Duke Claude D. Pepper Older Americans Independence Center
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ABSTRACT – Leadership and Administrative Core (LAC) Achieving meaningful advances in resilience research requires interdisciplinary collaboration that spans clinical, translational, and population science. The Leadership and Administrative Core (LAC) of the Duke Pepper Older Americans Independence Center (OAIC) is designed to meet this need by providing coordinated leadership and robust administrative infrastructure toward achieving our Center’s overall goal of improving the independence of older Americans through understanding and optimizing reserve and resilience. The LAC is essential to accomplishing the Center’s scientific aims by serving as a bridge and catalyzing innovation across multiple cores, investigators, and institutions. The LAC organizes and supports the Center’s three Resource Cores [Molecular Measures Core (MMC), Functional Measures Core (FMC), Data Analytics and Translational AI Core (DATA)], and two Scholar Cores [Pilot/Exploratory Studies Core (PESC) and Research Education Component (REC)]. Led by the PIs of the Duke OAIC, the LAC will draw on expert guidance from an Internal Operating Committee (IOC) comprised of all Core Leads and make use of mature central governance procedures, existing administrative support infrastructure, and robust institutional resources to facilitate overall Center objectives. The LAC will pursue the following Specific Aims: 1) Provide strategic leadership for the Center’s scientific agenda, including via coordination with internal and external partners and engagement with a Regional Partner Council and our Community Advisory Board; 2) Administer and coordinate Center activities, including financial management, ensuring compliance, communication, and oversight of scientific management and data operations; 3) Evaluate and report progress toward Center goals, including through systematic assessment of Center impact and solicitation of feedback from our External Advisory Board and other partners. To promote synergy across Cores, the LAC will implement strategies that facilitate ongoing interaction among Center investigators, such as the Data Integration Working Group (DIWG). The LAC will work closely with the PESC and REC to coordinate selection of projects and scholars, support their development and monitor their progress. Harnessing strong institutional support and close working relationships with multiple centers and institutes and the School of Medicine, the Core will optimize resources and infrastructure to increase efficiency and decrease expenses, thus enabling economies of scale that help ensure the Center’s long-term success.
ABSTRACT – Overall To optimize independence, a deeper understanding of the biological underpinnings of reserve and resilience is needed, as well as interventions that enhance each individual’s ability to withstand and recover from acute health stressors. The overall goal of the Duke Claude D. Pepper Older Americans Independence Center (Duke OAIC) is to understand and optimize reserve and resilience to acute health stressors. We define reserve as the capacity, in physical, cognitive, and psychological domains, that individuals draw upon when faced with an acute health stressor; resilience is the ability to recover from the adverse effects of a stressor. Resilience to an acute health stressor is constrained by pre-stressor reserve, which is in turn related to lifetime exposures including chronic medical conditions, social support, lifestyle, and the environment. Since adopting this focus in 2015, the Duke OAIC has become a national leader, making paradigm-shifting scientific discoveries regarding resilience measures, mechanisms, analytic methods, and biomarkers. Our Center has impacted clinical care through routine implementation of reserve measures across practice settings, and the development of new resilience- promoting interventions. We have mentored an impressive cadre of new investigators in resilience science. The Duke OAIC includes a Leadership and Administrative Core (LAC), three Resource Cores (Molecular Measures Core (MMC), Functional Measure Core (FMC), Data Analysis and Translational AI (DATA) Core), and two elements that coordinate activities supporting Pepper Scholars (Research Education Component (REC) and Pilot/Exploratory Studies Core (PESC)). To accelerate discovery, dissemination, and translation of our findings into practice, in this cycle our Cores add expertise in cellular senescence, artificial intelligence, integration of wearable and electronic Health Record (EHR) measures, data visualization, and implementation science. We will continue to draw upon our robust body of biorepositories and datasets, strong Duke programs and resources, and an abundant pool of talented early-career and senior researchers. We propose the following Overall Specific Aims: 1) Elucidate the mechanisms underlying reserve and resilience in older adults through support of pilot studies (PES), developmental projects (DP), and external projects (EP) and innovations in research design, measures, and analytic strategies to reveal the molecular, cellular, and physiologic mechanisms underpinning reserve and resilience; 2) Advance interventions that optimize reserve and resilience in older adults; 3) Equip researchers across disciplines to advance reserve and resilience research in older adults; and 4) Amplify the impact of individual OAIC studies and investigators of reserve and resilience. Through our ongoing collaborations with 10 other OAICs and NIH Centers of Excellence and with our thematic synergy and track record of success, the Duke OAIC will continue to propel scientific knowledge, methodology, and interventions to enhance reserve and resilience toward the goal of improving independence in older Americans.
