EPID 624 - Epidemiology of Chronic Disease 2017

C.M.G. Buttery


What can you find about the demography of those over 65
What can you find out about causes of death of those over 65, how are they different from the general population? How valid are the data?
The discussion this  week will look at the epidemiology of aging in relation to chronic disease.  Are we looking at association or cause and effect?  Can you find  literature that provides  research on topic.In March 2015, the following quote from the scientist is worth reviewing: "Aging is complex. It’s a whole-organism process that happens over a lifetime. It happens at the level of the genome—telomeres, DNA repair processes, and epigenetic modifications have all been linked to aging—as well as the level of proteins. Protein misfolding, mitochondrial dysfunction, and stem cell activity are also prime aging suspects. The Scientist tackled the diverse molecular dynamics underlying aging in the lead feature story in the special issue on aging. Two other features explored how diet affects aging and the role of retrotransposon-induced DNA damage. In the Literature section, we tackled collagen remodeling in C. elegans and growth-hormone signaling in mice. There’s no way we could have covered it all."

And there’s no way researchers will understand it all unless they are more open with their data, argues University College London and EMBL European Bioinformatics Institute postdoc Matthias Ziehm in an opinion piece on the need to share annotated longevity data. One question that the field is anxious to answer: How do we stay healthy as we live longer?

Dr. Cohen's Slide Set

Those of you who have not taken the Intro to Public Health Practice on-line course will benefit from reviewing the session on aging. Those of you who took this course would probably benefit from going over it again, in particular looking at the PBS video on aging..
Review the home Page of the National Institute for Aging , Click on the healthcare providers tab, then look at the research page. ALso look at this recent IOM publication on Cognitive Aging (Summary Only), and the JAMA Review on the subject.
Review the NIA Strategic Directions for Research on Aging Scan the PDF pamphlet on right and the strategies on the left, Consider the paper on delaying aging, and healthy aging (page1-4,5). Then review Healthy Aging, Pages 12-22 in this IOM release. Why is aging a problem in Japan? How about Centenarians in the US? Consider this article from the Kings Fund on paying for care (pages 4-13) of the elderly and consider how this might fit into the develoing aging and chronic disease care in the US. Also the first article from this Virginia Caregivers document on plannng for aging

Scan this document from the IOM of End of LIfe Care (focus on the highlighted boxes), scan this essay on assisted dying.

Older Americans Act at 50.

The following graphic show the increase in centenarians over the last 30 years.

new centenarians

Look at the attached graphic on health rankings of seniors, state-by-state.

Care of The Frail Elderly. This paper from the UK applies fine to the U.S., just substitute US any time you see UK, and review this perspective on Palliative Care, And this latest article on palliative care. also consider the role of the caregiver, then review this article on one perception of the End of Life..While not strictly epidemiologic, one should not leave the topic of aging without looking at strategies for caring for the aged which is a combination of social, economic, medical and supportive issues.Look at this IOM summary of caring for the aged (The entire document is available here if you have an interest in following this up, but is not required reading) and this essay on the crucial importance of care of the aged. The with recent discussions of end-of-life management is that of assisted dying which has had codes passed in both Oregon and also consider the role of family members and caring for their elderly relatives.

New article on elder abuse (NEJM Nov15)
New article from JAMA on Acess to Hearng Aids,
AMA Encourages Community-Clinical Partnerships
Look at CDC;s home page on Healthy Aging.  This page should help you look at the core issue of chronic disease and aging and whether the two must coincide.
Is there evidence that prevention works? Does the section on future directions suggest research topics/avenues?> Is this research translational?

Take a look at the January 2017 quarterly publication on the Virginia Center for aging and scan the issues being studied in attempt to improve healthy aging in Virginia.

Chronic Disease, The U.N.'s Millennium Goals:  How does this encompass the course.?  How is it relevant to future research? Look at this recent review on aging research from

Review this OP-Ed piece by Paul Samuelson from the Richmond Ttimes-Dispatch addition of August 22 2016 on the topic of "Are aging and the economic slowdown linked?

Review the January 2015 Issues of Health Affairs (Using TML libraryJournal page) which focuses on aging issues. The editorial sets the stage for the discussions. Scan the primary care section.

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