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Sleep Quality & Caregivers’ Well-being: Effective Interventions Needed

Better understanding of and advocating for caregivers’ needs is at the heart of much of Dr. Marcela Blinka’s research at COAH.  Recently, she and her colleagues considered that caregiving can be a source of stress, depression and anxiety, and that these factors can affect sleep quality.  So how does caregiving impact sleep quality? How much? What does that mean to the health of caregivers?

Seeking answers to these questions, Dr. Blinka and a team of COAH researchers examined data from the Caregiving Transitions Study (CTS), a highly-respected national population-based caregiver study.  Joining Dr. Blinka,  the COAH team consisted of Drs. Adam Spira, Orla Sheehan, and David L. Roth, and Tom Cidav, along with Dr. Virginia Howard and J. David Rhodes from the University of Alabama at Birmingham.   The CTS looks at how the caregiver role impacts the health of those who have recently become caregivers among participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.  REGARDS is a national population-based sample study of adults over age 45 in the US, looking at causal factors for the high stroke rate and death differences between Black and White residents of the Southern “Stroke Belt.”

Dr. Blinka and the research team delved into CTS data to examine the self-reported sleep characteristics of incident caregivers (CTS study participants that became caregivers after enrollment) and non-caregiving controls.  The controls were matched based on age, sex, race, education, marital status, history of cardiovascular disease, and self-rated health factors; controls did not have extended family caregiving responsibilities during their participation in the study.  The study examined the relationship between caregiving and multiple self-report measures of sleep duration and quality, as well as a number of additional factors. Blinka et al.’s findings are discussed in “Sleep Quality Reports from Family Caregivers and Matched Non-Caregiving Controls in a Population-Based Study,” which is published online ahead of print in the Journal of Applied Gerontology, March 26, 2022 and available here.

The implications of their study’s results are particularly meaningful because their data may apply to caregivers throughout the country. In 2020, the AARP and the National Alliance for Caregiving survey estimated that more than 50 million Americans provide unpaid care for adult family members or friends; projections of the number of Americans who are 80 years or older is expected to rise from about 13 million in 2015 to about 35 million in 2050. Anticipating their well-being is critically important to the future of our society.

Here’s what they discovered:

  • Caregivers reported significantly longer sleep onset latency than controls, before and after adjusting for covariates (ps < 0.05).
  • No differences were found on measures of total sleep time or sleep efficiency.
  • Among caregivers only, employed persons reported less total sleep time, and the number of care hours was a significant predictor of total sleep time.
  • Dementia caregivers did not differ from other caregivers.

Of noteworthy importance, however, Blinka’s team observed that poor sleep quality increases the risk for future physical and mental impairments—and with a vastly expanding number of caregivers projected in the future, this could become a health crisis if left unchecked: “Effective interventions to assess and improve caregivers’ sleep quality are needed.”

Wondering if you’re getting enough sleep? Experts recommend 6 to 8 hours of sleep for optimal health, in general.  And if you’re having trouble getting restful sleep, please make an appointment and discuss the matter with your doctor.

Dr. Blinka underscores the importance of the general research consensus on the cumulative effects of sleep deprivation over time; sleeping in on weekends doesn’t make up for it—“You can’t get it back.”  Dr. Blinka urges caregivers to be proactive in minding their sleep hygiene as a critical component of well-being and self-care.

Declaration of Conflict of Interest: Dr. Spira received an honorarium as a consultant to Merck and honoraria from Springer Nature Switzerland AG for guest editing special issues of Current Sleep Medicine Reports.


By Anthony L. Teano, MLA
Communications Specialist



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Top 10 Recommended Resources About LGBTQ+ Aging & Older Adults

As June comes to a close, I thought I would share with you a few studies and helpful resources in the field of LGBTQ+ Aging & Older Adults. Below are my top 10 recommended resources in this space. As a bonus, I’ve included a short list of my favorite curated resources. I hope you will find them useful and informative.  Without further ado:

Curated Resources:

    Especially for LGBTQ+ Older Adults Coming Out to Healthcare Professionals:

   Studies Seeking LGBTQ+ Participants:

 Relevant Presentations:

Center on American Progress: 6 Consequences of SDOH on LGBTQ+ Health:

      • Substance use disorders

        • Alcohol consumption
        • Rx misuse
        • Smoking
        • Street drug
      • Obesity & eating disorders
        • Mental health, anxiety & depression
      • Isolation & loneliness
        • Suicide rates
      • Heart disease
        • Glucose control
        • Smoking
      • Breast & cervical cancer
      • Sexually transmitted infections

Baltimore-Based LGBTQ+ Health Nonprofit:

 The Center for Disease Control and Prevention: LGBT Health Disparities:

“People who are Lesbian, Gay, Bisexual, or Transgender (LGBT) are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the country. The perspectives and needs of LGBT people should be routinely considered in public health efforts to improve the overall health of every person and eliminate health disparities”

Current Events Impacting LGBTQ+ Minority Stress:


By Anthony L. Teano, MLA
Communications Specialist


Halima Amjad

COAH Champion: Halima Amjad, MD, MPH, PhD

Halima Amjad, MD MPH PhD is a most valued core faculty member with the Center. She is an Assistant Professor with the School of Medicine in Division of Geriatric Medicine and Gerontology.  Her areas of clinical expertise include geriatric medicine and geriatric psychiatry, with a focus on individuals living with dementia. She is a provider at the Johns Hopkins Memory and Alzheimer’s Treatment Center, located at Bayview.  Dr. Amjad is known for being friendly, compassionate, and extraordinarily insightful in her research inquiries and findings. We are grateful for this opportunity to learn more about her personally and professionally, and share with you how truly wonderful Dr. Amjad is through this COAH Champion interview. Let’s start by recognizing a fabulous recent accomplishment! The PhD part of her credentials is new!

Congratulations on earning your PhD degree! This is in addition to your MD and MPH! What does that mean to you? What will you be able to do differently now?
Obtaining a PhD in Clinical Investigation highlights my commitment to a career in clinical aging research and acknowledges that formal training is important to ensuring that clinician researchers have the skills to plan, conduct, and disseminate high-quality research. Several geriatricians at Johns Hopkins followed a similar path to establish themselves as independent investigators, and I hope to do the same. The doctorate degree shows the world, particularly funders and collaborators, that I have a strong foundation in research methodology and a dedication to this career.

Tell us about your background, education, and path to COAH.

image of drawingAs a pre-schooler, I declared that I wanted to be “mommy and daddy’s doctor” and followed through! I was always drawn to a medical career, a career centered around caring for others. I made the commitment to medicine early, going to a joint BA/MD program for undergrad and medical school (Lehigh University and Drexel University in PA). During my internal medicine residency at Yale, I was drawn to geriatrics because I loved the emphasis on the whole person and family as well as the “less can be more” approach. I think I was subconsciously also led to geriatrics by my dad’s dementia diagnosis. I never envisioned a research career, but I got involved in my first research project related to advance care planning with Terri Fried at Yale. That first experience peeked my interest in research, and I came to Johns Hopkins for a clinical and research fellowship in geriatrics to image of Halima Amjad and Momget more training in aging research and see if I would enjoy research long-term (Hopkins was also closer to my parents, which was important to me). As a fellow, COAH Director Dr. David L. Roth was one of the first mentors I connected with. His mentorship helped me obtain my earliest grants using National Health and Aging Trends Study (NHATS) data to examine potentially unsafe activities among older adults with dementia and then extending that work to examine people living with undiagnosed dementia with NHATS-linked Medicare claims data. Many of my mentors are core or associate faculty of COAH, and I love the interdisciplinary connections and collaborations it brings.



Why did you choose to go into this field of work?

image of Halima Amjad and DadAs I carved out a career as a clinician investigator, I focused on dementia care and health services for people living with dementia due to my dad’s diagnosis. He was diagnosed with early-onset frontotemporal dementia just as I was graduating from medical school. Through our family’s experiences, and now also through experiences of my Memory Clinic patients, I have seen the many ways in which medical care and our health care systems fail people with dementia, from diagnosis until death. I know that there are policies, interventions, and clinical practice changes that can improve the care and support that individuals and families receive. My work, and the work of many others, is trying to bring those needed changes. Research can also be daunting when you see the work of senior or established researchers; because of my personal experience, I felt dementia care was one area where I had expertise even as an early career investigator.

What paper are you most known for or most proud of?
While my paper on continuity of care and healthcare utilization in older adults with dementia was published in my highest profile journal, I’m most proud of my paper characterizing people living undiagnosed or unaware of dementia in the Journal of General Internal Medicine (which you can find by clicking here). It is work that I envisioned and led. It’s often cited in research to improve diagnosis and disclosure of dementia, which is something that can be a long road for many patients and families, including mine.

Turning to the escapes you may have in your personal world, please share with us your favorite films or songs over the past year.
Two films that I loved happen to also hit home the importance of the work that COAH faculty do: The Father and CODA.

What is the top item on your bucket list?
Foreign travel! Between the pandemic and having triplets, it has been a long time since we’ve been able to explore new places, cultures, and most importantly, food.

Tell us about your hobbies… what renews you?
Time separating myself from work – focused time with my family, vacations (even short ones), exercise (Pamela Reif on YouTube is my go-to), and reading (mostly fiction). Hopefully I can report back with more hobbies and activities once my kids are older!

Favorite daytrip getaway destination?
Fort McHenry is a family favorite for a picnic, playing, and boat watching.

What’s your favorite city or state? Why?
Philadelphia – there’s no place like home.

We thank Dr. Halima Amjad for allowing us into her world through this very personal interview. Absolutely, her commitment to improving the lives of those living with memory loss and dementia comes from a place of sincere compassion, especially as it personally touches her immediate family; we were saddened to learn that her father, Dr. Muhammad Amjad, passed away on March 10, 2022. Diagnosed at age 59 and passing away of end-stage dementia at age 72, he lived 13 years with early-onset frontotemporal dementia at home under the loving care of his wife. Dr. Muhammad Amjad was known for his smile, laugh, generosity, and kindness—all wonderful attributes he clearly passed down to Dr. Halima Amjad.  The COAH family expresses our deepest heart-felt condolences on this great loss—may his memory be a blessing.

By Anthony L. Teano, MLA
Communication Specialist


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COAH 2022 Spring Awards Luncheon

I am overjoyed that we could gather at the center’s offices on May 10th for the 2022 COAH Spring Awards Luncheon. The center has been around for almost 25 years, and this luncheon has been a favorite part of happenings since 2014.

The purpose of this luncheon is really to bring people together and celebrate our successes and our talented, growing team. At the event, we highlight new hires, appointments and promotions. We recognize accomplishments individuals have earned through their dedication and hard work. And we acknowledge the prolific new financial awards/funding our team of researchers have gained to further advance scientific data around healthy aging.

Since this was the first COHA Spring Awards Luncheon since the pandemic began, it encompassed such laurels over the past two years.  Here are a few examples of our reasons to come together and celebrate:

New Hires:
Tom Cidav  –  New hire: Biostatistician (April 2020)

Tony Teano –  New hire: Sr. Administrative Coordinator (April 2020)

Talan Zhang  –  New hire: Sr. Biostatistician (August 2020)

Tim Sanders  –  New hire: Software Engineer (September 2020)

Cynthia Boyd – Director, Division of Geriatrics (August 2021)

Jennifer SchrackNamed new Co-PI of NHATS (2021)



Ravi Varadhan – Promoted to full professor (2021)

Marcela Blinka – Promoted to Research Associate (2021)

Tony Teano – Promoted to Communications Specialist (July 2021)

Marcela Blinka – MFL Staff Award of Excellence for Leadership (2019)

Tony Teano – SOM Pride Month Achievers Award (June 2021)

Tony Teano – MFL Award for Creativity & Innovation (June 2021)

Tony Teano – Wrote/won a Diversity Innovation Grant from APL/DLC for “Geriatricians Engaged and Ready for LGBTQ+ Aging, Health & Wellness” with Drs. Matt McNabney (Mosaic Initiative in Geriatrics) & Panagis Galiatsatos (Medicine for the Greater Good & Office of Diversity Inclusion & Health Equity) as co-leaders of this initiative, and with the support of Dr. Cynthia Boyd, Director of the Division of Geriatric Medicine & Gerontology (January, 2022)

Emma Nichols – Louis I. and Thomas D. Dublin Award (2022)

Elizabeth Linton – Delta Omega Scholarship – Applied Research Award (2022)

Erica Twardzik – ProQuest Distinguished Dissertation Award – (2022) Of the more than 800 dissertations submitted each year, only ten are selected. The ProQuest Distinguished Dissertation Awards recognize highly accomplished graduate students who have produced exceptional dissertations of outstanding scholarly quality in any field of study.

While the lists of new grant-funded research and prominent peer-reviewed articles are too long to enumerate here, suffice it to say that the center’s industrious team successfully gained the resources to advance research benefiting older adults and their caregivers nationally and globally with many interesting and innovative approaches and topics that promise to yield valuable findings.

As COAH’s director for more than a decade, I am proud of our team as individuals and as collaborators—both internally to Johns Hopkins as well as with prominent external researchers in the field of applied geriatrics. I congratulate you on your successes, and wish you many more!


By Dr. David L. Roth