This Mentored Research Scientist Development Award application will provide an intensive research, training, and career development program for Dr. Michelle Odden, an epidemiologist and developing investigator at the University of California, San Francisco (UCSF). Her long-term career goal is to become a leader in the evidence-based prevention of cardiovascular disease (CVD) and related comorbid conditions in elderly adults. Older adults are living longer and healthier lives, yet much of the current literature on CVD epidemiology and prevention has been derived from younger populations. In this application, Dr. Odden will develop a comprehensive evidence base for prevention of CVD events in adults aged 75 years and older. Guided by her mentorship team, Dr. Odden will identify the strongest risk factors for CVD in the Cardiovascular Health Study, an ongoing NIH-funded cohort study of elderly adults. She will use the results of these analyses to inform computer simulations of CVD in older adults, in order to identify the most promising interventions for CVD prevention at the lowest risk for unintended side effects. Dr. Odden will conduct these simulations with the CHD Policy Model, an established computer model of CVD in the U.S. population. To achieve these goals, Dr. Odden and her mentors have developed the following specific aims:1) To describe the epidemiology of CVD events in adults 75 years and older, and to identify the strongest determinants of CVD events, among both traditional and age-related risk factors;2) To forecast CVD incidence, prevalence, mortality, and quality of life in U.S. adults aged 75 years and older, by incorporating in-depth, novel epidemiological data into an established CVD computer model;3) To estimate the potential impact of prevention strategies for CVD in U.S. adults aged 75 years and older on the extension of healthy life years, based on an established CVD computer model. The long term goal of this research is to prevent CVD events in adults over 75, and to extend the healthy years of life for older adults. This research supports the National Institutes of Health's mission to prevent disease and improve the health and well-being of Americans. The primary training goals of this application are to build a foundation of knowledge and skill set that will prepare Dr. Odden to be a successful independent researcher in translational research - from research to practice - in older adults. Through the training and the mentorship of a multidisciplinary team comprised of senior investigators at UCSF, and accomplished external advisors, she will learn the principles of gerontologic clinical science and cardiovascular prevention, and expand her methodological expertise to include forecasting and decision analysis methods. Additional training in implementation and dissemination science will enable her to translate her research findings into public health and clinical practice recommendations. She will participate in the Clinical and Translational K Scholars Program, offered by the UCSF Clinical and Translational Science Institute, which will offer crucial support and mentoring as she develops her research program in translational aging research.
The proposed research will improve our understanding of the determinants of cardiovascular disease in adults over age 75 years, and identify the optimal strategies for prevention, at the lowest risk of unintended side effects. This research will improve public health by reducing the burden of cardiovascular disease in older adults and extending the healthy years of life.
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|Kaiser, Paulina; Arnold, Alice M; Benkeser, David et al. (2018) Comparing methods to address bias in observational data: statin use and cardiovascular events in a US cohort. Int J Epidemiol 47:246-254|
|Winovich, Divya Thekkethala; Longstreth Jr, William T; Arnold, Alice M et al. (2017) Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults. Stroke 48:1818-1826|
|Zeki Al Hazzouri, Adina; Mayeda, Elizabeth Rose; Elfassy, Tali et al. (2017) Perceived Walking Speed, Measured Tandem Walk, Incident Stroke, and Mortality in Older Latino Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 72:676-682|
|Wu, Chenkai; Shlipak, Michael G; Stawski, Robert S et al. (2017) Visit-to-Visit Blood Pressure Variability and Mortality and Cardiovascular Outcomes Among Older Adults: The Health, Aging, and Body Composition Study. Am J Hypertens 30:151-158|
|Smitson, Christopher C; Scherzer, Rebecca; Shlipak, Michael G et al. (2017) Association of Blood Pressure Trajectory With Mortality, Incident Cardiovascular Disease, and Heart Failure in the Cardiovascular Health Study. Am J Hypertens 30:587-593|
|Odden, Michelle C; Peralta, Carmen A; Berlowitz, Dan R et al. (2017) Effect of Intensive Blood Pressure Control on Gait Speed and Mobility Limitation in Adults 75 Years or Older: A Randomized Clinical Trial. JAMA Intern Med 177:500-507|
|Wu, Chenkai; Smit, Ellen; Peralta, Carmen A et al. (2017) Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study. J Am Geriatr Soc 65:1482-1489|
|Odden, Michelle C; McClure, Leslie A; Sawaya, B Peter et al. (2016) Achieved Blood Pressure and Outcomes in the Secondary Prevention of Small Subcortical Strokes Trial. Hypertension 67:63-9|
|Odden, Michelle C; Wu, Chenkai; Shlipak, Michael G et al. (2016) Blood Pressure Trajectory, Gait Speed, and Outcomes: The Health, Aging, and Body Composition Study. J Gerontol A Biol Sci Med Sci 71:1688-1694|
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