Training and Funding Opportunities
There are outstanding and varied training opportunities to students in the Mental Health and Aging Research Area. Each faculty member is involved in several projects in which students can gain research experience, both in and outside of the Department of Mental Health. Numerous opportunities are available for collaboration on scholarly publications in the areas of mental health and aging. The following are some of the studies in which they might become involved:
Aging and Dementia Training Fellowship
The goal of this doctoral and postdoctoral program is to train new investigators in age-related cognitive and neuropsychiatric disorders. It is an interdisciplinary program, funded by the National Institute on Aging, affiliated with the Department of Neurology at the School of Medicine and the Department of Psychology and Brain Sciences at the School of Arts and Sciences. Predoctoral and postdoctoral fellows are required to take ‘Cognition, Aging and Neurodegenerative Disease’ (330.802.01), for credit; to develop mastery in biostatistics, and to complete training in ethical conduct of research. Postdoctoral fellows are expected to engage in original research under the supervision of a faculty member. Doctoral trainees must complete the required coursework for their degree program, complete qualifying examinations and a research dissertation. Please contact Dr. George Rebok for further information.
Epidemiology and Biostatistics of Aging Training Program (EBA)
The Epidemiology and Biostatistics of Aging program offers training in the methodology and conduct of significant clinical- and population-based research in older adults. Training in a program that includes numerous investigators actively involved in multidisciplinary research provides experience in the successful conduct of the collaborative work essential in studies of health in older adults and offers mentoring that leads to career dedication to these issues. The specific mission of this training grant is to prepare epidemiologists and biostatisticians who will be both leaders and essential members of the multidisciplinary research needed to define models of healthy, productive aging and the prevention and interventions that will accomplish this goal. This training grant is funded by the National Institute on Aging, T32AG000247.
Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial
ACTIVE is the largest randomized controlled trial of cognitive training with older adults that has been conducted to date. ACTIVE is an NIA/NINR-funded multisite study coordinated by the New England Research Institute with research sites at the University of Alabama, Birmingham, Pennsylvania State University, Indiana University School of Medicine, Hebrew Rehabilitation Center for the Aged, Wayne State University, and The Johns Hopkins University. The goal of ACTIVE is to maintain functional independence in community-residing elders by improving basic mental abilities through different cognitive interventions, including memory, inductive reasoning, and speed of processing. The ACTIVE study was initiated in 1996 and the clinical trial phase ended with the second annual post-test in 2002. Phase II of ACTIVE started in July, 2003 as a followup study focused on measuring the long-term impact of training effects on cognitive function and cognitively demanding everyday activities. Subsequently a third annual post-test was completed in 2003 and a fifth annual post-test in 2005. Phase III of ACTIVE started in July 2008 and 10-year follow-up testing will be completed by the end of 2010. One of the objectives of the long-term follow-up is to determine whether there are any delayed effects of the training on health service utilization including long term care, health-related quality of life, and morbidity and mortality.
The Alzheimer’s Anti-Inflammatory Prevention Trial (ADAPT) and Follow-up Study (ADAPT-FS)
ADAPT was a multi-center, placebo-controlled, randomized primary prevention trial to test the efficacy of two different non-steroidal anti-inflammatory drugs (NSAIDs) to prevent the onset of Alzheimer’s disease among elderly individuals at risk due to a family history of the disease. The trial was terminated prematurely because of cardiovascular safety concerns with NSAID use among the elderly. The participants in the trial continue to be followed to assess the long-term effects of NSAID use on cognition and risk of Alzheimer’s disease.
Baltimore Experience Corps® study
The Baltimore Experience Corps® study is a randomized trial of the Experience Corps program, a community-based model of senior service designed to improve the educational outcomes of children in elementary schools in Baltimore, as well as the health and functional status of older adults. The trial evaluates whether senior volunteer roles within Experience Corps beneficially impact children’s academic achievement and classroom behavior in public elementary schools and the health of volunteers. Volunteers randomized to the program complete 30 hours of training in literacy support, including phonetics, library support and violence prevention, as well as background on school administration and culture. They are placed in classrooms in grades K–3, as well as in school libraries and other supportive roles within the school, such as attendance monitors. The study began in 2006 as a program project grant funded through NIA. The Baltimore Experience Corps is a collaboration of the Johns Hopkins University, Baltimore City schools, Civic Ventures (a nonprofit corporation in San Francisco, Calif.), the Greater Homewood Community Corporation, Intergenerational Community Services (nonprofit), and AARP.
The Brain Health Substudy is nested within the Baltimore Experience Corps® study, above, to apply sensitive in vivo functional magnetic resonance imaging (MRI) to measure the effects of Program participation on brain health in 120 older adults randomized to the program or to control. Based on pilot intervention data, we hypothesize that program participation will lead to improved function in prefrontal cortical regions responsible for executive function and memory, and increased brain volume in these regions.
Cache County Study
The Cache County Study is an NIA-funded population-based prospective study of the elderly residents of Cache County, Utah. The study involves collaborators from Utah State University, Duke University, University of Washington, and The Johns Hopkins University. It was initiated in 1995, and the participants have been followed over four assessments spanning 15 years. The goal of the study is to identify genetic and environmental risk and protective factors for cognitive impairments in aging.
Cardiovscular Health Study
The Cardiovascular Health Study (CHS) is a study of risk factors for development and progression of CHD and stroke in people aged 65 years and older. The initial objectives of the Cardiovascular Health Study were to:
- quantify associations of conventional and hypothesized risk factors with CHD and stroke;
- assess the associations of non-invasive measures of subclinical disease with the incidence of CHD and stroke
- quantify the associations of risk factors with subclinical disease
- characterize the natural history of CHD and stroke, and identify factors associated with clinical course; and
- describe the prevalence and distributions of risk factors, non-invasive measures of subclinical disease, and clinical CHD and stroke.
The study originated in 1988 from the recommendations of an NHLBI workshop on the management of CHD in the elderly that was initially funded for six years. Given its high retention, comprehensive annual assessments, rich biomarker data, and ability to address cardiovascular risk factors across a host of health outcomes, it has been continuously renewed and will mark its 25th anniversary in 2013 with 1000+ publications.
An ancillary study to the CHS further examined in 3660 participants whether 5-year changes in white matter hyperintensities on MRI were associated with an increased risk of Alzheimer’s and vascular dementias, potentially providing new approaches to early detection and prevention. Participants were approximately 76 years old during the initial brain MRI in 1992-3, and received a second MRI in 1997-8. The study adjudicated participants who developed clinical dementia, and is now evaluating the relationships between genotypic data, inflammation, and subclinical cardiovascular disease and incident clinical cardiovascular disease, hypertension and diabetes, and risk of dementia.
Ginkgo Evaluation of Memory (GEMS) Randomized Controlled Trial
This randomized, controlled trial was initiated in 2000 to evaluate whether ginkgo biloba was effective in preventing and delaying the onset of dementia and mitigate rates of cognitive decline in older adults. 3,069 persons 75 years and older and their proxies were recruited and randomized to ginkgo or placebo in 4 U.S. communities, including the Johns Hopkins site in Washington County, MD. Participants received a comprehensive neuropsychological evaluation with blood draw at baseline and all participants and proxies visited the clinic every 6 months to detect changes in cognitive and functional health, which would necessitate a diagnostic neuropsychological and neurologic evaluation, including MRI. The GEMS trial officially concluded in spring 2008 and study PI’s have since published two outcome papers in JAMA demonstrating no effect of ginkgo biloba (240 mg/day) in reducing risk for dementia or mitigating rates of cognitive decline. A number of ancillary studies have been initiated to examine inflammatory pathways to dementia, and, the utility of MRI brain volumetric and white matter hyperintensity data in a subset of healthy vs. MCI participants.
Women’s Health and Aging Study II: Cognitive Pathways
This is a 10-year, observational study of 436 cognitively and physically well-functioning women aged 70-79 living in Baltimore City. This study examined the natural history of cognitive and functional declines and the cognitive antecedents of functional decline and disability. Health, psychosocial, lifestyle, anthropometric, serum and genotypic biomarkers, and other information were prospectively obtained to evaluate hypothesized risk factors of cognitive and physical disability. We further carefully adjudicated both prevalent and incident major chronic diseases of aging, including Alzheimer’s disease, cardiovascular disease, and diabetes. An array of standardized cognitive tests and performance-based measures of independent function were prospectively obtained, including medication compliance, balance, grip strength, visual acuity, hearing and frailty.
Certificate in Gerontology
This program offers a rich curriculum on aging from basic science and public health research to health care management, drawing upon faculty from the Johns Hopkins Medical institutions, including the Bloomberg School of Public Health, the Schools of Nursing and Medicine. The program is housed in the interdisciplinary Center on Aging and Health (COAH). Please contact Brian Buta (firstname.lastname@example.org) for further information.