Author Archives: Coah Staff Admin

Associate Professor Rita R. Kalyani, MD, MHS, is a Core Faculty member with the Center on Aging and Health, and she is a thought leader in diabetes research and patient care. Her clinical research interests include studies on muscle loss and disability among older adults with diabetes and, broadly, the epidemiology of diabetes and its complications in high-risk populations. In addition to being the Editor-In-Chief of the Johns Hopkins Diabetes Guides, she published her second book for people living with diabetes this past spring called, Winning with Diabetes: Inspiring Stories from Athletes to Help You Thrive that she coauthored with colleagues Dr. Mark Corriere and Patrick Smith (Johns Hopkins University Press, 2023). The book is available from the publisher.  From the book blurb:

An ultra-marathoner, a three-time Olympic gold medalist, a major league pitcher, and an NFL star. What do these elite athletes have in common? They reached the top of their field—all while living with diabetes.

Essential reading for people who have diabetes and their families, “Winning with Diabetes” highlights the challenges, perseverance, and successes of sixteen elite athletes living with the disease. From mountain climber Will Cross to college softball champion Kylee Perez, to NBA legend Dominique Wilkins, and many more, these are the real-life stories of diagnosis, adapting new day-to-day routines, finding support, training, competing, and connecting with communities of other people living with diabetes. The book features advice for facing common fears and challenges, both on and off the playing field. Each chapter includes interviews with athletes about their experiences, paired with expert commentary from the authors. Chapters also include summaries of key concepts, along with illustrations and other graphics.

“Winning with Diabetes” will inspire readers of all ages—those newly diagnosed as well as those who have lived with diabetes for years. Written by physicians who have set the standards for management of the disease, this book brings you expert insight into finding ways to live your best life. Let the experts, the athletes, and the inspiration in “Winning with Diabetes” give you what you need to stay in the game.

For this blog, we asked Dr. Kalyani a few questions about the recent book, her research in the field, and what motivates her to inspire change for the better in the lives of real people living with diabetes.

Tony Teano: Dr. Kalyani, thanks for taking the time to entertain these questions. One of the things I’ve noticed about your work is that you go through great lengths to make information about diabetes readily available to patients and caregivers.  Why does public-facing, inspiring information matter?

Dr. Kalyani: Diabetes is a chronic illness that relies heavily on the ability of the patient to self-manage their disease.  Yet, health care providers may be limited during a routine clinic visit (for a variety of reasons) in their ability to adequately relay the important information needed for patients to optimally manage the disease.  Our goal in writing these books has been to provide accurate, up-to-date, expert-developed educational content for patients that is quickly accessible and emphasizes the most important facts that we, as health care providers, would want any person living with diabetes or their caregivers to know.  As individuals live longer, optimizing quality-of-life while living with diabetes has become a priority. The content in our books has the goal of empowering individuals with the critical knowledge that they need to confidently self-manage their disease and allow optimal management with their health care team to live a long, healthy life with diabetes.

Tony Teano: Tell us what is special about your latest book, Winning with Diabetes: Inspiring Stories from Athletes to Help You Thrive?

Dr. Kalyani: In our first book, Diabetes Head to Toe: Everything You Need to Know about Diagnosis, Treatment, and Living with Diabetes (Johns Hopkins University Press, 2018), our goal was to present medical information at a glance, with easy-to-digest bullet points on the many complications―head to toe―that people with diabetes can develop and to recognize the early warning signs before diabetes-related difficulties arise. Our purpose in the newest book, Winning with Diabetes: Inspiring Stories from Athletes to Help You Thrive, is to complement the educational content in our first book by providing inspiring stories which share the common ups and downs that people living with diabetes may encounter, and to let people with diabetes know that you don’t have to be a superstar elite athlete to thrive. Winning with Diabetes shares personal accounts from 16 top athletes, including five-time Olympic gold medalist swimmer Gary Hall Jr., WNBA pro Lauren Cox and PGA Tour golfer Scott Verplank. While almost all athletes had type 1 diabetes diagnosed either during childhood or as a young adult, some athletes such as NBA Legend Dominique Wilkins were diagnosed with type 2 diabetes later in life – after their intense training as a professional athlete had ended. The athletes’ stories are used as a basis to illustrate key aspects of diabetes and its complications, with relevant medical content further detailed in the corresponding author commentaries. The stories in the book are organized to reflect the life course of a person living with diabetes including chapters on:

1) The Diagnosis of Diabetes (Why me?)
2) Learning about Diabetes (Where did it come from?)
3) Living with Diabetes (How will I manage day-to-day?)
4) Self-care in Diabetes (How can I prevent complications?)
5) Finding Support (What will other people think?)
6) Winning with Diabetes (Can I accomplish my life goals?)
7) Building a Community (How can I give back?)

Tony Teano: What does it mean to “thrive” with diabetes?

Dr. Kalyani: There are many definitions for the word “thrive” but the dictionary definition that is most relevant states: “to progress toward or realize a goal despite or because of circumstances.” In the context of the athletes in the book, “thrive” reflects success in both achieving their professional goals and also attaining optimal health while living with diabetes. We initially sought out to understand how these athletes were successful in their professional pursuits in spite of diabetes. What we found, instead, was the exact opposite. Nearly all the athletes we interviewed attributed their success, in part, to their experience of living with diabetes. Many said the discipline and lessons they learned from an early age with diabetes, and the emphasis on self-care practices and healthy eating, helped them develop the maturity and determination they needed. Of note, the definition of “health” provided by the World Health Organization is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Thus, for most people with diabetes, the term “thrive” might be broadened to indicate success in achieving their goals while at the same time attaining optimal health—or, in other words, living their life to the fullest and having a long disability-free life with diabetes.

Tony Teano: What is the top takeaway you would like people living with diabetes to gain from reading this book?

Dr. Kalyani: It’s our hope that readers will gain a better understanding of diabetes and, ultimately, draw inspiration from the athletes in this book. This book disputes the idea that diabetes will beat you once diagnosed.  Full page color illustrations of the athletes by Jennifer Fairman, CMI highlight inspiring quotes from the athletes such as this one from Sébastien Sasseville, Canadian mountain climber and distance runner who summited Mount Everest and ran across Canada: “I’ve used [diabetes] as a purpose, a reason to do these difficult things…I have a disease that forces me to live a healthy life. I want to figure out my full potential and see what I can do.” We hope that readers will be motivated by the candid accounts that elite athletes with diabetes share, especially when approaching their own challenges and successes while living with diabetes, irrespective of whether they are athletes themselves. The stories in the book are broadly relatable to all people with diabetes and their caregivers.

Tony Teano: What research articles have you recently published or are working on in the field of diabetes?

Dr. Kalyani: One of the articles that I’d like to highlight is a scientific statement that I recently coauthored titled, “Hormones and Aging: An Endocrine Society Scientific Statement” (June, 2023). This statement highlights the differences between aspects of aging that are normal and sometimes over-treated, and those that can be treated and deserve more attention. I authored the section on diabetes and aging, which discusses unique aspects regarding the pathophysiology, epidemiology, and clinical care of diabetes in older adults, as well as current research gaps.  The goal of the statement is to inform future research on the prevention and treatment of age-associated endocrine health problems such as diabetes. Other research that our group is working on in the field of diabetes includes ongoing studies that investigate methods to reliably quantify the degree of contractile muscle loss in adults with insulin resistant states and, further, studies to identify those individuals with diabetes at highest risk for the development of functional disability. Our hope is that this research can ultimately inform the development of treatments to preserve physical function for people with diabetes as they age in the future. I have particularly enjoyed being a faculty mentor over the past few years to medical students from around the country, as part of the NIA-funded Medical Student Training in Aging Research (MSTAR) program at Johns Hopkins. It has been a privilege to mentor the next generation of diabetes and aging researchers and celebrate their successes.

Tony Teano: Clearly, you are very invested in research, clinical care, and public awareness about diabetes. Why? What motivates you to raise the bar for excellence—and constantly surpass it?

Dr. Kalyani: I first learned about diabetes in my early childhood years, as I witnessed grandparents and other family suffer complications from the disease. During medical school at Johns Hopkins, it became my focus and I decided to pursue a career in academic endocrinology. I was intrigued with all the different ways to approach and improve diabetes care, from research and the clinical side to educating people and empowering them with the knowledge to manage their disease at home. While the discovery of new knowledge is critically important to move science forward, the dissemination of that knowledge to those with the disease and who can most benefit is also important, in order to facilitate its implementation in clinical practice. Diabetes is a widely prevalent disease, that is projected to exponentially increase in the coming decades, with the highest prevalence in older adults— an estimated 1 in 4 Americans over the age of 65 years has diabetes. Research, clinical care, and public awareness are interlinked pursuits that all aim to ultimately improve health outcomes for people with diabetes.

We are grateful to Dr. Kalyani for taking the time to answer these questions. You may be interested in related material and selected research articles authored by her:

Use of Preventive Aspirin Among Older US Adults With and Without Diabetes.  
Liu EY, Al-Sofiani ME, Yeh HC, Echouffo-Tcheugui JB, Joseph JJ, Kalyani RR. JAMA Netw Open. 2021 Jun 1;4(6):e2112210. doi: 10.1001/jamanetworkopen.2021.12210.PMID: 34152419

Glucose-Lowering Drugs to Reduce Cardiovascular Risk in Type 2 Diabetes.
Kalyani RR. N Engl J Med. 2021 Apr 1;384(13):1248-1260. doi: 10.1056/NEJMcp2000280.PMID: 33789013

The Relationship of Lean Body Mass With Aging to the Development of Diabetes.
Kalyani RR, Metter EJ, Xue QL, Egan JM, Chia CW, Studenski S, Shaffer NC, Golden S, Al-Sofiani M, Florez H, Ferrucci L. J Endocr Soc. 2020 Apr 30;4(7):bvaa043. doi: 10.1210/jendso/bvaa043. eCollection 2020 Jul 1.PMID: 32666006

Body composition changes in diabetes and aging.
Al-Sofiani ME, Ganji SS, Kalyani RR. J Diabetes Complications. 2019 Jun;33(6):451-459. doi: 10.1016/j.jdiacomp.2019.03.007. Epub 2019 Apr 3.PMID: 31003924

Diabetes and Aging: Unique Considerations and Goals of Care.
Kalyani RR, Golden SH, Cefalu WT. Diabetes Care. 2017 Apr;40(4):440-443. doi: 10.2337/dci17-0005.PMID: 28325794

Pharmacologic Therapy for Type 2 Diabetes: Synopsis of the 2017 American Diabetes Association Standards of Medical Care in Diabetes.
Chamberlain JJ, Herman WH, Leal S, Rhinehart AS, Shubrook JH, Skolnik N, Kalyani RR. Ann Intern Med. 2017 Apr 18;166(8):572-578. doi: 10.7326/M16-2937. Epub 2017 Mar 14.PMID: 28288484

The relationship of fasting hyperglycemia to changes in fat and muscle mass after exercise training in type 2 diabetes.
Yalamanchi SV, Stewart KJ, Ji N, Golden SH, Dobs A, Becker DM, Vaidya D, Kral BG, Kalyani RR.Diabetes Res Clin Pract. 2016 Dec;122:154-161. doi: 10.1016/j.diabres.2016.09.026. Epub 2016 Oct 10.PMID: 27855341

Hyperglycemia predicts persistently lower muscle strength with aging.
Kalyani RR, Metter EJ, Egan J, Golden SH, Ferrucci L. Diabetes Care. 2015 Jan;38(1):82-90. doi: 10.2337/dc14-1166. Epub 2014 Nov 12.PMID: 25392294

Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases.
Kalyani RR, Corriere M, Ferrucci L. Lancet Diabetes Endocrinol. 2014 Oct;2(10):819-29. doi: 10.1016/S2213-8587(14)70034-8. Epub 2014 Mar 6.PMID: 24731660

Frailty status and altered glucose-insulin dynamics.
Kalyani RR, Varadhan R, Weiss CO, Fried LP, Cappola AR. J Gerontol A Biol Sci Med Sci. 2012 Dec;67(12):1300-6. doi: 10.1093/gerona/glr141. Epub 2011 Aug 26.PMID: 21873592

Hyperglycemia and incidence of frailty and lower extremity mobility limitations in older women.
Kalyani RR, Tian J, Xue QL, Walston J, Cappola AR, Fried LP, Brancati FL, Blaum CS. J Am Geriatr Soc. 2012 Sep;60(9):1701-7. doi: 10.1111/j.1532-5415.2012.04099.x. Epub 2012 Aug 10.PMID: 22882211

Glucose and insulin measurements from the oral glucose tolerance test and relationship to muscle mass.
Kalyani RR, Metter EJ, Ramachandran R, Chia CW, Saudek CD, Ferrucci L.J Gerontol A Biol Sci Med Sci. 2012 Jan;67(1):74-81. doi: 10.1093/gerona/glr022. Epub 2011 Feb 24.PMID: 21350243

Association of diabetes, comorbidities, and A1C with functional disability in older adults: results from the National Health and Nutrition Examination Survey (NHANES), 1999-2006.
Kalyani RR, Saudek CD, Brancati FL, Selvin E.Diabetes Care. 2010 May;33(5):1055-60. doi: 10.2337/dc09-1597. Epub 2010 Feb 25.PMID: 20185736

By Anthony L. Teano, MLA
Communications Specialist

 

 

Dr. David L. Roth shared his desire to step down as the Director of the Center on Aging and Health (COAH) last year.  We undertook a national search, led by Dr. Nancy Schoenborn and Dr. Karen Bandeen-Roche and an interdisciplinary committee, and I am thrilled to report that Dr. Jennifer Schrack will be the next director of COAH.  Thank you to Dr. Schoenborn and Bandeen-Roche and the entire committee!

Dr. Roth became the Director of COAH in January of 2012 and has served in this position for over 11 years.  His colleagues in the Center are grateful for his decade of steadfast leadership and commitment to the Center’s mission: to discover new and more effective ways to promote the health and well-being of older adults, and to help them continue to make valuable contributions to our communities. Empowering innovative colleagues, collaborating with interdisciplinary research teams, and mentoring students and trainees have all been hallmarks of his leadership.  Dr. Roth created a climate in which members from Johns Hopkins University’s schools of Medicine, Public Health, and Nursing collaborate with partners around the world on shared goals in population health and applied gerontology in the areas of research, training, clinical care, and public service. Dr. Roth gave the M. Powell Lawton lecture this past fall at the Gerontological Society of America, focusing on his body of work in applied gerontology, including groundbreaking work on family caregiving that incorporates epidemiology and health services research perspectives.  Cumulatively, the impact of his work on improving the quality of life of older adults and their family caregivers has reached large numbers of older adults.

“I am truly grateful for being given the wonderful opportunity to lead this Center for the past 11 years.  I have learned so much from my incredible colleagues about teamwork, innovation, compassion, persistence, and the never-ending quest to achieve excellence.  I am very excited to see how we will continue to grow and prosper under Dr. Schrack’s leadership,” said Dr. Roth.  Dr. Roth will continue to work with the Division of Geriatric Medicine and Gerontology and his COAH colleagues as a valued member of our faculty as a researcher, mentor, and leader in applied gerontology, and will ensure a smooth transition to Dr. Schrack’s leadership.

Dr. Jennifer Schrack is an epidemiologist and gerontologist who studies the intersection of movement and health in late life. Dr. Schrack is currently the PI or MPI of multiple NIH-funded grants focused on how changes in movement and physical functioning associate with changes in physical and cognitive health in late life.  Dr. Schrack is also the MPI of the National Health and Aging Trends Study (NHATS), a large and robust ongoing cohort study of the health and function of older adults, along with Dr. Vicki Freedman from the University of Michigan.   Dr. Schrack is excited to grow the scientific focus of COAH through several initiatives with COAH’s partners in the School of Medicine, the Bloomberg School of Public Health, the School of Nursing and more.  Working with interdisciplinary partners across the university, Dr. Schrack aims to leverage the NHATS dataset and the associated claims and geographic linkages to examine contributors to and consequences of disability and accommodations in late life.  Furthermore, Dr. Schrack aims to grow interventional research focused on helping older adults function optimally as they age.  A respected mentor, Dr. Schrack is looking forward to helping strengthen training programs in aging and foster the future academic success of students, fellows and junior faculty.

Regarding her new leadership role with COAH, Dr. Schrack said “It is an honor to be chosen for the position of COAH Director. I have been affiliated with COAH in various positions (trainee, fellow, faculty) since 2006. I am fortunate to work with an outstanding group of faculty, students, fellows, and staff who are dedicated to improving the lives of older adults. Together I know we will accomplish great things, and I am excited to have the opportunity to help COAH grow in its next phase.”

Please join me in thanking Dr. Roth and welcoming Dr. Schrack!

You may also be interested in these prior COAH blogs about Drs. Roth & Schrack: 

• COAH Champion: Dr. Jennifer A. Schrack
• Q&As with NHATS Co-PI Dr. Jennifer Schrack: Featuring NHATS/NSOC Webinars
• COAH Champion: Dr. David L. Roth
• Dr. David L. Roth Announces Plans to Step Down as Director of COAH
• David L. Roth to Receive the 2021 M. Powell Lawton Award from the Gerontological Society of America (October, 2021)

 

 

Author: Cynthia M. Boyd, MD, MPH
Director, Division of Geriatric Medicine and Gerontology

The American Geriatrics Society (AGS) has named Dr. Halima Amjad an Outstanding Junior Investigator of the Year for 2023. This award was established to recognize outstanding achievement in geriatric research by a junior investigator who is in the career development stage of their research career.

An active member of the AGS, Dr. Amjad has a passion for health services research and dementia care. Dr. Amjad’s body of research encompasses 34 peer-reviewed publications, including: 13 first- or senior-author research manuscripts; five invited commentaries; and seven oral abstract presentations.

Dr. Amjad has received an impressive total of seven internal and external research and career development awards to date, including: a KL2 award; a Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research pilot award; an NIA R03 award; and an NIA K23 award.

Through these grants, Dr. Amjad has researched potentially unsafe activities and healthcare utilization in older adults living undiagnosed or unaware of dementia, diagnosis challenges in minoritized older adults, and practical interventions to facilitate high-quality post-diagnosis care for dementia in primary care settings.

Upon learning of this fabulous news, we checked in with Dr. Amjad and asked three quick questions.

Tony Teano: Congratulations! How does this amazing recognition make you feel?

Dr. Amjad: I feel humbled, honored, excited and grateful. In academic medicine and with amazing colleagues, it’s easy to feel like I’m not doing enough. This recognition reminds me that what I am doing is more than enough. I’m grateful not just for the recognition but for all the support that led to this award. I’m grateful for the training, mentorship, collaborations, colleagues, and students at Johns Hopkins and COAH that support my research.

Tony Teano: Of what three research projects are you most proud and why?

Dr. Amjad: I’m proud of every project I’ve led or collaborated on so it’s hard to pick specific ones. I’m proud of the body of work I’m building on individuals living undiagnosed or unaware of dementia, moving from describing these populations to understanding their health utilization outcomes to thinking about how we can link diagnosis and awareness to high quality care. Within that work, I’m particularly proud of the qualitative research we’re doing. Being able to hear and amplify the voices of patients, caregivers, and frontline primary care clinicians and staff is so important and enlightening–it reminds us of why we are doing the research while we’re in the field. I’m also proud of the research I’m working on for the Maximizing Independence at Home (MIND at Home) dementia care coordination studies and programs, led by my mentor Dr. Quincy Samus. We’ve been able to learn so much about dementia care needs and how to address those needs. It is particularly exciting to support health plans and clinics that are actively implementing the program. We get to see the research making a difference for individuals living with dementia and their caregivers.

Tony Teano: What impact does this award have on your drive to do more research in the future?

Dr. Amjad: This award renews my drive to build upon the research I’ve done. Research can feel like a slog at times, and I often have to step back to look at the big picture. With this award and stepping back to reflect on the dementia journey my dad, my patients, and so many others experience, I’m motivated to push forward until we make real changes in the care and support we provide in dementia, guided by the research so many of us are doing.

Congratulations, again, Dr. Amjad!  Your COAH family are, as ever, duly impressed and proud to work with you.

Dr. Halima Amjad is Core Faculty at the Johns Hopkins University Center on Aging & Health, and Assistant Professor of Medicine with the Division of Geriatric Medicine and Gerontology.

For more information about this AGS honor, visit: AGS HONORS EXPERT & EMERGING GERIATRICS LEADERS AT 2023 ANNUAL SCIENTIFIC MEETING (#AGS23)

By Anthony L. Teano, MLA
Communications Specialist

 

 

Core Faculty with the Center on Aging & Health (COAH), Jennifer A. Schrack, PhD, is our Summer 2023 COAH Champion, and we are delighted to bring you this interview so you may learn more about Dr. Schrack as a person as well as a professional.

 Dr. Schrack is an Associate Professor with the Johns Hopkins University Bloomberg School of Public Health with a primary appointment in Epidemiology of Aging, and she has a joint appointment in the School of Medicine. She studies movement and health, and, in addition to COAH, Dr. Schrack is affiliated with these Johns Hopkins University research centers: Welch Center for Prevention, Epidemiology and Clinical Research; George W. Comstock Center for Public Health Research and Prevention; and Alzheimer’s-related Resource Centers for Minority Aging Research. 

Additionally, she is the Johns Hopkins University co-PI with the National Health & Aging Trends Study (NHATS); you may be interested in a prior COAH Blog about her involvement with NHATS, which you may access here. In it she discusses perspectives as an epidemiologist studying movement and health, as well as the nexus of medicine and public health, and Dr. Schrack describes very interesting studies using NHATS data and possible implications for future work in the field.

Tony Teano: Thanks so much for taking the time to meet for this interview—Congratulations on being named the Summer 2023 COAH Champion!  For those who may not know you well, please tell us about your background, education, and path to COAH.

Dr. Schrack:  My undergraduate degree is actually in accounting!  I graduated from Villanova University, and I liked math, numbers, and statistics—those kinds of courses. But I really didn’t know what I wanted to do for a career.

My advisor suggested I try accounting because it is very analytical, numbers-focused, and I enjoyed those classes. It led me to a pretty prestigious corporate banking training program, and I had a job set up before I graduated. But when I graduated, I found out that I didn’t like the job–I was working as a financial analyst for a bank in Philadelphia, and I did that for 3 years… but I didn’t like it at all. I was just bored. I was managing a portfolio of clients that included the University of Pennsylvania, Thomas Jefferson University, and Pennsylvania Hospital.  I found I was more interested in the work that my clients were doing rather than just providing their financial services. So, I thought maybe I didn’t like “Corporate America,” and I got a job at a smaller real estate investment firm—and that was even worse!

During that time, I decided I needed to make a change, and I started taking night classes. I had always been interested in activity and health, but it was more like a hobby—I always enjoyed sports as a kid. I never really thought about it as a career. So, I started taking classes: anatomy; physiology; and nutrition. I just loved it. I was fascinated by all of them, so I applied to Master’s programs in Kinesiology, which is movement science, and was accepted to the University of Michigan, where I primarily focused on Cardiovascular Health and Obesity.  While there, I started working on a study with Dr. Neil Alexander, who is a geriatrician at Michigan, and he was very interested in preventing falls in older adults, and how strengthening lower extremity leg muscles could help prevent falls.  I thought it was a fascinating concept for a study, and that something so simple could make such a big difference in people’s lives. That led me to a job at as an Exercise Physiologist at the National Institute on Aging, where I worked for the Baltimore Longitudinal Study of Aging with Dr. Luigi Ferrucci when he first took over.  That was my introduction to Epidemiology, and I loved the concept of following people for life to try to understand who ages well, and why.

That led me to pursue my PhD in Epidemiology at Johns Hopkins University. It was hard coming from a laboratory science background, and—at first—I really wasn’t sure I belonged. It took about 6 months to really feel like this is where I belonged. In the second year of my program, I was accepted into the Epidemiology and Biostatistics of Aging Training Program run by Drs. Linda Fried and Karen Bandeen-Roche, and that’s when it started to come together for me. I found that I had always been interested, like I said, in activity, but I realized I was also interested in mobility and disability.

I grew up very close with both my grandmothers, who lived incredibly independent and mobile lives until about the age of 93. Towards the end, I saw them struggle mostly with mobility, and how restrictive it was for them. In a way, that was the foundation for my motivation for trying to understand this link between movement and health.

I started studying gait speed because that was the “darling” of gerontological researchers at the time. And then, through the years, I got into newer technology—such as wearable devices—and trying to understand how people move in their own environment, how much they move, and their patterns of movement, and what that could tell us not only about their mobility, but also their cognitive health and their general physical health. At the time, I found it fascinating because it was a newer way to gather research data and was a wide-open field; today, it is not really new anymore—it has been around for a good decade—but the methodology is still new. We’ve come up with a lot of new ways to look at this data, and ways to help understand what’s going on in older people’s lives in a more in-depth way than simply measuring how they function in a clinical setting.

Tony Teano: Can you give us an example of your research in this space?

Dr. Schrack: I think the article that is probably most known is a review paper on Assessing Physical Activity in Older Adults. I wrote it with Dr. Tammy Harris before she retired from NIA. And I’m proud of it because it set the tone for trying to understand physical activity in older adults in a different way.  Traditionally, physical activity research has focused on how active are you in terms of your MVPA—your “Moderate to Vigorous Physical Activity.” Are you meeting the Government guidelines of 30 minutes of MVPA a day?  That is an important question, but for older people, it may not be the most effective way to gage how active they are…. Whether they meet the guidelines or not may have a lot to do with their functional ability. We wrote this review article saying, “There are other ways to look at this, and these ways may actually tell us more about people’s health than simply quantifying how much time they spend at a certain intensity of exercise.”

More recently, we’ve been taking these methods that we developed over the years and applying them to specific research questions around physical and functional decline. One example is a recently published online ahead of print paper that was part of a clinical trial run by Dr. Larry Apple, STURDY, where we looked at vitamin D supplementation for prevention of falls in older people. Specifically, the question was, “If we give vitamin D supplements to older adults who are a vitamin D deficient, will this affect their falls risk?”  We found no effect on falls. But I also convinced Larry it was important to understand how much the participants move.  People who fall have to be moving. You can’t fall If you’re just sitting in a chair. You have to be actually walking or moving in order to fall. Therefore, we put accelerometers on everybody in the STURDY trial. What we found was very interesting: giving people who have low serum vitamin D supplements didn’t do anything to attenuate their physical activity decline. Specifically, people with vitamin D deficiency declined more in their physical activity during the study, but the supplementation did not slow this decline.  This is a sign that those with low vitamin D may be in an accelerated state of decline in terms of their health, and but giving them vitamin D doesn’t seem to matter. Other therapies are needed.

It is a little frustrating that we didn’t find an answer, but at the same time I think it’s very, very interesting.  It shows us the complicated kind of heterogeneity that happens at the end of life.

Tony Teano: After you went into accounting/finance and realized it wasn’t your calling, what was your “Ah-Ha!” moment when everything clicked that examining the relationship between movement and health was in fact your path? How did you know?

Dr. Schrack: That’s a great question, I think I was fascinated by the fact that we can understand so much about a person’s health by just looking at how much they move and how quickly they move. And that this is true, across species, not just in humans. It’s true in animals.  If you’ve ever had a dog or a cat, you know how they move less, and they move slower as they get older. It’s true in mice, too. And fish swim slower as they get closer to death.  So, it crosses species—it isn’t just true in humans.  Decline of movement is really predictive of so many outcomes. And I find that fascinating—that something so relatively simple like measuring how much someone

moves or how fast they move can tell us more than many clinical tests. This work allows me to combine my two graduate degrees—my kinesiology degree and my epidemiology degree. And then there’s my undergraduate degree, which was really numbers-focused and very analytical. I use a lot of those skills every day as well.

Tony Teano: Knowing what you now know about this profession and your career path, what advice would you give to college students today who are gifted in math and science and who are interested in health, and how the body moves and ages?

Dr. Schrack: That’s a hard question because I never would have thought of studying movement as a career path!  Looking back, if you think about it, it’s just not something anyone would have ever thought of at that time, and the college pathways at that time very clearly lead to practical jobs in statistics, accounting and finance—or teaching those subjects. And I really enjoyed statistics, so the path I pursued made sense. However, there are a lot of options out there that I just didn’t know existed. Now, young people are more naturally going into the quantitative sciences.  Today, I’d definitely encourage students with similar interests to mine to think about how valuable mathematics is as a quantitative science. Also, I would encourage them to get creative and “think outside of the box” to find possibilities where their personal passions and professional aptitudes overlap. Consider setting up a brief Zoom “informational interview” or exchanging emails with someone doing something unique in the field that seems appealing. Additionally, I think now there’s more emphasis on STEM, especially—women and minorities in STEM. There’s a lot of options and opportunities out there!  Actively seek them out!

Tony Teano:  Thank you for those suggestions, Dr. Schrack!  I hope those starting to dream about their futures in this field will consider your insights. You have a wealth of professional knowledge and experience to offer those suggestions and discovering and really making your own way.

Now, if you don’t mind, I’d like to turn to another side of you: “Jennifer”—who you are outside of work, as a real person.  What activities do you like to do?

Dr. Schrack: I like to be active.  I am a runner.  I like to garden.  I like to ski both on snow and water.  I like to sail. We have a lake house in upstate New York on Otsego Lake, and we spend as much time as we can there in the summer. We ski, we paddle board, we swim, we sail.  It’s really a nice place to go and relax and unplug, and renew ourselves—and get ready to face the world again.

Tony Teano: You say “we”—who are “you”?

Dr. Schrack: My husband, Nick, who is faculty at Towson University in Kinesiology.  We met and worked in the same lab in Michigan.  And then I have three daughters: Ella, Kate, and Leah. Ella is 13.  Kate and Leah are twins, who are 10.  And we take our dog and two cats to the lake, too. We all love it and have a great time.

Tony Teano: That sounds like a great time for one and all! Tell us about a few of your favorite things—a movie or a book, etc.

Dr. Schrack: One of the best books I read recently was the book Educated: A Memoir by Tara Westover.  It’s a true story about a woman’s fight for her education. It was amazing to me because it’s something so many of us take for granted. We grow up with education in our lives, and this was a story about a woman who grew up in rural Idaho, and her parents didn’t believe in formal education—and that’s all she wanted, and so it was kind of her fight for education. It it’s a really good book.

Tony Teano:  This sounds like a great story!  Other favorite ways to pass time?

Dr. Schrack:  We are a game family!  My husband and I really like to play cards. We’re always looking for people to play cards with.  Also, we spend a lot of time cooking, baking and canning. My kids like it when I cook for them, and a favorite meal I cook that’s a hit is Arugula Pesto.

Tony Teano: I know that you have several animal companions. Tell us about them.

Dr. Schrack: We have a lot of animal companions. There’s a Chesapeake Bay retriever and two cats. Those are our house animals… and then we have four Sicilian Miniature Donkeys. They came with property and were living here when we moved to our current house four years ago.

The guy who owned it before us had rescued them, and we didn’t really have the heart to make them leave. We also have three sheep, and eight chickens.

Tony Teano: I bet you were popular among your neighbors when a dozen eggs cost $5!

Dr. Schrack: Four of them are young, and haven’t started to lay yet, but I think later this summer we will be drowning in eggs, probably.  The animals are a lot of fun.  They keep us busy, but they’re fun. Spending time with them at the end of a busy day is always a bit of a stress relief.

Tony Teano: Now that you’ve told us about all your animals, if they could talk, what would they say about you?

Dr. Schrack: They’d probably tell you that I spoil them, and that I’m the fun one!  My husband does more of the day-to-day care with the barn animals. On the days that I go down there, I tend to bring them treats—like apples or carrots—and they know it, too! When they see me, they’re expecting it. So, what would they say about me? “Mom spoils us!”

Tony Teano: It sounds idyllic! What a great place to call home, and what a rich family life.  Now for the last question, taking us away to your “bucket list” vacation—if you could visit any place in the world, where would you want to go?

Dr. Schrack: That’s a tough one!  I would really like to see Israel.  There’s a lot of history there.  It’s not a place that we commonly go for conventions, conferences, or meetings.  Someday, I would like to make it to Israel.

Tony Teano: Thank you for taking time to do this. I know you’re very busy with your job, and it has been a real treat to get to know you better as a COAH Champion and an everyday person.

For more information about Dr. Schrack’s research lab team, please visit:

• ENGAGE (Energy, Physical Activity & Aging) Research Lab

You may be interested in a few research publications to which Dr. Schrack contributed:

• COVID-19 pandemic experiences of older adults with dementia in community and residential care settings: Results from a US national survey
• Association between walking energy utilisation and longitudinal cognitive performance in older adults
• Association of walking energetics with amyloid beta status: Findings from the Baltimore Longitudinal Study of Aging
• Assessing Daily Physical Activity in Older Adults: Unraveling the Complexity of Monitors, Measures, and Methods
• Assessing the “Physical Cliff”: Detailed Quantification of Physical Activity and Aging

On Twitter, you may follow Dr. Schrack @jenschrack and the NHATS/NSOC @NHATS_NSOC.

By Anthony L. Teano, MLA
Communications Specialist