequality is a mediating mechanism linking macro-level structural racism and individual-level health trajectories among older adults. This information is critical for understanding and addressing pathways through which SR affects health in later life. To address these critical gaps, this pilot will create and disseminate a dataset on SR, spanning economic, social, political, and judicial domains as well as over time between 2000 and 2020. This data resource will be a valuable tool for the research community to efficiently build the knowledge base on how SR shapes population health and aging processes. Second, the pilot will provide novel information about the longitudinal relationships between SR and trajectories of health. Finally, the pilot will test the following: a) whether higher levels of SR exposure are predictive of worse health trajectories (levels and rates of accumulation of chronic diseases and disability), b) the extent to which cumulative (and changes in) exposure to SR impacts trajectories of health, and c) whether there are lagged effects of SR exposure on chronic disease and disability trajectories.

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


  • 2021. Gregory Samanez-Larkin. Adult age differences in learning and decision making related to differences in sensitivity to different types of reward.

    Neuroscientific research on decision making and aging has focused almost exclusively on monetary incentives. Despite evidence for intact processing of and motivation by monetary gains in old age, preserved function does not extend to learning-based decision making where these incentives must be applied. Here older adults learn more slowly from monetary gains and losses compared to younger adults. These age deficits in learning have been linked to the structure and function of frontostriatal brain circuits, and some studies suggest that enhancement of this neural network via pharmacological increases in dopamine levels selectively improves reward learning in older adults. Although age differences in incentive motivation have been suggested to be due to motivation to maximize well-being (i.e., based on socioemotional selectivity theory), almost no studies have examined age differences in social incentive processing. An interesting possibility is that social incentives may provide a non-pharmaceutical and non-invasive enhancement of frontostriatal networks thus improving learning in old age. The goal of the proposed pilot studies is to examine adult age differences in behavioral and neural sensitivity to social and monetary incentives and examine the behavioral and neural effects of these incentives on learning-based decision making. For the proposed studies we have developed cognitive tasks that will investigate subjective emotional responses during anticipation and receipt of social and monetary incentives (Aim 1), neural sensitivity to the anticipation and receipt of social and monetary incentives (Aim 2), and learning from probabilistic social and monetary outcomes during decision making (Aim 3). One behavioral pilot study (Study 1) and one behavioral and neuroimaging pilot study (Study 2) will be conducted.

    Priority Research Areas: Cognitive Aging and the Demography of Dementia, Disability, Health Care and Long-Term Care


  • 2021. V. Joseph Hotz . Assessing New Data Source for Measuring Income Volatility to Study Its Relationship with Mortality in the U.S.

    This pilot will assess the use of data from a commercial consumer database on all households in the U.S. to construct reliable measures of the volatility of household income. If successful, the resulting data will be used to assess the relationships between income volatility and mortality in the U.S. and how that relationship varies by race/ethnicity, age and gender of heads of households in the U.S. Study of the latter relationship has been hampered by the lack of availability of samples of households in the U.S. that contain longitudinal data on income and that are of sufficient size to form reliable estimates for all or most counties in the U.S. for different race/ethnic, age and gender groups. If this assessment of the measures of income volatility produced by this data source are positive, others will be able to conduct the first large-scale assessment of the role that income volatility may have played in explaining the recent declines in life expectancy for working age adults in the U.S. and may explain differences in mortality rates by regions of the U.S., and disparities in mortality across racial and ethnic groups.

    Priority Research Areas: Determinants of Health, Well-Being and Longevity, Consequences of U.S. and Global Aging


  • 2020. Susan Alberts . Early adversity in a wild primate model: Physiological mediation and social mitigation.

    Adversity in early life has far-reaching effects on health, well-being, and survival in adulthood, especially when multiple adverse events co-occur. This association is seen not only in humans, but also in captive and wild nonhuman primates. Captive primates exposed to nutritional deficits or maternal neglect show decreased survival in adulthood compared to control animals. Wild baboons who experienced multiple forms of early adversity show reduced adult survival compared to unaffected individuals. Studies of humans and captive animals suggest that immune processes may mediate the effects of early adversity on survival. Early social and physical adversity in humans and captive animals is associated with increased risk of cardiovascular disease, diabetes, mental illness, and allostatic load. In several studies of humans, early-life trauma is also associated with chronic inflammation or heightened inflammatory response to an immune threat. Population-based, prospective, longitudinal studies with multiple repeated measures of adult traits are necessary to fully understand the developmental and physiological underpinnings of early adversity. Innovation. This pilot offers a solution to these challenges by using existing prospective, full life-course data, with real-time, direct observations of both early life adversity and adult sociality, as well as repeated noninvasive measures of adult immune function measured in biological samples that have already been collected. Investigators anticipate the development of a novel dataset that will generate a large number of repeated measures of immunity for each subject in our study; this pilot will be one of the first to measure baseline and acute inflammation in serum from wild animals, a method that may be useful for other wild animal and human research. It will also be one of the first to leverage repeated measures within subjects to quantify baseline versus acute inflammation levels

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


  • 2020. Herman Ponzer . The Daasanach pastoralist population of northern Kenya: A model for healthy aging—specifically the avoidance of non-communicable disease and frailty.

    Small-scale subsistence populations like the pastoralist population of northern Kenya, the Daasanach, have remarkably low prevalence of age-related frailty and cardiometabolic disease, diseases strongly associated with aging and responsible for the vast majority of morbidity and mortality in the U.S. and other industrialized populations. This pilot will investigate which aspects of lifestyle (physical activity, diet, etc.) promote healthy aging among the Daasanach. Two aspects of Daasanach life are of particular relevance to the study of aging. First, like many rural populations across the developing world, the Daasanach are moving from active traditional lifestyles to more sedentary, market-integrated village life. Second, the Daasanach have a largely animal- based diet (blood, milk, and meat). The Daasanach are at the epicenter of the epidemiological transition. Understanding lifestyle changes affecting their life course will help shape strategies to promote healthy aging and other positive health outcomes for them and for other populations in transition and post-transition. This pilot takes advantage of a societal transition in a pastoral environment to capture biosocial processes over the life course that lead to differential aging

    Priority Research Areas: Consequences of U.S. and Global Aging


  • 2019. William Pan. Sarcopenia and Sarcopenic Obesity Assessment in the US Population.

    Project nearing completion.


  • 2018. Jenny Tung, Daniel Belsky. Biological Age in Rhesus Monkeys: Causal Effects of Early Development Stress and Social Status.

    Project completed.


  • 2018. Susan Alberts. Effects of Early Life Adversity on Maternal Care and Offspring Survival in Wild Baboons.

    Project nearing completion.


  • 2018. Terrie Moffitt. A Segment of the Population with Large Economic Burden: The New Zealand Integrated Data Infrastructure (NZ-IDI).

    Project Completed. Manuscript published Nature-Human Behavior.


  • 2018. Gregory Samanez-Larkin. Optimizing physical activity-related health promotion across adulthood using neuroimaging.

    Project completed.


  • 2017. Jen'nan Read. Disaggregating Ethnic Diversity in the Non-Hispanic White and Black Populations: Implications for Disability across the Life Course.

    Project completed. Manuscript under review.


  • 2017. Lynch, Scott. Cognitive and Happy Life Expectancy in the US.

    Project completed. Manuscript published Jo of Gerontology-Psychological Sciences


  • 2016. Jenny Tung. DNA methylation age in primate models of aging.

    R01 from NICHD recently awarded; R24 awarded January 2020.


  • 2016. Tyson Brown. Systematic investigation of racial/ethnic disparities in health among older adults.

    Manuscripts completed in Journal of Gerontology, Health and Social Behavior and Social Forces; NIA proposal in preparation.


  • 2016. Kenneth Land, Patrick J. Eric Stallard. Duke Alzheimer's Progress Index: Development of Software for Clinical Applications.

    Project completed. P30 Administrative Supplement awarded in 2018 for continuation of project now nearing completion. R01 in preparation.


  • 2016. Daniel Belsky. Advancing Translation of Molecular Signatures of Biological Aging.

    R21 awarded.


  • 2015. Elizabeth Frankenberg, Duncan Thomas. Computer-based Cognitive Testing of Adults following a Disaster.

    Project completed. R01 pending award.


  • 2015. V. Joseph Hotz, Candace Odgers. Pilot Study on Connectedness & Mobile Technology .

    Renewal proposal for CPHA includes Core D that extends this project to rural areas.



Center-Supported Publications


Center Administrator/Media Contact: Mimi Davis