Aging & Geriatrics

Research overview

As the world’s population is aging, and U.S. baby boomers are entering their golden years, Kaiser Permanente Washington scientists are at the forefront of research to help older adults lead healthier lives.

“Research on aging cuts across virtually everything our institute does,” says Eric B. Larson, MD, MPH, a senior investigator who previously served as executive director of Kaiser Permanente Washington Health Research Institute (KPWHRI) and Kaiser Permanente Washington vice president for research and health care innovation.

This includes studies looking at brain health, physical activity and behavior change, unsafe and unnecessary treatment, cardiovascular health, and chronic disease management, among other research areas. Now, new funding for aging research — especially Alzheimer’s and related disorders — offers even greater opportunities for KPWHRI scientists and their colleagues who work in health care systems.

Studies spanning decades

The institute has hosted several long-running cohort studies, including the Adult Changes in Thought (ACT) Study, a collaboration with the University of Washington, among other partners. For more than 30 years, ACT researchers, led by Dr. Larson, have focused on finding ways to delay or prevent Alzheimer’s disease, other dementias, and cognitive decline. Through ACT and related studies such as the Seattle Longitudinal Study, the institute has discovered clues to healthy aging that translate into guidance for safely staying active, avoiding injurious falls, and reducing cardiovascular risks. These and other changes have likely contributed to lowering of dementia rates in the United States and other countries.

More recently, ACT researchers have also been contributing to research on traumatic brain injury and on the genetic foundations of various diseases, including Alzheimer’s. ACT has established one of the world’s largest brain banks set in a community health care system and dedicated to the study of the aging brain, Alzheimer’s disease, and dementia, with more than 880 brains donated from ACT volunteers.

In May 2021, the National Institute of Aging awarded ACT a new grant totaling $55.6 million — 3 times the amount of the study’s previous funding round. Under the 5-year grant, ACT partners are expanding the existing cohort of 2,000 Kaiser Permanente Washington members to 3,000 and implementing new strategies to recruit a more diverse population. Additionally, as part of the grant, the ACT team is making its data more accessible to researchers nationwide.

Wide-ranging research

Scientists at KPWHRI are advancing age-related research in many other areas as well. Some highlights:

• The often-cited Chronic Care Model — developed at KPWHRI’s Center for Accelerating Care Transformation (formerly known as the MacColl Center for Health Care Innovation) — is widely recognized as the leading care-design model for everyone, including older people, with chronic disease.
• Drs. Diana Buist, Karen Wernli, and Ellen O’Meara’s work on cancer screening has underscored the need for more research into when the benefits of screenings for breast and lung cancers are worth the risks for older adults, particularly those with comorbidities.
• The institute’s drug safety research is contributing to better understanding of how certain medications affect older adults’ well-being and how to avoid unsafe and unnecessary medications. Among other initiatives, KPWHRI researchers are developing a compendium of tools and resources to improve the management of opioids in older adults. Dr. Michael Parchman is also leading a trial to study the impact of training clinical value champions to reduce inappropriate prescribing for people with dementia.
• In a pilot trial co-led by Dr. Larson, researchers are examining whether health coaching to improve physical activity, diet, cognitive activities, social activities, and other modifiable risk factors for dementia is an effective way to improve cognition as people age.  
• Dr. Dori Rosenberg is leading a randomized controlled trial examining whether reducing the amount of time older adults spend sitting can improve their health.  In her pilot studies, she showed that helping older adults to sit less — by encouraging more standing and moving — fit into their daily lives more easily than focusing only on promoting structured bouts of exercise. 
• In addition to the institute’s work promoting healthier aging, KPWHRI scientists — through the ACT Study, its predecessors, and other research — has contributed to the growing movement to improve caregiving, especially for persons living with dementia, and their caregivers and care partners. Our investigators are also seeking ways to help older adults receive late-life care that best reflects their values and preferences.

“We’re learning what our study participants value as they grow older,” Dr. Larson says. “And we hope to apply that to help them have a positive experience with aging — promoting their independence and providing them with skills to cope with any problems that may occur.” ​​​​​

Affiliate researchers

James Bowen, MD
Neurologist
Swedish Medical Center

Paul Crane, MD, MPH
Professor, Internal Medicine
University of Washington

David R. Crosslin, PhD
Assistant Professor
Biomedical Informatics and Medical Education
Adjunct Faculty
Genome Sciences, Division of Medical Genetics
University of Washington

Kristen Dams-O'Connor, PhD
Associate Professor
Department of Rehabilitation Medicine
Icahn School of Medicine at Mt. Sinai

James Floyd, MD, MS
Assistant Professor, Department of Medicine

Shelly Gray, PharmD, MS, AGSF
Professor, Department of Pharmacy
University of Washington

Gail Jarvik, MD, PhD
Professor, Medical Genetics, Genome Sciences, Department of Medicine
University of Washington

Dirk Keene, MD, PhD
Department of Pathology
Harborview Medical Center

Zachary A. Marcum, PhD, PharmD
Assistant Professor, School of Pharmacy
University of Washington

Wayne McCormick, MD, MPH
Head of Gerontology and Geriatric Medicine
UW Medicine

Sue McCurry, PhD
Research Professor, Psychosocial and Community Health
University of Washington

Elizabeth Phelan, MD, MS
Associate Professor, Medicine/Gerontology and Geriatric Medicine
Harborview Medical Center
Adjunct Associate Professor, Health Services
University of Washington

Janelle S. Taylor, PhD
Professor, Department of Anthropology
University of Toronto

Linda Teri, PhD
Professor, Psychosocial & Community Health
Director, Northwest Research Group on Aging, Psychosocial and Community Health
University of Washington

Oleg Zaslavsky, PhD, MHA, RN
Assistant Professor Biobehavioral Nursing and Health Systems Department
Associate Director of Research, de Tornyay Center for Health Aging
School of Nursing, University of Washington