Purdue researchers look at life through the whole body of work
by William Meiners
“I’d rather be dead than singing Satisfaction when I’m 45.” — Mick Jagger
Last summer a celebrity birthday may have struck a chord with the baby boomer generation. Mick Jagger turned 70 on July 26. Is it truly possible that an original rock-and-roll bad boy is now a septuagenarian? How has he held up so well? And with bandmate Keith Richards surviving right alongside him. Questions pondered, though maybe not specifically about any of the Rolling Stones, by Purdue researchers every day.
It’s the fortunate ones who reach old age. So says Ken Ferraro, director of Purdue’s Center on Aging and the Life Course (CALC), which officially came into being in 2003. These older people have avoided accidents and disease and have been fortunate enough to advance to their golden years, perhaps with some chronic aches and pains in tow. And while many candles on a birthday cake are something to celebrate, no one has been able to unlock a secret code to longevity.
Ferraro leads a unique collaborative that brings together researchers and students from all over campus to study the wide-ranging differences in how people age. “It really is an interdisciplinary endeavor,” he says. “One of the big issues in gerontology is that it’s hard to solve with just one department. We’re addressing issues related to quality of life and maintaining independence.”
For Ferraro, also a distinguished professor of sociology, it’s a subject close to his personal and professional heart. He grew up in a multigenerational household where he would often help his grandmother physically move his grandfather, who suffered from rheumatoid arthritis. Now he leads one of the major university-based aging centers in the United States.
Examining the life course
No one gets old overnight. “There’s a fascinating genre of research that looks at the origins of adult health,” Ferraro says. “Sometimes we think that when people hit 60 or 65, these health problems just suddenly appear, but they’re actually just surfacing. They may have been apparent in a biological sense very early.”
Ferraro says there’s more and more information coming out about early childhood experiences (even in utero experiences) that can be consequential to the developments of health problems later on. He points to the examples of chicken pox in childhood leading to shingles later in life or a long-past spring break sunburn that could put a middle-aged man under the knife of a dermatologist.
So researchers interested in this notion of the “life course” attempt to understand aging in an historical context. “The baby boomer generation is just another example of major changes in our society as a result of fertility,” Ferraro says. “So we’re also studying fertility and these birth cohorts who are marching through history.”
Baby boomers may be increasing the research need, but an abundance of national data may be driving the outcome. Elliot Friedman, an assistant professor of human development and family studies, says he’s always been interested in the ways psychological experiences affect biology. But his research took a turn toward gerontology while at the University of Wisconsin because of both collaborative opportunities and access to national data.
In July, Friedman received a $1.2 million grant from the National Institute of Aging to study why some older adults living with two or more chronic medical conditions, such as diabetes or heart problems, are more likely than others to succumb to the effects of aging.
Multimorbidity, which means living with multiple conditions, implies a quicker slide to disability and mortality, says Friedman. “The more conditions you have, the more likely you are to suffer from things we typically associate with aging, such as memory loss, disability, or early death.”
The wildcard seems to be the divergent paths people take in response to a double, or triple, diagnosis of bad health news. “Some people with multimorbidity have a reasonably high quality of life and remain active,” Friedman says. “So what are the key differences between these people and the ones who become disabled or cognitively impaired?”
Throughout a five-year study, Friedman and colleagues will look at two possible influences that could enable active and longer lives in spite of the multiple chronic conditions. One is the role of positive psychosocial factors, such as good friends and family and having a greater sense of purpose in life. The other looks at a biological process, inflammation, which could contribute to age-related impairments. He says the idea is that positive psychosocial factors are protective, lowering inflammation levels, and in turn lowering rates of disability to bolster cognitive functioning and extending life.
“Ultimately, the grant helps us conduct basic research to identify relationships that may inform better interventions,” Friedman says.
Through many research lenses
Laura Sands, the Katherine Birck Professor of Nursing, first came to the field of gerontology as a graduate student at the University of California, Berkeley, where she became interested in how chronic disease affected cognitive functioning. When she arrived at Purdue in 2002, she took the chance to cross campus to expand her own research view through various collaborations. CALC provides an interdisciplinary home for faculty experts from more than 20 departments at Purdue.
“Collaborations can be formalized or informal,” Sands says. “The center offers both.”
Though there may be learning curves with any multidisciplinary effort, the research byproduct is often much richer for it. As a health services researcher, Sands says she formulates research questions in a way that is decidedly different from a sociologist. But theory-driven sociologists often help her step back to take a broader perspective in terms of how she poses questions and develops experimental designs.
These days Sands poses very practical questions about how human help can enhance an aging person’s ability to live in a community rather than going to a nursing home. In a grant she’s finishing up from the National Institute on Aging, Sands is looking at the consequences of older adults not having enough help with their disabilities.
“In the long run, the lack of assistance is more expensive,” Sands says. “We’ve been able to show that people who do not have sufficient help for their disabilities are more likely to use costly services and be re-hospitalized. So there are downstream consequences to insufficient help.”
A nursing home setting put Nicholas Turiano (MS HHS’12, PhD HHS’12), then working as an activities coordinator through a semester-long internship at Penn State, on his path to gerontology. “I had always been interested in the psychology of aging,” Turiano says. “In the retirement home I saw some people who were very vibrant, healthy, and outgoing, and others who just seemed withered and miserable.”
Wanting to understand the predictors of aging outcomes, Turiano enrolled at Purdue for the chance to earn a dual-title PhD in gerontology and human development and family studies. “Most schools with gerontology programs talked about a few courses you could take,” he says. “I really decided on Purdue because the Center on Aging and the Life Course was so strong with ample course offerings and diverse research interests.”
Turiano pursued those connections between physiology and psychology, exploring behavioral risk factors that contribute to inflammation, disease, and earlier mortality. In one study he examined personality traits and how the corresponding behaviors could be somewhat hazardous to one’s health. For example, people who are neurotic may be more likely to engage in drinking and smoking, perhaps shortening their life spans. Turiano says the interdisciplinary approach that afforded him mentors from fields as diverse as psychology, sociology, biology, and anthropology helped lead to his current position at the University of Rochester Medical Center, where he is a National Institute of Mental Health Postdoctoral Fellow.
There are few guarantees in life. Growing old gracefully, or otherwise, could be left to biological markers and chance. In aging, the only certainty may be in the vast variety of our aging possibilities.
Options for optimal aging
Ferraro prefers the phrase “optimal aging” to “successful aging.” Who would set the standard for success? Broken in body, maligned with chronic ailments, you could still qualify for optimal aging regardless of your day-to-day functioning. Ferraro’s bottom line seems to be about working with what you have to facilitate that higher quality of life.
Turiano, in a career that’s likely to become more clinical to help better spot those biomarkers linked to longevity, is still learning. “There’s not one recipe for optimal aging,” he says. “There’s too much variability. You can have someone with the five worst risk factors for poor health and, for some reason, they’re perfectly fine.”
Still, the CALC researchers will keep taking the long look — the cradle factors leading to the grave. In another project, Ferraro examined the role of childhood hardship on adult health. “Just consider the types of misfortune — financial stress, abuse, living in a fatherless home, a child’s physical and mental problems,” he says. “Simply counting them up would seem to greatly reduce the likelihood that a person will reach later life disease free.”
But like Turiano, Ferraro is often amazed by the survivors who overcome hardships. “This research is about people and the stories of their lives,” he says. “Some people have incredibly hard lives, but it doesn’t seem to scar them. So there’s this concept of resilience.”
Maybe it’s about easing the journey to the inevitable — multimorbidity bound to a final resting place. Friedman and Ferraro have both studied the benefits of volunteering in older adults. Instilling that sense of purpose even late in life. “Is there something we can do to equip people with psychosocial strengths that might actually change their health outcomes?” Friedman asks.
For all of the evidence pointing to the “downstream consequences” of leaving older adults unattended, consider the positive flipside of understanding the value of providing in-home help so these people can live somewhat independently within their homes and communities. To provide sufficient help to keep an elderly woman from burning or scalding herself, going hungry, or falling would improve her quality of life and ultimately reduce the likelihood of having to place her in a nursing home.
“This is the information we’re getting by analyzing Medicaid and Medicare data,” Sands says. “Information we need to share with policymakers.”
Policy change could be greatly affected by an aging demographic hurtling toward social security benefits. Ferraro is a sociologist who sees himself as a bit of a community organizer. The community happens to be a diverse group of faculty and student researchers that he simply wants to align in order to make great discoveries. “We have a clarion call for what the center’s mission and purpose is about,” he says.
And that’s a research philosophy that will never grow old.
William Meiners is a freelance writer. Illustrations by Shaw Nielsen.