Aging & Geriatrics

  • “My work helps expand knowledge about the risks and benefits of medications, especially for older adults and other vulnerable populations.”

    “My work helps expand knowledge about the risks and benefits of medications, especially for older adults and other vulnerable populations.”

  • “We are working hard to identify factors that promote heart and brain health as people age.”

    “We are working hard to identify factors that promote heart and brain health as people age.”

  • “I’ve been able to contribute to KPWHRI’s strong tradition of aging research through my collaborations with the Adult Changes in Thought (ACT) Study, which is expanding our understanding of cognition, brain aging, and other factors relevant to the health of older adults.”

    “I’ve been able to contribute to KPWHRI’s strong tradition of aging research through my collaborations with the Adult Changes in Thought (ACT) Study, which is expanding our understanding of cognition, brain aging, and other factors relevant to the health of older adults.”

Research overview

As the world’s population is aging, scientists at Kaiser Permanente Washington Health Research Institute (KPWHRI) are at the forefront of research to help older adults lead healthier lives.

Among the questions KPWHRI scientists have examined include whether getting regular exercise may reduce the risk of dementia, whether widely used medications increase the risk of falls and fractures, how long-term use of opioid pain medications affects the brain, and what approaches can help frail older adults become more physically active. Our research includes studies looking at brain health, physical activity and behavior changemedication safetycardiovascular health, and chronic disease management, among other research areas. Now, new funding for aging research — especially research on Alzheimer’s and related dementias — offers even greater opportunities for KPWHRI scientists and their colleagues who work in health care systems.

Studies spanning decades

The institute has hosted several long-running cohort studies, including the Adult Changes in Thought (ACT) Study, a collaboration with the University of Washington. For more than 30 years, ACT researchers have studied risk factors for dementia, with the goal of finding new ways to delay or prevent Alzheimer’s disease and cognitive decline.  

In May 2021, the National Institute of Aging awarded ACT a new grant totaling $55.6 million. With this additional funding, ACT will further examine how various health factors across our life span can impact later-life heart and brain health.  The funding will allow ACT to examine the health impacts of sleep, physical activity, socio-economic factors, and prescription medications, as well as to examine brain imaging. In addition, ACT will continue to collect and study participants’ brains after their deaths to better understand how brain physiology is impacted by lifestyle factors.

Under the 5-year grant, ACT partners are expanding the existing cohort of 2,000 Kaiser Permanente Washington members to 3,000 and implementing new strategies to recruit a more diverse population. Additionally, as part of the grant, the ACT team is making its data more accessible to researchers nationwide. You can find out more about the ACT Study and collaborate with the team at www.actagingresearch.org

Wide-ranging research

Scientists at KPWHRI are advancing age-related research in many other areas as well. Some highlights:

  • The institute’s research on medication safety is contributing to better understanding of how certain medications affect older adults’ well-being and how to avoid unsafe and unnecessary medications. Among other initiatives, KPWHRI researchers are developing a compendium of tools and resources to improve the management of opioids in older adults. Michael Parchman, MD, MPH, is also leading a pilot clinical trial to study the impact of training clinicians to become value champions to reduce inappropriate prescribing for people with dementia.

    Additionally, Ben Balderson, PhD, is working with scientists at the University of Washington on 2 grants to test an approach to help older adults reduce or stop risky medications. The researchers are reaching out to primary care doctors and patients with information and education about medications such as opioids, benzodiazepines, and muscle relaxants that may increase the risk of falls, dementia, or other challenges. These studies are set within 18 primary care clinics at Kaiser Permanente Washington.
     
  • In a pilot trial of 172 older adults with risk factors for dementia, researchers at KPWHRI and the University of California, San Francisco (UCSF) are examining whether health coaching to improve physical activity, sleep, and other modifiable risk factors for dementia is an effective way to prevent cognitive decline as people age.  
     
  • Dori Rosenberg, PhD, MPH, and colleagues are leading a randomized controlled trial examining whether reducing the amount of time older adults spend sitting can improve their health.  In her pilot studies, she showed that helping older adults to sit less (by encouraging more standing and moving) fit into their daily lives more easily than focusing only on promoting structured bouts of exercise. 
     
  • Sascha Dublin, MD, MPH, is leading work to promote earlier recognition and diagnosis of dementia.  Together with researchers at UCSF, she and her team developed the eRADAR risk score, which uses routine data from electronic health records to identify people at higher risk of having undiagnosed dementia.  Now, with funding from the National Institute on Aging, they are conducting a randomized clinical trial to test the impact of applying this model and reaching out to high-risk patients in 8 primary care clinics at Kaiser Permanente Washington and UCSF.
     
  • Robert Penfold, PhD, is leading a pragmatic randomized trial to develop and test STAR-VTF, a training program to support caregivers of people with dementia and reduce the use of antipsychotic medications among these patients. The program was originally created by colleagues at the University of Washington and has now been adapted to provide online training and virtual visits.
     
  • Marlaine Figueroa Gray, PhD, is collaborating with scientists at the University of Toronto and on the ACT Study to examine the lived experiences of older adults with cognitive subtypes of dementia and the perspectives of those who care for them. She has also partnered on projects to determine health outcomes of kinless elders living with dementia, to examine the experience of people living with advanced dementia who receive specialty palliative care, and to understand the perspectives of patients, families, and providers on a screening tool that would provide information on the risk of living with undiagnosed dementia.
     
  • The cancer screening work by Karen Wernli, PhD, and Ellen O’Meara, PhD, has underscored the need for more research into when the benefits of screenings for breast and lung cancers are worth the risks for older adults, particularly people with other serious illnesses.
     
  • The Chronic Care Model — developed at KPWHRI’s Center for Accelerating Care Transformation (formerly known as the MacColl Center for Health Care Innovation) — is widely recognized as the leading care-design model for everyone, including older people, with chronic disease.
     
  • In addition to the institute’s work promoting healthier aging, KPWHRI scientists — through the ACT Study, its predecessors, and other research — have contributed to the growing movement to support and improve caregiving, especially for people living with dementia. Our investigators are also seeking ways to help older adults receive late-life care that best reflects their values and preferences.

Recent publications on Aging & Geriatrics

Smith BM, Wiemken A, Hoffman EA, Keenan BT, Allen NB, Bertoni AG, Jacobs DR Jr, Michos ED, Watson KE, Redline S, Schwab RJ, Barr RG, Heckbert SR. Upper and lower airway dysanapsis and airflow obstruction among older adults. Am J Respir Crit Care Med. 2022 Jun 9. doi: 10.1164/rccm.202202-0353LE. Online ahead of print. PubMed

Miller-Rosales C, McCloskey J, Uratsu CS, Ralston JD, Bayliss EA, Grant RW. Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients. Med Care. 2022 Aug 1;60(8):563-569. doi: 10.1097/MLR.0000000000001735. Epub 2022 May 30. PubMed

Bagi Z, Kroenke CD, Fopiano KA, Tian Y, Filosa JA, Sherman LS, Larson EB, Keene CD, Degener O'Brien K, Adeniyi PA, Back SA. Association of cerebral microvascular dysfunction and white matter injury in Alzheimer's disease. Geroscience. 2022 May 25. doi: 10.1007/s11357-022-00585-5. [Epub ahead of print]. PubMed

Eissman JM, Dumitrescu L, Mahoney ER, Smith AN, Mukherjee S, Lee ML, Scollard P, Choi SE, Bush WS, Engelman CD, Lu Q, Fardo DW, Trittschuh EH, Mez J, Kaczorowski CC, Hernandez Saucedo H, Widaman KF, Buckley RF, Properzi MJ, Mormino EC, Yang HS, Harrison TM, Hedden T, Nho K, Andrews SJ, Tommet D, Hadad N, Sanders RE, Ruderfer DM, Gifford KA, Zhong X, Raghavan NS, Vardarajan BN; Alzheimer’s Disease Neuroimaging Initiative (ADNI); Alzheimer’s Disease Genetics Consortium (ADGC); A4 Study Team, Pericak-Vance MA, Farrer LA, Wang LS, Cruchaga C, Schellenberg GD, Cox NJ, Haines JL, Keene CD, Saykin AJ, Larson EB, Sperling RA, Mayeux R, Cuccaro ML, Bennett DA, Schneider JA, Crane PK, Jefferson AL, Hohman TJ. Sex differences in the genetic architecture of cognitive resilience to Alzheimer's disease. Brain. 2022 May 13:awac177. doi: 10.1093/brain/awac177. Online ahead of print. PubMed

Marcum ZA, Cohen JB, Larson EB, Williamson J, Bress AP. Can preferentially prescribing angiotensin II receptor blockers (ARBs) over angiotensinconverting enzyme inhibitors (ACEIs) decrease dementia risk and improve brain health equity? NAM Perspect. 2022; 2022: 10.31478/202205c. Published online 2022 May 9. doi: 10.31478/202205c. PubMed

Researchers in Aging & Geriatrics

Sascha Dublin, MD, PhD

Senior Investigator
206-287-2870
Sascha.Dublin@kp.org

Curriculum vitae (CV)

Dori E. Rosenberg, PhD, MPH

Associate Investigator
206-287-2532
Dori.E.Rosenberg@kp.org

Curriculum vitae (CV)

Erin J. Bowles, MPH

Manager, Collaborative Science
206-287-2708
Erin.A.Bowles@kp.org

Curriculum vitae (CV)

Ellen O'Meara, PhD

Principal Collaborative Scientist
206-287-2938
Ellen.S.O'Meara@kp.org

Curriculum vitae (CV)

Melissa L. Anderson, MS

Principal Collaborative Biostatistician
206-287-2647
Melissa.L.Anderson@kp.org

Curriculum vitae (CV)

Rod L. Walker, MS

Senior Collaborative Biostatistician
206-287-2895
Rod.L.Walker@kp.org

Curriculum vitae (CV)

Laura Harrington, PhD, MPH

Assistant Investigator
206-287-2066
Laura.B.Harrington@kp.org

Curriculum vitae (CV)

Michael L. Parchman, MD, MPH

Senior Investigator, ACT Center
206-287-2704
Michael.X.Parchman@kp.org

Curriculum vitae (CV)

Katie Coleman, MSPH

Director, Collaborative Science; Director, ACT Center
206-287-2872
Katie.F.Coleman@kp.org

Curriculum vitae (CV)

Robert Penfold, PhD

Senior Investigator
206-287-2232
Robert.B.Penfold@kp.org

Curriculum vitae (CV)

Marlaine Gray, PhD

Assistant Investigator
206-287-2620
Marlaine.S.Figueroagray@kp.org

Curriculum vitae (CV)

Ben Balderson, PhD

Senior Collaborative Scientist
206-287-2803
Benjamin.H.Balderson@kp.org

Curriculum vitae (CV)

Jennifer C. Nelson, PhD

Director, Biostatistics; Senior Investigator
206-287-2004
Jen.Nelson@kp.org

Curriculum vitae (CV)

Onchee Yu, MS

Principal Collaborative Biostatistician
206-287-2389
Onchee.Yu@kp.org

Curriculum vitae (CV)

Jessica Chubak, PhD

Senior Investigator
206-287-2556
Jessica.Chubak@kp.org

Curriculum vitae (CV)

Nora Henrikson, PhD, MPH

Associate Investigator
206-287-4675
Nora.B.Henrikson@kp.org

Curriculum vitae (CV)

Yu-Ru Su, PhD

Assistant Biostatistics Investigator
206-287-2948
yuru.su@kp.org

Curriculum vitae (CV)

Chloe Krakauer, PhD

Collaborative Biostatistician II
chloe.a.krakauer@kp.org

Curriculum vitae (CV)

Karen Wernli, PhD

Senior Scientific Investigator
206-287-2934
Karen.J.Wernli@kp.org

Curriculum vitae (CV)

Mikael Anne Greenwood-Hickman, MPH

Collaborative Scientist
(206) 287-2908
Mikael.Anne.Greenwood-Hickman@kp.org

Brian D. Williamson, PhD

Assistant Biostatistics Investigator
206-287-2024
Brian.D.Williamson@kp.org

Curriculum vitae (CV)

Pamela A. Shaw, PhD, MS

Senior Biostatistics Investigator
Pamela.A.Shaw@kp.org

Curriculum vitae (CV)

Nicole M. Gatto, PhD, MPH

Principal Collaborative Scientist
Nicole.M.Gatto@kp.org

Curriculum vitae (CV)

 

Affiliate researchers

James Bowen, MD
Neurologist
Swedish Medical Center

Paul Crane, MD, MPH
Professor, Internal Medicine
University of Washington

David R. Crosslin, PhD
Assistant Professor
Biomedical Informatics and Medical Education
Adjunct Faculty
Genome Sciences, Division of Medical Genetics
University of Washington

Kristen Dams-O'Connor, PhD
Associate Professor
Department of Rehabilitation Medicine
Icahn School of Medicine at Mt. Sinai

James Floyd, MD, MS
Assistant Professor, Department of Medicine

Shelly Gray, PharmD, MS, AGSF
Professor, Department of Pharmacy
University of Washington

Gail Jarvik, MD, PhD
Professor, Medical Genetics, Genome Sciences, Department of Medicine
University of Washington

Dirk Keene, MD, PhD
Department of Pathology
Harborview Medical Center

Zachary A. Marcum, PhD, PharmD
Assistant Professor, School of Pharmacy
University of Washington

Wayne McCormick, MD, MPH
Head of Gerontology and Geriatric Medicine
UW Medicine

Sue McCurry, PhD
Research Professor, Psychosocial and Community Health
University of Washington

Elizabeth Phelan, MD, MS
Associate Professor, Medicine/Gerontology and Geriatric Medicine
Harborview Medical Center
Adjunct Associate Professor, Health Services
University of Washington

Janelle S. Taylor, PhD
Professor, Department of Anthropology
University of Toronto

Linda Teri, PhD
Professor, Psychosocial & Community Health
Director, Northwest Research Group on Aging, Psychosocial and Community Health
University of Washington

Oleg Zaslavsky, PhD, MHA, RN
Assistant Professor Biobehavioral Nursing and Health Systems Department
Associate Director of Research, de Tornyay Center for Health Aging
School of Nursing, University of Washington