Dr. David L. Roth’s Recent Latent Variable Study Identifies Possible Inhibitory Pathway Contributing to Long-Term Caregiver Stress

“Inflammation is a complex, multistage process, and the latent variable modeling approach helped us to disentangle that and identify an inhibitory pathway that may be impacted by long-term caregiving stress.” –Dr. David L. Roth

Center on Aging and Health Director Dr. David L. Roth led a detailed analysis of latent variables of inflammation to hone in the measurement of stress on family caregivers and its effects on health among 502 U.S. study participants covering a span of 9 years.  The research findings were published online this spring: “Transitions to Family Caregiving and Latent Variables of Systemic Inflammation Over Time.” Center colleagues Drs. Jeremy Walston and Karen Bandeen-Roche from Johns Hopkins joined him as well as researchers from the University of Mississippi, the University of Vermont, and the University of South Florida.

Researchers say molecules found in blood samples can provide clues to the types of inflammation a person may be experiencing. Of note, our researchers found new evidence to suggest that caregiving stress affects an inhibitory feedback loop, possibly indicating a mechanism or a vulnerability to the long-term regulation of systemic inflammation and immunity for those who provide care to a loved one with a disability over many years.

Previous studies reported minor differences using different analytic approaches to measure the consequences of stress on inflammation; as a whole, the body of existing research was often confusing. Dr. Roth’s team’s latent variable approach examined data on six specific inflammation biomarkers collected from two blood samples drawn almost a decade apart—once prior for all participants when they were not caregivers, and again for all participants about a decade later—when half of them had become caregivers. Comparing the results of these two groups, researchers reported that:

“Two latent factors, termed ‘up-regulation’ and ‘inhibitory feedback,’ were identified, and the transition to family caregiving was associated with a lower increase over time on the inhibitory feedback factor indexed by interleukin (IL)-2 and IL-10. No caregiving effect was found on the up-regulation factor indexed primarily by IL-6 and C-reactive protein.”

In other words, the latent variable methodology led the researchers to discover a new pathway by which long-term stress may have a biological impact among those who became family caregivers and sustained caregiving over a significant span of many years.

Consequently, not only do these findings illustrate the advantages of using latent variable models in research studies, but they also could lead to future research and recommendations about possible interventions to benefit caregivers’ health, alleviating them from the bodily harms of stress and mitigating consequences of chronic inflammation over time.

Dr. Roth is available to media for inquiries and further information at: (410) 955-0491.

By Anthony L. Teano, MLA
Communications Specialist


image in color of brain matter

Looking for dementia caregiver resources in Maryland?

It can be difficult to find support for dementia caregivers, and information about the many programs that can help their loved-one with dementia. To address this gap, #BrainMatters held a webinar on “Dementia Caregiving & Caregivers,” which highlighted a host of resources and provided key considerations from top experts in Maryland and throughout the nation. If you know someone who might benefit from this material, please pass it along:

#BrainMatters is a community-based collaboration spearheaded by Johns Hopkins Memory and Aging, part of the Johns Hopkins Alzheimer’s Disease Research Center’s (JHADRC) community outreach efforts. These efforts include providing the broader Maryland community with education and resources on topics related memory loss and aging, as well as ways to become involved in research studies that advance science around brain health, memory loss, and dementia including Alzheimer’s disease.  The JHADRC is led by Dr. Marilyn Albert, who is a COAH Senior Associate Faculty member.

For more information about the JHADRC and the types of studies currently enrolling participants, visit: http://www.alzresearch.org/participate-in-research.cfm.

Follow Johns Hopkins Memory & Aging on social media!

Facebook: https://www.facebook.com/jhmemoryandaging

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By Anthony L. Teano, MLA
Communications Specialist



Congratulations, 2022 Mason F. Lord Award Winners!

Talan Zhang (left) and Monique Lee (right), pictured with Dr. David L. Roth (center). This picture was taken at the reception for the Division of Geriatric Medicine & Gerontology’s Town Hall on June 28, 2022, at which the Mason F. Lord Staff Excellence Awards were presented.

At its annual town hall on June 28, the Division of Geriatric Medicine and Gerontology presented four high-performing professional staff with the Mason F. Lord Staff Award of Excellence.

It is worth taking a moment to reflect on the awards’ legendary namesake, Dr. Mason F. Lord. A 1954 graduate of Johns Hopkins Medicine, he is considered as one of the founders of modern Geriatric Medicine. In the 1950’s and 60’s, when the Johns Hopkins Bayview Medical Center was still known as the Baltimore City Hospitals, Dr. Lord was the first full-time Chief of Geriatrics. At the time, many older adults arrived at the hospital with advanced chronic illnesses and they were kept at the hospital until their death in order to tend to their medical needs; the average older adult in the chronic illness section of the City Hospitals stayed for 3 or more years. To improve care for the aged ill, Dr. Lord envisioned an innovative approach involving care for older adults before they reach a critical tipping point in health and bringing them to the hospital when necessary for advanced care, and then placing them back in their homes whenever possible accompanied by regular physician home visits to continue patient care. Over time, this revolutionary approach became a national model.

The Mason F. Lord Staff Award of Excellence recognizes staff who demonstrate outstanding accomplishments in four categories—each is a hallmark of Dr. Lord’s legacy.  Here are those categories reflecting the outstanding attributes he embodied, along with the 2022 winners of the award named in his honor:

  • Performance Excellence: Monique Lee
  • Creativity and Innovation: Talan Zhang
  • Leadership: Brandon LaCour
  • Safety and Service: Jeanette Wooden

The Center on Aging and Health congratulates all of the winners, and we are particularly proud that two of these amazing professionals work with the Center’s team: Monique Lee and Talan Zhang!  Below is a description of their distinguished service.

Monique Lee, Administrative Coordinator

In his nomination for Monique, COAH Director Dr. David L. Roth said: “Monique Lee has been the full-time administrative coordinator in COAH since December of 2018.  Over the past 3 and ½ years, she has consistently been a positive and welcoming face of the Center and has also shown tremendous growth in her professional skills.  Whenever anyone calls or emails the Center, the first person they encounter is Monique, and she always warmly welcomes them and strives to be as helpful as possible.  As Center Director, I basically rely on Monique for everything….”  Monique is responsible for: scheduling and coordination of the Center’s various activities among multiple collaborators; website content management and updates; scientific clerical tasks pertaining to publications; and “Division Citizenship”—participating in many activities and to meet needs across the entire division. Without a doubt, Monique is a critical part of the COAH team.

Talan Zhang, Senior Biostatistician

Dr. Roth praised Talan’s data and programming skills in his nomination for her: “Talan has superb programming skills that have really enhanced the innovation and creativity of the teams she has been working on.  Talan has programmed the data management systems in SAS that track who is eligible to be recruited, who has been contacted, and which patients have followed up to receive the intervention…. Because of Talan’s skill and amazing dedication, she was able to basically take over this important infrastructure role in our Center….”  Talan has demonstrated creativity and innovation skills to track patents, to master accelerometry data analysis, and to analyze NHATS data. Dr. Roth added, “Using the NHATS database, Talan examined the distributions of the continuity measures and determined that these distributions were not suitable for conventional regression analyses, so she led the effort to conduct alternative quantile regression analyses instead.  The reviewers for the Journal of the American Geriatrics Society were very impressed with this innovative approach and quickly accepted the paper for publication.”


Monique & Talan: Up Close & Personal

I had an opportunity to interview Monique and Talan to get to know them a little better as people, and to ask them about their reaction to receiving their award.  Here’s what they had to say:

Tony: How long have you been with COAH?
Monique: I’ve been with COAH since December 2018–so 3 ½ years.
Talan: I started it in Sep, 2019, so less than 2 years.

Tony: What do you love about your job?
Monique: My colleagues.  I can probably tell you a fun fact about everyone!
Talan: I can utilize my skills and knowledge.

Tony: What motivates you to work in the area of aging and health?
Monique: Knowing that in some small way, I’m helping people to care for family members or themselves as they age.  Being one of the caregivers to my mom, working in aging has open my eyes as to how I can help her in this phase of her journey.
Talan: I have been a data person in health care area for over 10 years. I love doing research, finding patterns behind the data, and implement the findings in the real world to benefit patients.

Tony: How does receiving an MFL award from the division make you feel?
Monique: It was a pleasant surprise.  I felt good to know that others appreciate what I do.
Talan: I feel honored, very happy.

Tony: When you are not at work, what are a few of your hobbies or favorite ways to spend your down-time?
Monique: Reading, spending time with my family/friends and helping women with their skincare needs.
Talan: Sitting meditation, reading book and listening to music.

Tony: What is at the top of your bucket list?
Monique: Shopping in Italy!
Talan: Haven’t thought about my bucket list yet!

Tony: Anything else you’d like to say?
Monique: Thank you to all who voted for me to be this year’s recipient of the MFL Performance Excellence award.
Talan: I’m very grateful for the nice colleagues’ help and support.


You may learn more about the awards and see more images from the event in a related Medicine Matters blog.

Mason F. Lord, MD

Interested in learning more about Dr. Mason F. Lord?  See these articles from the Baltimore Sun:


By Anthony L. Teano, MLA
Communications Specialist

COAH All-Stars Join #BrainMatters’ “Dementia Caregiving & Caregivers” Webinar on 7/21 at Noon

COAH Core Faculty Dr. Halima Amjad and Associate Faculty Dr. Quincy Samus will join other leading experts for a #BrainMatters webinar on “Dementia Caregiving & Caregivers” to be held on Thursday, July 21 at noon ET, for which you may register here: tinyurl.com/JulyCaregiving. #BrainMatters is a collaboration among the Johns Hopkins Alzheimer’s Disease Research Center and JH-RCMAR with nonprofits such as the Greater MD Chapter of the Alzheimer’s Association and the AARP’s Global Council on Brain Health, as well as two community-based chapters of the Delta Sigma Theta Sorority, Inc. The #BrainMatters team is committed to sharing science-based information about brain health, health disparities, memory loss, and Alzheimer’s disease and related dementias.

 In For this special 1 hour webinar for dementia caregivers, Drs. Amjad and Samus from our center will join Johns Hopkins colleague Dr. Chanee Fabius with the Johns Hopkins Resource Center for Minority Aging Research (JH-RCMAR), as well as Rita B. Choula, MA from the AARP Public Policy Institute and Ilene Rosenthal from the Greater Maryland Chapter of the Alzheimer’s Association. The webinar will be moderated by Jo Ann Scipio, MSN, RN from the Annapolis Alumnae Chapter of Delta Sigma Theta Sorority, Inc.  These expert panelists will share information about dementia caregiving, as well as useful tips and helpful resources, and they will provide a set of key take-aways for caregivers. Audience members will have the opportunity to engage with these leading experts for Q&A.

 From my point of view as a Communications Specialist with the Johns Hopkins Alzheimer’s Disease Research Center’s “Memory & Aging” initiative, I am very enthusiastic about having a webinar for caregivers. “Dementia Caregiving & Caregivers” will be #BrainMatters’ first webinar, and we are looking forward to engaging with caregivers directly about their top priorities and responding to their most pressing concerns via a virtual Zoom event. This conversation will put the art of caring for the caregiver at the heart of the conversation so they can better serve their loved-ones. As a former caregiver to my Mom, who had an early-onset Frontotemporal Dementia, I am especially excited about this webinar because it will give caregivers great advice and helpful resources to empower caregivers to take better care of their loved-ones—as well as themselves.  And the Q&A feature in real time will allow experts to respond to some caregiver concerns with timely, sage advice.  I believe every caregiver needs support on their journey, and this webinar is an opportunity to take a few steps together and share tips for a smoother path ahead.

For #BrainMatters, the webinar is an innovative idea to reach people where they are; up until now, #BrainMatters has focused on Twitter Chats to discuss topics such as brain health, overcoming disparities, and providing information about the latest research in the field.  People can search the hashtag #BrainMatters on those topics to see the resources covered in those prior chats.  Also, I encourage anyone interested in brain health, memory research, and caregiver concerns to follow our social media accounts on Twitter and Facebook.

 For more information, email me at: tony.teano@jhu.edu


By Anthony L. Teano, MLA
Communications Specialist