Major Research Projects Since 2000
- Adult-Onset Mobility Loss
- Adherence to HAART Among HIV+ African Americans
- Advanced Cognitive Training for Independent and Vital Elders (ACTIVE)
- Aging American Voter Project
- City of Detroit 2001-2002 Elderly Needs Assessment
- Cognitive Aging and Neuroimaging
- Cognitive Assessment and Early Detection of Dementia
- Community living After Spinal Cord Injury: Models and Outcomes
- Community Participation After Spinal Cord Injury: Idioms of Beliefs and Behaviors
- Diabetes in Older Latinos, Stress and Brain Changes
- Examing Inequalities in Occupational Therapy Services
- HeadMinders: A Computer Internet-Based Cognitive Assessment System
- Helping Older Minority Women Transition from Homelessness
- Hemodynamic Predictors of Brain and Cognitive Aging
- HIV Risk Behavior by African Americans Receiving Protease Inhibitor Therapy
- Minimum Premium Plans: Defined Contributions and Employer-Sponsored Health Insurance
- Occupational Therapy Training to Improve Mental Health Services
- Social Identity and Political Participation of African Americans
- Telling My Story
- Vascular Depression and Function in Older Latinos
- Women and Aging: Well-being in Late Life
Epidemiology of Late-Life Depression and Ethnicity Research Study (ELLDERS)
PI: Haan, M.N. and Co-PI: González, H.M.
NIA/Department of Health and Human Services, 2003-2008, $8.3 million
The aim of this study is to examine risks for prevalent and incident dementia in community-dwelling older Mexican Americans.
Downsizing Possessions for Residential Moves in Later Life
Co-PIs – WSU Site: Mark Luborsky, PhD & Cathy Lysack, PhD
Funder: National Institutes of Health
The goal of this project is to investigate possession management, disposition, and disposal as an adaptation to the vulnerabilities of age when people move to smaller quarters in later life. In this “Downsizing Households” study the specific aims are to: (1) Describe the strategies and emotions of household downsizing as perceived by those who accomplish a move; (2) Confirm the developmental character of such episodes by examining move circumstances; (3) Identify the heuristics—mental shortcuts—that people use to disband under constraints of limited time and knowledge; and (4) Describe self-representations and explore their role as resources for the accomplishment of downsizing and making a residential move. Investigators with expertise in the study of life reorganization are conducting this study in two-sites: in Lawrence, Kansas, and Detroit, Michigan. In-home interviews will be conducted within 100 households of older persons (age 65 and older) who have moved to smaller quarters in the last year. In addition, there will be interviews in another 50 households twice before and once after the move. The analysis of informants’ accounts will clarify how individuals motivate, execute, and evaluate these transitions. This project will generate practical information for the public and for health and social service professionals that can be applied to catalyze disbandment and facilitate residential relocation as a means to better self care.
Adult-Onset Mobility Loss
Mark Luborsky, Ph.D., Principal Investigator
The goal of this project is to describe the experiences and meanings of adult onset mobility loss among a sample of Caucasian and African-Americans (N=216) aged 45 - 62, and test three competing theory-based hypotheses regarding the nature and impact of psychosocial experiences consequent to the loss of physical mobility. Funding: NICHD/NCMRR - #R01HD34940
Adherence to HAART Among HIV+ African Americans
PI: Sankar, A.
Co-PI: Luborsky, M.
NIH/National Institute on Allergy and Infectious Disease, 2001-2006, $2.1 million
The goal is to develop factors related to long-term adherence to High Acting Antiretroviral Therapy among minorities and to develop best practice to increase the likelihood of compliance thereby reducing excess disability, deaths, and emergence of drug resistant strains of HIV.
Advanced Cognitive Training for Independent and Vital Elders (ACTIVE)
Peter Lichtenberg, Ph.D. (Wayne State University Site Principal Investigator)
Michael Marsiske, Ph.D. (Project Principal Investigator)
June Clark (Project Director)
This is a multi-site clinical trial study conducted at six locations nationally (University of Alabama Birmingham, Harvard's Hebrew Rehabilitation Center for Aged, Indiana University School of Medicine, Johns Hopkins University, Pennsylvania State University, and Wayne State University), and funded by NIA and NINR. The goal of the trial is to assess whether basic cognitive training (in remembering, concentrating, and problem solving) can have positive effects in the ability to perform critical everyday tasks. Over a planned two-year follow-up interval, the study will address whether such training can have beneficial effects for such public health outcomes as institutionalization, morbidity, and mortality. Nationally, approximately 2880 participants aged 65 and older, about a third of whom are expected to be African American, will be enrolled in the study.
The Aging American Voter Project is an ongoing line of research exploring the relationship between the aging process and changes in political behavior and orientation over the adult life span. Using 48 years worth of National Election Study surveys, the project seeks to illuminate the ways in which adult political learning, attachment to community, social affiliation, partisan identification, and other age-related factors influence political participation and opinion. The project also attempts to explain large-scale trends in U.S. voting turnout and other forms of participation by considering aging effects, cohort differences, and changes in historical context.
The Detroit Senior Citizens Department wants to find out what services senior citizens need. This citywide study in Detroit will use trained WSU interviewers to contact residents over the age of 60. During the survey, seniors will be asked questions about many topics including health care, prescription drugs, transportation, recreation, housing, tax preparation and other quality of life issues. Survey participants will be chosen at random. Participants will be recieve a $10 gift certificate to either Rite-Aid or CVS Pharmacy. The results from the study could impact how City services are delivered in Detroit. Funding: City of Detroit
Cognitive Assessment and Early Detection of Dementia
Peter A. Lichtenberg, Ph.D., ABPP
Jeffery Barth, Ph.D., ABPP
David Erlanger, Ph.D.
Larry Lawhorne, M.D.
Michael Maddens, M.D.
Amanda Schaefer, M.A.
This series of projects funded by a number of different sources including the NINR, Eisai and Pfizer Inc. and the Geriatric Education Center of Michigan is looking at three main areas to improve early detection of Alzheimer's Disease; (1) Use of the Fuld Object Memory Evaluation to assess cognition in African American elders, and to assess change after treatment in African American elders with Alzheimer's Disease; (2) Validation of a computer internet-based cognitive assessment system Headminders protocol; and (3) A statewide initiative to improve primary care physician awareness and ability to assess and treat dementia.
Community Living After Spinal Cord Injury: Models and Outcomes
PI: Lysack, C.
Co-PI : Luborsky, M.
National Institute of Child Health and Human Development/
National Center for Medical Rehabilitation Research, 2003-2007, $1,089,578
The goal of this study is to extend basic knowledge of longer term spinal cord injury outcomes by evaluating competing social-ecological hypotheses about community (both desired forms of community and modes of valued participation) by comparing adult Caucasian and African Americans with spinal cord injury (n=160) across a range of age of onset and duration beyond 5 years post injury. The main emphasis in this study is on evaluating the relative importance of spatial/geographical versus social/ecological elements of theories of community formation. This study also emphasizes the full developmental spectrum of adults with SCI, thus illuminating how persons participate in the full spectrum of social roles and normative communities across six decades of the human lifespan.
Community Participation After Spinal Cord Injury: Idioms of Beliefs and Behaviors
PI: Lysack, C.
Co-PI: Luborsky, M.
National Institute on Disability and Rehabilitation Research, 2002-2005, $450,000
For persons with severe permanent and visible injuries like spinal cord injury (SCI), the challenge of overcoming physical and attitudinal barriers in the community and realizing full community re-integration and inclusion can be significant. The primary goal of this three year practice-focused study (n=72) is to identify individual and environmental level barriers and resources to community independence and re-integration among teenagers and younger adults in the early years post spinal cord injury. This study also seeks to shed light on the ways persons with spinal cord injury envision their sense of community and identify the modes of community engagement over time as they move from the acute post-injury phase to long term adjustment. A substantial body of literature documents that the absence of meaningful community participation is a risk factor for poor long-term medical and psychosocial outcomes in persons with a wide range of disabilities. Thus, the project is anticipated to contribute new data on community re-integration with the potential to assist persons with SCI and persons with other disabilities as well.
Compensating Wage Differences in Older Workers
Gail Jensen, Ph.D., PI
Michael Morrisey, Co-PI
Employers are the principal source of health insurance for Americans under age 65. Economic theory argues that workers pay for health insurance in the form of lower wages or reductions in other forms of compensation. This paper uses 1994 and 1998 Health and Retirement Survey data to examine the wage-health insurance trade-off for older U.S workers. Job and insurance choice are treated as endogenous in a two stage least squares framework. There is strong evidence supporting the treatment of nonwage benefits as endogenous. The preferred specification indicates an annual health insurance wage adjustment of $6,300. The magnitude of the tradeoff is fragile, however.
Diabetes in Older Latinos, Stress and Brain Changes
PI: Haan, M.N.
Co-PI: González, H.M.
NIA/Department of Health and Human Services
1999-2006, $1.42 million
The objectives of this study are to examine the role of diabetes and stress on the cognitive and functional status of community-dwelling older Mexican Americans.
Examing Inequalities in Occupational Therapy Services
Cathy Lysack, PhD, OT(C), PI
The main goal of this study is to identify the factors that predict referral to occupational therapy home evaluation services. Research in the realm of health inequalities has confirmed that access to medical care and duration of rehabilitation varies by insurance payer, not merely objective medical need. We will conduct a secondary data analysis of a 5-year sample of all rehabilitation patients discharged from the Rehabilitation Institute of Michigan (between January 1, 1994 and December 31, 1998; n=7902) to identify, describe and compare the demographic, insurance provider, and functional independence profiles of rehabilitation patients that receive an occupational therapy home evaluation and those who do not. Results are expected to have direct implications for the design and delivery of occupational therapy home evaluation programs.
HeadMinders: A Computer Internet-Based Cognitive Assessment System
PI (WSU): Lichtenberg, P.A.
NIH/National Institute on Aging (SBIR), $239,000
Despite being one of the top ten causes of death, Alzheimer’s disease continues to be poorly assessed, detected, and treated within the primary care setting. Unfortunately, this setting is where the majority of older adults experiencing symptoms of an age-related dementia are likely to first seek help. Thus, with incredible growth in the U.S. population of older adults, especially those over age 75, improving the ability of the primary care physicians to diagnose and treat Alzheimer’s disease and other age-related dementias is of high priority. Time constraints within the primary care setting and lack of technical expertise regarding cognitive testing are consistently identified as major barriers for improving care for patients with Alzheimer’s disease. Because of these barriers, Practice Guidelines and Best Practice Standards have failed to substantially improve detection and treatment of Alzheimer’s disease in the primary care setting. The HeadMinder Cognitive Screening Test (CST) was created to eliminate constraints of time and technical expertise while allowing for fundamental cognitive screening.
Helping Older Minority Women Transition from Homelessness
PI: Washington, O.G.M.
Wayne State University President’s Research Enhancement Program, 2005-2007, $160,682
The 24-month study focuses on examining systematically the issues that, African American women who are 45 years of age and older face and determining how these issues compromise successful transition. Action research methods are employed, which include older minority homeless women in transition as expert participants to identify issues they face and design assessment tools to evaluate barriers impeding their successful emergence from homelessness. This study also will facilitate the use of documented issues confronting older minority women in the development and refinement of transitional issues assessment tools and an advocacy intervention designed to help resolve issues presenting during their transition out of homelessness. This research also seeks to augment women’s awareness, motivation and skills in resolving issues they perceive as most serious and relevant to them personally.
Hemodynamic Predictors of Brain and Cognitive Aging
PI: Raz, N.
NIH/National Institute on Aging, 2004-2006, $144,172
This research explores the feasibility of using Transcranial Doppler Sonography (TCD) for assessment of the influence exerted by hemodynamic factors on differential age-related changes in brain and cognition. We are specifically interested in exploring the links between age-related slowing of cerebral arterial blood velocity (CBF-V) in anterior and middle cerebral arteries, as a marker for cerebral hypoperfusion, and regional increase in white matter hyperintensities (WMH) burden as well as shrinkage of the cortex and the underlying white matter. In cognitive domain we will focus in the executive functions which are differentially sensitive to aging and prefrontal pathology. Our hypotheses are based on the body of clinical and preclinical studies that suggested CBF-V slowing as risk factor for developing WMH, our own studies that support the plausibility of modifying influence of cerebrovascular risk factors on age-related brain shrinkage and on the studies that suggest differential vulnerability of executive functions to mild hypertension. While a preliminary report  indicates that reduced CBF-V may be associated with structural brain pathology (global WMH burden), neither regional specificity, nor cognitive relationship nor longitudinal course of that index have been established. We have conducted research on a cohort of healthy adults (age 18-85) and obtained cognitive and MRI-based structural brain measures on more than 100 individuals. In this project, we propose to use these data as baseline measures in a two-year longitudinal study and to relate hemodynamic variables to the rate of neuroanatomical and cognitive change. Thus, this research represents a pilot study that examines the feasibility of applying a technique widely used in the clinic to research healthy aging, and it will benefit from statistical analysis of existing data.
The goal of this project is to reduce risk behavior by minorities taking protease inhibitor treatments. It will identify how risk and risk behavior is defined by African-Americans (N=60), congruence with medical definitions and evaluate how treatment programs address perceived needs related to HIV risk behaviors. Funding: NIMH - #R01MH54391
This study examines the extent of use of alternative contribution plans for health insurance coverage offered by employers, analyzes the determinants of choice, and estimates the effect of the choice on the cost of health insurance. Data for the study come from the 1997 Robert Wood Johnson Foundation Employer Health Insurance Survey, which is nationally representative of private and public employers in the U.S. The study is first describing the use of alternative premium contribution arrangements among employers. Then, models are being estimated describing the factors that influence an employer's choice of funding arrangement, so that the role of worker heterogeneity can be isolated from other factors relevant to that choice, such as firm characteristics and the nature of the firm's local market area. Finally, the results of this analysis are being used to examine the effects of alternative contribution policies on premiums in employment-based health plans.
Bringing together a team of occupational therapists, psychologists, pharmacists and physical therapistsThis project created a set of 6 one hour DVD based training modules. The modules include actual patient-practitioner interactions; assessments and interventions. The efficacy of the modules is being evaluated across 30 Occupational Therapists in home, outpatient and nursing home settings.
By studying racial group consciousness, salience, common fate, cohesion, outgroup attitudes, and preferred strategies for political inclusion, we seek to better understand the socialization experiences that occur within formal and informal African American networks. In particular, our interest lies in exploring the political integration of successive generations of African Americans into the larger community and the relationship between social identity and the growth in political participation over time.
Telling My Story
Using Humanistic Social Science to Illuminate First Person Accounts of Women Surviving Homelessness in Late Life
PI: Washington, O.G.M.
Humanities Center Innovative Proposal Competition & Institute of Gerontology
Vascular Depression and Function in Older Latinos
PI: González, H.M.
National Institutes of Health, 2003-2008, $834,520
The objectives of this study are to examine how depression and vascular disease are associated with cognitive and functional changes in community-dwelling older Mexican Americans.
The fastest growing segment of the American elderly population is women age 85 years and older. Yet, we lack an adequate understanding of experiences of aging and well-being from the perspective of these women. What can they tell us about the meaning of health and well-being at the end of life that can inform the complex process of developing and sustaining healthful attitudes and health promoting behaviors? Furthermore, how closely do the characteristics and predictors of "successful aging" defined by researchers approximate the domains of quality of life as defined by older adults themselves? The specific aims of this pilot project are to describe: 1) how very elderly women perceive aging and well-being across the life course; 2) how issues, dilemmas, and concerns associated with advanced age relate to present well-being; and 3) how very elderly women view and evaluate the quality of their lives in late life. This qualitative research project is focused on 20 women (10 White and 10 African American) age 85 years or over, identified by others in their communities as having lived active, satisfying and meaningful lives. Funding: National Institute on Aging