Research

The Division’s research goal is to conduct cutting-edge research that improves the health and health care of seniors. Our Division utilizes a multisystem, multidisciplinary, and translational perspective that integrates biology, physiology, clinical medicine, behavior, social support, community, and health systems. Over the last year, Geriatrics Division faculty have received a number of renewed and new grants from a variety of sources.

A number of Division of Geriatrics researchers, scholars, and trainees work through the University of Pittsburgh’s Clinical & Translational Science Institute (CTSI) to conduct research at Clinical and Translational Research Centers (CTRCs) located at Montefiore University Hospital, Western Psychiatric Institute and Clinic, Magee Women’s Hospital, Children’s Hospital, and University of Pittsburgh Cancer Institute. These CTRCs provide state-of-the-art infrastructure, inpatient and outpatient facilities, specialized equipment, and experienced staff to support clinical and translational research within Geriatrics and across the wider University research community.

The Division of Geriatric Medicine offers nationally recognized research programs with a commitment to advancing the care of older adults.

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Longevity and Successful Aging

PITTSBURGH CLAUDE D. PEPPER OLDER AMERICANS INDEPENDENCE CENTER
The University of Pittsburgh Pepper Center’s mission is to expand the body of scientific knowledge, using disciplined inquiry and translational research, to improve how we maintain or restore the independence of older adults. The Pepper Center’s primary data collection and research training space is based in the SMART Center, located on the 12th floor of the Kaufmann Medical Building on the University of Pittsburgh’s main campus. The SMART Center features a 180-foot oval track, which is used in research for the measurement of qualitative and quantitative aspects of gait and for walking and balance-based exercise interventions.

GERIATRIC RESEARCH, EDUCATION, AND CLINICAL CENTER (GRECC)
The VA Pittsburgh Healthcare System’s GRECC offers resources to expand the capability of the Veterans Administration to best respond to the medical, psychological, and social needs of older veterans. The GRECC aims to facilitate a higher quality of geriatric care through geriatric and gerontological research, the training of health personnel, and the development of improved models of clinical care for aging veterans.

AGING INSTITUTE
The Aging Institute is a partnership between the University of Pittsburgh and UPMC that is focused on promoting innovative research in aging. The Institute offers seed grant funding for promising junior faculty, encourages collaboration between researchers and clinicians to identify emerging issues in aging-related fields, and promotes the exchange of research ideas and information through research forums and publications.

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Chronic Pain

Debra K. Weiner, MD, focuses her research on chronic pain. She serves as PI on a multisite pilot study designed to improve the management of low back pain in older adults. She is also PI on a multisite prospective cohort study to ascertain predictors of outcome in veterans undergoing decompressive laminectomy for lumbar spinal stenosis. Both studies are supported by VA Merit Review awards. In addition, Dr. Weiner is PI of a GRECC-funded pilot study to develop a mobile application to help PCPs evaluate and manage chronic non-cancer pain. She also collaborates on several NIH-funded studies, including a study of mindfulness meditation for the treatment of chronic low back pain in older adults; the treatment of co-morbid depression and chronic low back pain in primary care (with Jordan Karp, MD, Department of Psychiatry); and the examination of the impact of co-existing hip osteoarthritis on pain and functional limitations in older adults with low back pain (with Gregory Hicks, PT, PhD, University of Delaware).

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Incontinence and Nocturia

The Geriatric Continence Research Lab has conducted pioneering research in the field of geriatric voiding dysfunction and incontinence— syndromes that lead to significant disability. Work by Neil Resnick, MD, has improved the understanding of the causes of incontinence and has resulted in the development of novel approaches to diagnosis and treatment.

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Osteoporosis and Fractures

Under the directorship of Susan L. Greenspan, MD, the Osteoporosis Prevention and Treatment Center is a comprehensive clinical research center. The Center maintains a large research portfolio, including ongoing studies related to management of osteoporosis in the long-term care population and a Fracture Liaison Service for adults with recent fracture. The Osteoporosis Prevention and Treatment Center is integrated with the Claude C. Pepper Older Americans Independence Center.

UNIVERSITY OF PITTSBURGH MOBILE OSTEOPOROSIS CENTER
The Mobile Laboratory Unit has increased investigators’ ability to enroll in their clinical studies frail participants living in the community and in long-term care facilities. Such individuals are generally unwilling or unable to come to a clinical center outside of their home environment. The unit is a novel and valuable resource that facilitates research for vulnerable individuals related to our mission. The unit was featured in this Discovery Channel promotional piece.

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Geriatric Cardiology

Daniel E. Forman, MD, focuses his research on novel approaches in cardiac problems in older adults. With support from a VA Merit award, he is studying the functional impact of skeletal muscle morphology, mitochondrial bioenergetics, and gene expression in older patients with heart failure. In a complementary effort, funded by the NIH and VA, Dr. Forman is evaluating the benefits of exercise training in older cardiac patients to improve physical and cognitive function, focusing particularly on skeletal muscle as the key mediator of these benefits. He is also studying novel strategies to improve the caregiving process, specifically targeting improved enrollment and adherence, supported by the VA and PCORI.

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Telemedicine

In addition to his role as Director of Geriatric Tele­medicine Programs, Steven M. Handler, MD, PhD, CMD, serves as Medical Director for Telemedicine and Health Information for the RAVEN (Reduce AVoidable hospitalization using Evidence-based interventions for Nursing facilities in Western Pennsylvania) CMS Innovation Award. A practicing geriatrician, Dr. Handler’s primary research focuses on medication and patient safety, telemedicine, and clinical decision support sys­tems for older adults in the post-acute and long-term care setting.

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Antibiotic Stewardship

David A. Nace, MD, MPH, researches infectious disease in long-term care, particularly antimicrobial stewardship, vaccine preventable diseases, and outbreak prevention and response. He is the PI of the Improving Outcomes of UTI Management in LTC Study, an AHRQ funded dissemination and implementation project. As part of the IOU project Dr. Nace’s team developed guidelines for the diagnosis and treatment of uncomplicated cystitis in nursing home residents and is testing the implementation of these guidelines in a national cohort of nursing homes. Dr. Nace’s team received the AMDA/ABIM Choosing Wisely Campaign Award in March 2019 for this work. Dr. Nace is now leading work to develop a potential antibiotic stewardship quality measure that can be used by facilities and physicians. This would be the first quality measure that describes appropriateness of antibiotic prescribing as opposed to the existing crude utilization measures. This pilot work is being funded by the PA Department of Health. Dr. Nace is Co-PI on a CD-funded study evaluating the humoral and cellular response to the influenza vaccine in a cohort of adults 50 years and older by frailty status. He is also conducting a Pepper Center-funded pilot study to evaluate the impact of sarcopenia on humoral and cellular response among older adults. He serves as Co-Medical Director for our recently renewed $39 million CMS Innovations Award project (RAVEN), which has developed innovative approaches to reducing unplanned hospital transfers from nursing homes. Finally, he collaborates with other Division researchers on a variety of NIH, AHRQ, and foundation-funded studies of older adults regarding infection control, osteoporosis, adverse drug events, palliative care, interprofessional training, and quality assessment and improvement.

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Neurobiology of Aging

The University of Pittsburgh’s Alzheimer Disease Research Center is funded by the National Institute on Aging and is one of the nation’s leading research centers specializing in the diagnosis of Alzheimer disease and related disorders. Its mission is to integrate, coordinate, and support new and ongoing Alzheimer disease and aging research.

Neelesh Nadkarni, MD, PhD, focuses on understanding the impact of brain amyloid deposition and cerebral small-vessel disease on the interface between mobility and cognition in older adults, supported by an NIH K award. He is also conducting a pilot study supported by our NIH-funded Alzheimer Disease Research Center, and serves on the adjudication committee of the NIA-funded Lifestyle Interventions and Independence for Elders (LIFE) Study.

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Pharmacotherapy

Professor of Medicine Joe Hanlon, PharmD, MS, directs the NIH Geriatric Pharmacotherapy Center of Excellence, which was launched with funding from an NIH K07. Dr. Hanlon is also a key contributor to the renowned “Beers List,” which is used by researchers, clinicians, and the federal government (e.g., CMS, NQF, HEDIS). The Center’s goals are two-fold: 1) to conduct systematic evaluations of drug use and medications recommended for older people; 2) to support a fellowship training program in geriatric pharmacotherapy. The Pharmacotherapy Center-supported fellows have established a history of research excellence.

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Division of Geriatric Medicine
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Kaufmann Medical Building, Suite 500
3471 Fifth Ave
Pittsburgh, PA 15213

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