Our research addresses important questions about the development and management of disease throughout the lifespan. For example, what impact do lifestyle factors such as diet, alcohol consumption, and exercise have on an individual's probability of having a heart attack and what role do genetic variables play? Specific research interests include the identification and reduction of risk factors for cardiovascular disease and cancer as well as the identification and reduction of risk factors for stroke and diabetes. Another focus is identifying factors associated with the maintenance of cognitive function and prevention of dementia. In the clinical setting, we are evaluating predictors of delirium among older patients during the hospital stay and evaluating potential intervention programs. In addition, using large, population-based databases, we are studying the characteristics of individuals who achieve exceptional longevity.
Staff Research Interests
Luc Djoussé, MD, MPH, DSc
Since joining the Division of Aging in 2005, Dr. Djoussé's national and international reputation has continued to grow.
Dr. Djoussé's research is focused on nutrition and genetic factors, and the interaction between both on the risk of cardiovascular disease. Over the past decade, his work has contributed to our understanding of the role that diet and other modifiable factors play on the risk of hypertension, coronary heart disease, stroke, diabetes, and heart failure, primarily using major epidemiologic cohorts such as the Framingham Heart Study, the NHLBI Family Heart Study, the HyperGen Study, the Physicians' Health Study, the Cardiovascular Health Study, and the Women's Health Study. His work has also advanced our knowledge of the burgeoning field of gene-environment interactions, particularly as they relate to the intake of moderate alcohol consumption and cardiovascular disease. His recent work has demonstrated beneficial effects of a healthy diet and moderate alcohol consumption on the risk of hypertension, heart failure, and diabetes.
Dr. Djoussé is a fellow of the American Heart Association.
Jane A. Driver, MD, MPH
Trained as both an oncologist and a geriatrician, Dr. Driver is interested in the prediction and prevention of age-related cancer and neurodegenerative disease. She became a faculty member of the Division of Aging in 2007, following a productive research fellowship. Her early work has focused on the epidemiology, risk factors, and mortality of cancer and Parkinson's disease, using the Physicians' Health Study cohort. She has also demonstrated a decreased risk of nearly all types of cancer in patients with Parkinson's disease, and is currently pursuing the hypothesis that patients destined to develop Alzheimer's disease also have a decreased risk of cancer. Interestingly, cancer and neurodegenerative diseases share common genes and biological pathways. A deeper understanding of the relationship between these two diseases might lead to new forms of treatment or prevention.
Dr. Driver is currently broadening the scope of her work to include translational research. Pin1 is a newly described protein that is key to the pathogenesis of both Alzheimer's disease and cancer, which has exciting potential as a biomarker and therapeutic target for both diseases. In collaboration with Dr. Kun Ping Lu, who first described Pin1, she will determine whether genetic variation in the PIN1 gene, or serum levels of the Pin 1 protein, can be used as a biomarker for either disease.
Wildon R. Farwell, MD
As a general internist, Dr. Farwell is interested in the prediction and prevention of chronic illnesses. He is a faculty member in the Division of Aging and the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) at the VA Boston Healthcare System. Dr. Farwell is investigating the role of statins in the prevention of several types of cancer, including prostate cancer and melanoma. He is also part of a research team at the VA that is investigating whether 5-FU, a cream currently used to treat skin cancer, may be able to prevent skin cancer.
Dr. Farwell has also been investigating the relationship between the acid-base status of the blood and the risk for chronic illnesses. In collaboration with Dr. Eric Taylor, he is exploring whether small differences in the acid-base status can predict future development of hypertension and diabetes mellitus.
Dr. J. Michael Gaziano, MD, MPH, Chief, Division of Aging
Dr Gaziano is a nationally and internationally recognized chronic disease epidemiologist. He has a particular interest in the roles that individual lifestyle choices (diet, exercise, smoking), metabolic factors (obesity, high cholesterol, and hypertension), and biochemical and genetic markers play on the risk of coronary artery disease and stroke. Also of interest is the impact that vascular disease has on other organ systems, including cognitive dysfunction and renal disease.
Recently, Dr. Gaziano has initiated a number of research projects to investigate the diverse nature of atherosclerosis. While atherosclerosis plaques from only in certain large and medium-sized vessels, the process of atherogenesis (the formation of plaque in the inner lining of arteries) affects arteries of all sizes. For example, cognitive decline and osteoporosis-related fractures have been linked to various cardiovascular disease risk factors, suggesting a role for small vessel disease in vascular dementia and in abnormal bone remodeling. These projects are intended to explore the extent to which atherosclerotic disease in small vessels leads to these and other chronic conditions, such as renal failure.
Two internationally know and widely utilized resources are the centerpieces of his research: the Physicians' Health Study (PHS) and the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). The PHS is an internationally known cohort of over 29,000 physicians, which has been the source for a wealth of important health information for more than 25 years. Dr. Gaziano is principal investigator for the ongoing PHS II study, a large-scale trial of vitamins in the prevention of chronic disease. He is also co-director of MAVERIC, which is one of three national centers of epidemiology funded by the Department of Veterans Affairs. In addition, he serves as the director of the Geriatric Research and Education Center (GRECC) at the Boston Veterans Administration Healthcare System.
Elizabeth V. Lawler, MPH DSc
Since joining the Division of Aging in 2007, Dr. Lawler's research has focused on the epidemiology of aging, chronic disease epidemiology, and pharmacoepidemiology and drug safety in the elderly. She works primarily with data from the Veterans Health Administration, in addition to longitudinal cohorts such as the Normative Aging Study and the Physicians' Health Study. Dr. Lawler's ongoing projects include investigations of drug safety in the elderly, genes and aging, and veterans' health.
Elizabeth C. Leritz, PhD
Dr. Leritz is a clinical neuropsychologist who joined the Division of Aging in 2005 as a research fellow and is now a faculty member. She is also affiliated with the Geriatric Neuropsychology Laboratory, located in the Geriatric Research, Education, and Clinical Center (GRECC) at the Boston VA Healthcare System.
Dr. Leritz's early work, supported by an individual NIH postdoctoral fellowship, focused on understanding how memory functioning is affected in individuals who are at risk for neurodegenerative diseases such as Alzheimer's disease and cerebrovascular disease. Since that time, she has broadened the scope of her work to include neuroimaging in order to better understand the interplay between risk factors and neuropsychological function. Her current research, supported by a Career Development Award from the National Institute of Neurological Disorders and Stroke, examines the differential effects that Alzheimer's disease and cerebrovascular disease risk factors (such as apoE4, high blood pressure, high cholesterol, and diabetes) have on brain structure and cognition. She will also explore how cognitive reserve mediates these relationships over time.
William Milberg, PHD
In addition to being a faculty member in the Division of Aging, Dr. Milberg is an associate professor of psychology in the Department of Psychology at Harvard Medical School and the director of the Boston Division of the New England Geriatric Research, Education, and Clinical Center (GRECC). The Boston GRECC has a long tradition of focusing on basic and clinical research related to the cognitive problems of aging, and has been funded for nearly 20 years to study such issues as semantic memory and attentional disorders in Alzheimer's disease, as well as the neural basis of the phenomenon know as hemispatial neglect, which can occur with stroke and result in patients being unable to sense the limbs on one side of the body, for example. Dr. Milberg's team has begun testing a promising new treatment for this problem that employs low-level electric current to stimulate the vestibular system.
More recently, he and fellow researchers have become interested in the anatomical, physiological, and neuropsychological characteristics of patients at risk for developing cerebrovascular disease. Their studies have revealed strong associations between risk factors such as hypertension and diabetes and specific cognitive domains. Through ongoing studies, they are exploring cerebral white matter changes and cerebral blood flow changes that are associated with these risk factors.
James Rudolph, MD, MPH
In addition to being a geriatrician at Brigham and Women's Hospital and the VA Boston Healthcare System, Dr. Rudolph is a researcher and educator. His area of expertise is the relationship of atherosclerosis to functional (cognitive and physical) deficits in older persons, particularly after surgery.
Driven by his clinical work, his research focuses on two main areas that frequently overlap: 1) thinking and recovery after surgery, and 2) the impact of medications on function. His research accomplishments include: identification of which patients will develop delirium (acute change in cognitive function) after surgery, survival of nursing home patients who are admitted to the Intensive Care Unit, and the development and validation of the Anticholinergic Risk Scale, designed to rank medications that may cause side effects in older patients. He has authored more than 20 publications on this topic.
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