According to the World Health Organization, every country in the world is experiencing growth in both the size and the proportion of older adults in their population. By 2030, one in six people across the globe will be aged 60 years or over, and by 2050, the world’s population of adults over 60 will double.
In our own country, the aging of the Baby Boomer generation has been known for years as “the silver tsunami,” the accelerated rate at which adults are maturing past 65. Carolina researchers are addressing the many complexities arising from our aging population, from healthcare to labor dynamics to assisted living. Carolina researchers are making discoveries and building the evidence base to support healthy aging and improve quality of life across the life course.
CEAL@UNC
Last month, the national Center for Excellence in Assisted Living (CEAL), which has focused on advancing the well-being of people who live and work in assisted living through research, practice, and policy for more than 20 years, was rehomed at Carolina under the new name CEAL@UNC.
The center will be based within the School of Social Work and supported by the Office of the Vice Chancellor for Research’s (OVCR) Sheps Center. CEAL@UNC will be led by Sheryl Zimmerman, who also serves as the co-director of the Sheps Center’s Program on Aging, Disability, and Long-Term Care. Research at the new center will ensure that aging adults have access to high-quality supportive care which will enable them to age with dignity and respect. The School of Social Work recently hosted a reception to celebrate the announcement of CEAL@UNC that drew people from across the university, the state, and the country and highlighted the significant impact of this exciting center for excellence.
Add Health
Another OVCR center that has addressed the many facets of aging for decades is the Carolina Population Center, which hosts several population-based cohort studies that follow individuals across the lifecycle, including the Cebu Longitudinal Health and Nutrition Survey, the China Health and Nutrition Survey, and Add Health — the largest and most comprehensive longitudinal study of its kind in the nation. The study began with more than 20,000 adolescents surveyed in 1994-95. Since then, researchers have been collecting data about the participants’ lives through early adulthood and now into middle age.
Add Health is co-directed by Robert Hummer and Allison Aiello, and collaborators include sociologists, psychologists, epidemiologists, physicians, and methodologists from RTI International, the University of Vermont, and Exam One. Add Health researchers study cognitive, mental, and physical health of study participants with attention given to disparities in health outcomes across racial and ethnic, socioeconomic, and gender groups. The current focus of the project’s research facilitates data collection surrounding rising health risks in middle age and beyond.
Cardiovascular disease
Cardiovascular diseases (CVD) are the most common cause of death and disability in the state of North Carolina and across the United States. The spectrum of CVD is enormous, including more common afflictions such as hypertension and atherosclerosis (which can cause heart attacks and strokes), and some rare types that can severely affect otherwise healthy young individuals. The rate at which CVD affects aging adults is staggering, and genetic and environmental factors that contribute to heart disease are still being assessed.
To address those unknowns, the UNC McAllister Heart Institute has assembled many talented investigators who study various aspects of CVD. The institute fosters interaction and collaboration between basic scientists and practicing clinicians, resulting in innovative research projects that provide immediate benefits to patients and foundational discoveries to help even more patients in the future.
The Cardiovascular Epidemiology program at the Gillings School of Global Public Health is an international leader in studies of the underpinnings of the development of CVD, a major legacy of W.R. Kenan, Jr. Distinguished Professor and CVD researcher Gerardo Heiss, who recently passed away. Some of the program’s most significant datasets are hosted at the Collaborative Studies Coordinating Center, including the Atherosclerosis Risk in Communities Study and the Hispanic Community Health Study/Study of Latinos. These cohort studies, with long-term follow up, provide rich data to understand the diverse etiological factors that underpin healthy aging, ranging from molecular and genomic to social determinants of health to acculturation. The CVD epidemiology program also includes innovations like drone access to defibrillators.
Physician scientists in the School of Medicine are addressing basic causes of the spectrum of heart diseases, developing novel diagnostic technologies to prevent the worse from happening, working with colleagues in the Eshelman School of Pharmacy to develop new therapeutics that treat the entire range of diseases, and translating the best of this combined research to improve patient care.
Methodological innovations
Carolina researchers are leaders in the methods used to advance understanding of cognitive aging and neuroscience. The Human Neuroimaging Group in the Department of Psychology and Neuroscience Department is a notable example. Kelly Giovanello is using functional MRI (fMRI) to understand how cognitive and neural processes mediate memory and change with healthy aging and neurodegenerative diseases, like Alzheimer’s disease.
Tanya Garcia in the Department of Biostatistics uses cutting-edge statistical methods to estimate the progression of neurodegenerative diseases in very large datasets with highly correlated data. There is innovative and translational research also occurring across campus in the Center for Aging and Health; the Thurston Arthritis Center; the Geriatric Oncology Program in the Lineberger Cancer Center; and particularly in the Vector Core and the light microscopy facility, which fosters novel approaches to understanding how cells communicate with each other, increasing our understanding of biological aging and potential biomarkers for early detection of aging-related diseases. There is also the work of Jason R. Franz in the Joint Department of Biomedical Engineering’s Applied Biomechanics Laboratory which focuses on the neuromuscular biomechanics of human movement and seeks to identify engineering solutions to help people avoid falls and age gracefully.
Kenan-Flagler
For years, Kenan-Flagler’ Business School’s Jim Johnson has been researching and publishing scholarly work addressing “disruptive demographics,” which are changes to the population makeup that will have ramifications across not only healthcare, but also business.
For companies, Johnson suggests that far more agility and flexibility in the workplace will be required to accommodate a considerable number of employees affected by the “silver tsunami” — including the Boomers themselves, who are more likely to continue working past 65, and the more than one million millennials who will have elder care obligations. Johnson works with leaders in many industries to help them understand and strategize how to embrace the changes and the opportunities that come with them.
Assistive technologies
One potential area of viable research translation will be technologies that afford individuals autonomy as the population continues to age. Led by Ron Alterovitz, the Computational Robotics Research Group investigates new robot designs to enable physicians to provide better medical care and to assist people in their homes.
Their research is examining new algorithms for minimally invasive medical devices such as steerable needles and tentacle-like robots that can provide physicians with access to targets that previously were unreachable without open surgery. The group is also applying those algorithms to personal robots that can assist people with a variety of daily routine tasks at home and in the workplace. Robots capable of learning and performing assistive tasks have the potential to help people who are elderly or disabled to live independently with a higher quality of life.
Similarly, John Batsis in the Division of Geriatric Medicine is using novel technologies, telemedicine, and remote monitoring to reduce transportation and geographic barriers to accessing health care services for older adults, particularly in rural parts of the country.
Carolina’s collaborative research brings significant strengths to contribute to a broad spectrum of aging research: ranging from cellular senescence to epigenetic changes to neurocognitive disorders to disability to physical and social environments. Carolina researchers are making major inroads to ensuring the health and well-being of all adults as they age and ensuring healthy aging for all.