Advertisement
In-Depth Review: The Future of Health and Aging Review Article| Volume 163, ISSUE 5, P446-455, May 2014

Infrastructure and resources for an aging population: embracing complexity in translational research

  • Kevin P. High
    Correspondence
    Reprint requests: Kevin P. High, Professor of Medicine/Infectious Diseases, Wake Forest School of Medicine, 100 Medical Center Boulevard, Winston-Salem, NC 27157-1042.
    Affiliations
    Wake Forest School of Medicine, Winston-Salem, NC
    Search for articles by this author
Published:October 04, 2013DOI:https://doi.org/10.1016/j.trsl.2013.09.001
      The population of the United States and most industrialized nations is undergoing rapid expansion of persons aged 65 years and older. This group experiences more illness, disability, and dependency than young adults and consumes the majority of heath care resources. This demographic change presents a number of challenges to current research infrastructure aimed at translating discoveries to improved human health. Key issues include the need to expand the workforce trained in aging research, development of specific resources and harmonization of measures and outcomes, and a culture change within the scientific community. In particular, complexity must be represented within research design and embraced as an important aspect of review panel critiques.

      Abbreviations:

      AGS (American Geriatrics Society), CTSA (Clinical and Translational Science Award), DWJS (Dennis W. Jahnigen Scholars), EMR (Electronic medical record), GEMSSTAR (Grants for Early Medical and Surgical Specialists in Aging Research), NHP (nonhuman primate), NIA (National Institute on Aging), NIH (National Institutes of Health), OAIC (Older Americans Independence Center), PROMIS (Patient-Reported Outcomes Measurement Information System), RCDC (Research Career Development Cores), SPPB (Short Physical Performance Battery), TFWS (T. Franklin Williams Scholars), VA (Veterans Affairs)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Translational Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. http://www.aoa.gov/Aging_Statistics/future_growth/future_growth.aspx.

      2. http://www.un.org/esa/population/publications/worldageing19502050/pdf/90chapteriv.pdf.

        • Federal Interagency Forum on Aging-Related Statistics
        Older Americans.
        U.S. Government Printing Office, Washington, DC2012
        • Federal Interagency Forum on Aging-Related Statistics
        Key indicators of well-being.
        U.S. Government Printing Office, Washington, DC2012
        • Kirkland J.L.
        Translating advances from the basic biology of aging into clinical application.
        Exp Gerontol. 2013; 48: 1-5
        • Institute of Medicine
        Retooling for an aging America: building the health care workforce.
        National Academic Press, Washington, DC2008
        • Leipzig R.M.
        • Granville L.
        • Simpson D.
        • Anderson M.B.
        • Sauvigne K.
        • Soriano R.P.
        Keeping granny safe on July 1: a consensus on minimum geriatrics competencies for graduating medical students.
        Acad Med. 2009; 84: 604-610
        • Williams B.C.
        • Warshaw G.
        • Fabiny A.R.
        • et al.
        Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.
        J Grad Med Educ. 2010; 2: 373-383
        • Leipzig R.M.
        • Hall W.J.
        • Fried L.P.
        Treating our societal scotoma: the case for investing in geriatrics, our nation's future, and our patients.
        Ann Intern Med. 2012; 156: 657-659
        • Bragg E.J.
        • Warshaw G.A.
        • van der Willik O.
        • et al.
        Paul B. Beeson Career Development Awards in Aging Research and U.S. medical schools aging and geriatric medicine programs.
        J Am Geriatr Soc. 2011; 59: 1730-1738
        • Washington D.
        A preliminary analysis of the effectiveness of the Paul B. Career Development Awards in Aging Initiative, 2004–2006.
        National Institute of Aging, Bethesda, MD2007
      3. http://www.im.org/AcademicAffairs/Aging/TFWS/Pages/default.aspx.

      4. http://specialists.americangeriatrics.org/jahnigen/apply/default.php.

        • High K.P.
        • Clayton C.P.
        • Woolard N.
        • Regenstreif D.I.
        • Lundebjerg N.
        • Hazzard W.R.
        Expanding geriatrics into subspecialty internal medicine healthcare, research and education: caring for older adults and the T. Franklin Williams Career Development Awards.
        Am J Med. 2002; 113: 533-536
        • Katz P.R.
        • Burton J.R.
        • Drach G.W.
        • et al.
        The Jahnigen scholars program: a model for faculty career development.
        J Am Geriatr Soc. 2009; 57: 2324-2327
        • Sonu I.S.
        • High K.P.
        • Clayton C.P.
        • Woolard N.F.
        • Hazzard W.R.
        An evaluation of geriatrics activities within internal medicine subspecialties.
        Am J Med. 2006; 119: 995-1000
        • Ingraham A.M.
        • Richards K.E.
        • Hall B.L.
        • Ko C.Y.
        Quality improvement in surgery: the American College of Surgeons National Surgical Quality Improvement Program approach.
        Adv Surg. 2010; 44: 251-267
        • McGory M.L.
        • Kao K.K.
        • Shekelle P.G.
        • et al.
        Developing quality indicators for elderly surgical patients.
        Ann Surg. 2009; 250: 338-347
        • Abadir P.M.
        • Foster D.B.
        • Crow M.
        • et al.
        Identification and characterization of a functional mitochondrial angiotensin system.
        Proc Natl Acad Sci U S A. 2011; 108: 14849-14854
        • Fragoso C.A.
        • Concato J.
        • McAvay G.
        • Yaggi H.K.
        • Van Ness P.H.
        • Gill T.M.
        Staging the severity of chronic obstructive pulmonary disease in older persons based on spirometric Z-scores.
        J Am Geriatr Soc. 2011; 59: 1847-1854
        • McAdams-DeMarco M.A.
        • Law A.
        • Salter M.L.
        • et al.
        Frailty as a novel predictor of mortality and hospitalization in individuals of all ages undergoing hemodialysis.
        J Am Geriatr Soc. 2013; 61: 896-901
        • Rosas S.E.
        • Reese P.P.
        • Huan Y.
        • Doria C.
        • Cochetti P.T.
        • Doyle A.
        Pretransplant physical activity predicts all-cause mortality in kidney transplant recipients.
        Am J Nephrol. 2012; 35: 17-23
        • Abecassis M.
        • Bridges N.D.
        • Clancy C.J.
        • et al.
        Solid-organ transplantation in older adults: current status and future research.
        Am J Transplant. 2012; 12: 2608-2622
      5. http://www.nia.nih.gov/research/dab/aged-rodentcolonies-handbook/available-strains.

      6. http://ipad.primate.wisc.edu.

        • Mattison J.A.
        • Roth G.S.
        • Beasley T.M.
        • et al.
        Impact of caloric restriction on health and survival in rhesus monkeys from the NIA study.
        Nature. 2012; 489: 318-321
        • Heuer E.
        • Rosen R.F.
        • Cintron A.
        • Walker L.C.
        Nonhuman primate models of Alzheimer-like cerebral proteopathy.
        Curr Pharm Des. 2012; 18: 1159-1169
        • Messaoudi I.
        • Ingram D.K.
        Overview of aging research using nonhuman primate models.
        Age (Dordr ). 2012; 34: 1047-1049
        • Shively C.A.
        • Willard S.L.
        • Register T.C.
        • et al.
        Aging and physical mobility in group-housed Old World monkeys.
        Age (Dordr ). 2012; 34: 1123-1131
        • Plate J.F.
        • Bates C.M.
        • Mannava S.
        • et al.
        Age-related degenerative functional, radiographic, and histological changes of the shoulder in nonhuman primates.
        J Shoulder Elbow Surg. 2013; 22: 1019-1029
      7. http://www.nia.nih.gov/research/scientific-resources.

      8. http://nihlibrary.ors.nih.gov/nia/ps/niadb.asp, http://www.nia.nih.gov/research/dbsr/publicly-available-datasets, http://www.icpsr.umich.edu/icpsrweb/NACDA/.

      9. http://www.nia.nih.gov/alzheimers/alzheimersdisease-research-centers.

      10. http://www.peppercenters.org.

      11. http://www.nia.nih.gov/research/dab/nathan-shock-centersexcellence.

      12. http://www.nia.nih.gov/research/dbsr/edward-r-roybal-centers-translation-research-behavioraland-social-sciences-aging.

      13. http://www.nia.nih.gov/research/dbsr/centers-demography-and-economics-aging.

      14. http://www.nia.nih.gov/research/dbsr/resource-centersminority-aging-research-rcmar.

      15. http://www.jhartfound.org/grants-strategy/centers-of-excellence-in-geriatricmedicine-and-training-national-program-o.

      16. http://www.afar.org/research/centers/.

      17. http://www.pcori.org/funding-opportunities/funding-announcements/clinical-data-research-networkscdrn-improving-infrastructure-for-conducting-patientcentered-outcomes-research-pcor/.

      18. http://www.pcori.org/fundingopportunities/funding-announcements/patient-powered-research-networks-pprn-improving-infrastructurefor-conducting-patient-centered-outcomes-researchpcor/.

      19. http://www.nihpromis.org/.

        • Anderson S.
        • Eldadah B.
        • Halter J.B.
        • et al.
        Acute kidney injury in older adults.
        J Am Soc Nephrol. 2011; 22: 28-38
        • Castriotta R.J.
        • Eldadah B.A.
        • Foster W.M.
        • et al.
        Workshop on idiopathic pulmonary fibrosis in older adults.
        Chest. 2010; 138: 693-703
        • High K.P.
        • D'Aquila R.T.
        • Fuldner R.A.
        • et al.
        Workshop on immunizations in older adults: identifying future research agendas.
        J Am Geriatr Soc. 2010; 58: 765-776
        • Anderson S.
        • Halter J.B.
        • Hazzard W.R.
        • et al.
        Prediction, progression, and outcomes of chronic kidney disease in older adults.
        J Am Soc Nephrol. 2009; 20: 1199-1209
        • Effros R.B.
        • Fletcher C.V.
        • Gebo K.
        • et al.
        Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions.
        Clin Infect Dis. 2008; 47: 542-553
        • Boyd C.M.
        • Ritchie C.S.
        • Tipton E.F.
        • Studenski S.A.
        • Wieland D.
        From bedside to bench: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Comorbidity and Multiple Morbidity in Older Adults.
        Aging Clin Exp Res. 2008; 20: 181-188
      20. Universal health outcome measures for older persons with multiple chronic conditions.
        J Am Geriatr Soc. 2012; 60: 2333-2341
      21. https://www.ctsacentral.org/ic.

      22. https://www.thelifestudy.org/public/index.cfm.

      23. http://sigs.nih.gov/geroscience/Pages/default.aspx.