Lena K. Makaroun, MD, MS
Core Investigator
Center for Health Equity Research and Promotion
VA Pittsburgh Healthcare System
Assistant Professor of Geriatric Medicine
University of Pittsburgh
Topic:
Assessing Frailty at Scale: Experience with the Risk Analysis Index and Opportunities for Integrating Functional Measures into Perioperative Evaluation
The Biology of Mobility and Aging Core (BMAC) is a new Core within the Pepper Center. It has been established to facilitate the translational gap from basic research at the bench to the clinic, by providing Pepper Center investigators unprecedented access to state-of-the-art instrumentation, resources, and intellectual and technical expertise in aging biology and translational science. The BMAC will foster collaborations of clinicians and basic scientists in order to better enable in-depth interrogation of pathways linking aging “hallmarks” with age-related phenotypes and healthspan indicators. This will ultimately enable clinical trials of novel interventions to preserve mobility and balance in aging populations.
The goal of this new core is to promote both basic-to-human and human-to-basic translation. The BMAC builds on the momentum of the Aging Institute, created several years ago with support from Pitt/UPMC. The BMAC will provide an engine of discovery and innovation to guide and enhance our clinical and translational efforts. Specific emphasis includes using basic science approaches to uncover novel biomarkers that might aid in the treatment of age-related alterations in mobility and balance. Moreover, the BMAC will assist in the development and characterization of innovative pre-clinical animal models that can be used to mechanistically explore the fundamental basis of age-related changes in mobility, gait and balance. Other aspects in which the BMAC will function will be to provide guidance on the use and interpretation of various ‘omic’ technologies. For instance, the BMAC will aid Pepper investigators in the appropriate use of various molecular tools such as single cell RNAseq and metabolomics, which might provide valuable mechanistic insight to complement various ongoing clinical and translational endeavors.
The BMAC will also help Pepper investigators who might wish to pursue any of a number of high throughput screening approaches including whole genome CRISPR-based screens or screens of diverse chemical libraries. Such screens are envisioned to be essential to uncover new molecular targets or novel therapies that might, for instance, improve age-related muscle function. Finally, the BMAC will catalyze our Team Science efforts, as a way of accelerating the adoption of a ‘common language’ between basic, translational and clinical scientists.
The Pilot/Exploratory Studies Core (PESC) promotes and supports innovative multidisciplinary research related to balance, mobility, and aging. The PESC encourages supplements to ongoing studies by funding new and ongoing studies, informing investigators of opportunities for pilot funding supplements, and promotes innovative techniques and methods.
The PESC has partnered with the CTSI and the Aging Institute to increase individual pilot projects.
Investigator: Rocha
Topic: Small molecules to prevent mobility decline
Investigator: Rogers
Topic: Remote physical activity intervention
Investigator: Scheunemann
Topic: Social determinants of health, functional status and health care utilization
Investigator: Torres-Oviedo
Topic: Gait automaticity and locomotor adaptation
Investigator: Farsijani
Topic: Dietary protein, gut microbiome and mobility
We strive to provide a comprehensive, individualized career development program to prepare future investigators to become leaders in mobility, balance, and aging research. All of the pilot projects that are supported by the ISC, involve at least one other core (DMAIC, REC, PESC, CPOC, BMAC). The ISC interacts with the CPOC to develop assessment tools that are accessible in the clinic and community. The ISC interacts with the DMAIC regarding formats for data entry, pre- processing of data, data quality control, interpretation of findings and novel analytic techniques for complex data. The ISC interacts with REC by providing consultation and training on various instrumentation, and laboratory techniques. The ISC helps REC members apply for small REC pilot funds and interacts with the PESC by providing pre-award consultation, cost estimates and access to key laboratory facilities. The ISC interacts with the BMAC for translational studies.
CPOC plays a critical role in training REC investigators in the rationale and application of key methodologies in aging research. The primary focus is to ensure that all trainees are knowledgeable about the clinical syndrome of mobility impairment and falls and the rationale for clinically relevant assessment of balance. Trainees are also oriented to the potential use of existing data for preliminary or independently funded studies and in methods to promote retention. Training can include observation of methods as currently applied in ongoing studies. As part of REC activities, all basic science and non-clinical trainees are required to observe the conduct of core measures in an ongoing study. Please see the REC section of this progress report for more details.
CPOC Activities: