Bonnie K. Swenor, PhD, MPH is the Director of the Johns Hopkins Disability Health Research Center and Associate Professor of Opthalmology at the Wilmer Eye Institute. She will present “Included: Advancing Health Equity for People with Disabilities” at the November 1 Scientific Seminar Series.
Dr. David L. Roth, Professor of Medicine in the Division of Geriatric Medicine and Gerontology and Director of the Johns Hopkins Center on Aging and Health (COAH), will receive the M. Powell Lawton Award at the Gerontological Society of America (GSA) Meeting in November 2021. According to Google Scholar, Dr. Roth’s research has been cited over 22,000 times and he has the most citations of any scholar in the field of Applied Gerontology. He has led a strong program of research on family caregiving and well-known for his 2015 paper, “Informal caregiving and its impact on health: A reappraisal from population-based studies.” These and other papers have gained increasing attention, including: an interview with Dr. Roth in The New York Times.
When asked about what this award means to him, Dr. Roth expressed gratitude for the GSA’s leadership in having such awards as a way to draw public attention to key global aging matters. “I think, with the population around the world getting older, understanding the special needs of older adults as well as their accumulated wisdom is very important. The GSA is leading the way in supporting and rewarding successful researchers who are investigating key questions in aging research. I’m grateful to GSA for having awards like the Lawton Award to promote research and scientific discoveries around the globe,” Dr. Roth said.
“Like all awards, this is really a reflection of the larger teams I have been so fortunate to be on over the years. I am grateful to have had so many outstanding colleagues and truly honored to be selected for this award,” Dr. Roth stated upon hearing that he had won the award. Known for his collaborative nature and statistical expertise, Dr. Roth has developed a reputation for bringing excellence in methodology, elegance in statistics, and vision in creative and innovative ideas to his many collaborations. Notably, Dr. Roth has collaborated on many papers over time with Dr. William Haley at the University of Southern Florida, Dr. Virginia Howard at the University of Alabama at Birmingham, and Dr. Mary Mittelman at New York University. Additionally, he has joined numerous research teams with many colleagues at Johns Hopkins University.
As an investigator, Dr. Roth has contributed at least one meaningful, original, peer-reviewed, data-based research publication across a diverse range of topics every year for the past 37 consecutive years. Here is a sampling of some of the influential and highly cited papers by him and his colleagues:
- Assessing mobility in older adults: the UAB Study of Aging Life-Space Assessment
- Trajectories of life-space mobility after hospitalization
- Improving caregiver well-being delays nursing home placement of patients with Alzheimer disease
- Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with Alzheimer’s disease
- “Changes in social support as mediators of the impact of a psychosocial intervention for spouse caregivers in persons with Alzheimer’s Disease”
- “Family caregiving and all-cause mortality: Findings from a population-based propensity-matched analysis”
- “Is family caregiving associated with inflammation or compromised immunity? A meta-analysis”
- “The transition to family caregiving and its effect on biomarkers of inflammation”
As COAH’s director since 2012, and as a senior faculty member in the Division of Geriatric Medicine and Gerontology, Dr. Roth supports a diverse group of scholars engaged in aging-related research and public service. This includes mentoring and supporting numerous postdoctoral fellows and junior faculty members. Dr. Roth is proud that COAH can provide a comprehensive resource for specialized research, training, and community engagement. “COAH is a voice in the community and our work is having an impact on the world,” he said. Personally, he has provided expertise to the local community through his membership on the Baltimore, and Maryland State, Commissions on Aging. Also, Dr. Roth has served on the Editorial Boards of top journals in gerontology, including Psychology and Aging, Journal of Gerontology: Psychological Sciences, and Journal of Aging and Health.
In an announcement to the Division of Geriatric Medicine and Gerontology, Director Dr. Cynthia Boyd noted that “Dr. Roth bridges methodological rigor with expertise in content and theory in highly interdisciplinary applied interventional research. 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.”
The COAH family salute Dr. Roth upon this remarkable achievement. Congratulations!
The M. Powell Lawton Award, sponsored by Abramson Senior Care’s Polisher Research Institute, recognizes outstanding contributions from applied gerontological research that have benefited older people and their care. The award was established to honor the memory of the late M. Powell Lawton, PhD, director emeritus of the Polisher Research Institute and a leading figure in aging research. Recipients exemplify Dr. Lawton’s personal and professional qualities, and their contributions in gerontology have led to innovations in gerontological treatment, practice or service, prevention, or amelioration of symptoms or barriers. Individuals who have influenced public policy changes or demonstrated leadership in defining and implementing a creative program that led to improvement in the lives of older persons are also eligible.
Associate Professor of Epidemiology, Jennifer A. Schrack, PhD, MS, with the Johns Hopkins Bloomberg School of Public Health, recently ascended to a Co-PI leadership role with the National Health and Aging Trends Study (NHATS), which systematically gathers information over time from a nationally representative sample of Medicare beneficiaries ages 65 and older.
Regarding this significant research role, Dr. Schrack said, “I look forward to continuing what has been done so well by NHATS for the past decade, and to looking for ways to expand and advance our understanding of disability in late life.” Annual NHATS interviews with participants are critically important to collect insightful information about the physical, social, and economic well-being of older and differently abled adults, such as: the physical, social, technological and service environment; tests and self-reports of physical and cognitive capacity; use of assistive devices and rehabilitation services; help received with daily activities (self-care, household, and medical); and participation in valued activities. Additionally, participants’ family members may be interviewed about the quality of end of life care that was received by NHATS participants who have died. Dr. Schrack is well-qualified for NHATS leadership. Her primary research focuses on the role of physiological factors in maintaining mobility and preventing disability with aging. She directs the Epidemiology of Aging Track and co-leads the Accelerometry Research Core at the Johns Hopkins Center on Aging and Health. With a Masters in Exercise Physiology from the University of Michigan and a PhD in Epidemiology from the Johns Hopkins Bloomberg School of Public Health, Dr. Schrack has extensive clinical research as an exercise physiologist, with an emphasis on the assessment physical function, energy expenditure, and physical activity using accelerometers.
In addition to previously being an investigator with NHATS, Dr. Schrack is the PI of a U01 from the NIA to delineate associations among energy regulation, physical activity, and Alzheimer’s disease, and the Co-PI of a R01 from the NIA to investigate sensory and motor contributions to the development of preclinical Alzheimer’s disease. In addition, she is a co-investigator of the Baltimore Longitudinal Study of Aging (BLSA), the Study of Physical Resiliency iN Geriatrics (SPRING), the Study to Understand vitamin D and falls in You (STURDY), the Aging, Cognition, and Hearing Evaluation in Elders (ACHIEVE) Randomized Trial, and the Atherosclerosis Risk in Communities (ARIC) study. Dr. David Roth, the Director of the Center on Aging and Health at Johns Hopkins, lauded the selection of Dr. Schrack for her new leadership role in NHATS. Dr. Roth noted that “Dr. Schrack is an extremely talented, committed, and influential scholar who also has outstanding organizational and supervisory skills. She will do a great job in leading NHATS in collaboration with the other exceptional researchers working on that very important project.”
The Johns Hopkins University Bloomberg School of Public Health and the University of Michigan’s Institute for Social Research lead NHATS with support from the National Institute on Aging, with data collection via Westat. Dr. Vicki Freedman from the Institute for Social Research at the University of Michigan is NHAT’s senior co-PI; Dr. Schrack steps into this role following the death of her friend and Bloomberg School of Public Health colleague, Dr. Judith Kasper, the former NHATS Co-PI from Johns Hopkins, who deceased on August 5, 2021 from a heart attack at her home in Bolton Hill, Baltimore; you may read Dr. Kasper’s obituary here.
Stroke is a major cause of morbidity and mortality in the US, and a prior stroke is one of the biggest risk factors for future stroke events. Stroke survivors face a 13% increased risk of a subsequent stroke in the first year after stroke, and over 40% experience a second stoke within 10 years. Prior stroke history is also a major risk factor for other cardiovascular events and mortality. Preventing a second stroke is critically important among initial stroke survivors, and the use of secondary prevention medications can reduce the risk of additional stroke event by more than 80%.
“After a stroke, compliance with prescribed medications dramatically reduce the chance of another cardiovascular event. Having an engaged caregiver improves medication adherence for stroke survivors. We need to do more to understand why Black stroke survivors stop antithrombotic medications more frequently than White stroke survivors and address potential racial disparities in recurrence rates,” said lead researcher Orla C. Sheehan, MD, PhD at the Johns Hopkins Center on Aging and Health (COAH) and team examined health care disparities between Black and White stroke survivors based on data from the Caring for Adults Recovering from the Effects of Stroke (CARES) study, an ancillary study of the national REasons for Geographic and Racial Differences in Stroke (REGARDS). The national REGARDS study was designed to identify the causes of regional and racial disparities in stroke mortality, and CARES data enabled the team to analyze information among 172 stroke survivors paired with 160 caregivers. Johns Hopkins researchers Chelsea Liu, Dr. Jin Huang, and COAH Director Dr. David L. Roth were also on this team.
They found that 10 months after hospital discharge, Black stroke survivors were more than twice as likely as White stroke survivors to have discontinued antithrombotic medications, known to help prevent another ischemic event, despite having similar prescription rates at the time of hospital discharge. Antithrombotic usage decreased by 18% for Blacks compared to only 8% for Whites. These findings suggest that Blacks may be at an increased risk of experiencing a second stroke compared to Whites. Delving deeper into the data, they also observed that Black stroke survivors were less likely than White stroke survivors to live with a family caregiver. Interestingly, researchers found that antihypertensive persistence was high regardless of race; the research team credit that fact to effective public health campaigns, such as the National High Blood Pressure Education Program.
“In our cohort, persistence to secondary preventive medication regimens was high likely due to the presence of an engaged caregiver. Routine involvement of caregivers in medication management at the time of hospital discharge and during follow up has the potential to increase adherence to secondary prevention regimens. Use of both antithrombotic and lipid lowering medications fell over time in our population, likely increasing the subsequent stroke risk in those participants—particularly Black stroke survivors who were significantly more likely to discontinue antithrombotic medications The effect of changes in patterns of medication usage on health outcomes particularly in Blacks deserves continued investigation,” added Sheehan.
Sheehan and her team underscore that vigilant caregiver help with medication management is critically important to increase adherence to secondary stroke prevention medications, thereby decreasing the odds of their loved-one having another stroke event. Also, the research team suggests that public health campaigns focused on groups of medications—not just blood pressure medications—may help educate stroke survivors about how important they are to preventing secondary vascular conditions. Moreover, the team believes that the effect of changes in patterns of medication usage on health outcomes, especially in Blacks, warrants further research.
Drs. Sheehan and Roth are available for interview.