|Rachel Pruchno, PhD, is director of Research at the New Jersey Institute for Successful Aging at SOM, where she also holds positions as University Professor and Endowed Professor of Gerontology.
The demographic tidal wave of aging Americans is awesome. Over the next two decades almost two million people in our country will turn 65 each year, swelling the ranks of this population to 71.5 million by the year 2030. Well over one million of New Jersey’s residents are currently older than 65, a number that is projected to grow to nearly two and a half million by 2025.
To respond to the increasing healthcare needs of this population, the New Jersey Institute for Successful Aging (NJISA) was launched in November 2005. The Institute’s mission is to improve the quality of life of older adults throughout the state by integrating clinical practice, education, and research in geriatrics. NJISA builds on the excellent reputation of the Center for Aging at UMDNJ’s School of Osteopathic Medicine, which has established itself as a first-rate clinical training and education site for medical students and residents in this specialty area. Fall 2006 marks the establishment of our large-scale, longitudinal research program, ORANJ BOWL (Ongoing Research on Aging in New Jersey: Bettering Opportunities for Wellness in Life). ORANJ BOWL will operate as a unique research panel to help specialists in this field better understand what it means to age
successfully. Over the course of the next year, 10,000 New Jersey residents ages 50 to 74 will be recruited through random probability sampling methods to participate in an hour-long telephone interview, and will also have the opportunity to take part in a host of research projects. This model was designed to both lessen the costs of conducting high quality scientific research and to promote collaboration among investigators. It provides a unique resource for conducting research in the areas of geriatrics, social gerontology, clinical trials of drugs and therapeutic protocols; and will also generate data that could be useful in consumer marketing and commercial product development.
ORANJ BOWL data will be collected by the staff of our new, state-of-the-art computer assisted telephone interviewing (CATI) facility. Our CATI facility features one supervisor and 11 interviewer stations, which are linked together and controlled by three separate, but tightly integrated and powerful, computer servers.
Our first CATI data collection project is a nationwide study of women ages 50 to 64 who are working full time and providing unpaid care to a community-dwelling older adult. While the number of middle-aged women faced with the challenges of working full time and providing care to an older family member has grown dramatically over the past several years, little is known about how these women cope with their dual roles. As principal investigator of the BALANCE study, which is funded by the National Institute on Aging, I have had the opportunity to generate a national sample of 350 of these women in just four months using a combination of probability and non-probability recruitment strategies.
Significant health changes are associated with the aging process. The majority of older people have at least one chronic illness, and many suffer from multiple disorders. By age 75, the average American has three chronic medical conditions and uses five different prescription drugs. Hypertension, arthritis, and heart disease are the leading disorders of older people, who also have the highest rate and longest length of hospitalizations and the most office visits with doctors. Yet much of the disability associated with the aging process can be either minimized or prevented.
My staff and I recently completed an intervention study in which older people were randomly assigned to participate in a 12-week Tai Chi program, a 12-week low-impact exercise program, or a control group. Results from our “Memory & Motion” study indicate that participants in both exercise groups improved with respect to grip strength, balance, endurance, lower body strength, sleep disturbances, and anxiety. We concluded that both Tai Chi and low impact exercise are safe and cost-effective ways to improve the physical and psychological functioning of older people. This supports a growing body of knowledge indicating that adopting healthier behaviors can dramatically reduce a person’s risk for many chronic diseases, including the leading
causes of death and disability in this age group.
Improved medical care has changed both the ways that people live and the ways that they die. Chronic diseases and degenerative illnesses have replaced the infectious diseases and acute illnesses that once claimed lives. Yet our current healthcare workforce is too small to provide adequate care for the elders of today, and wholly unprepared for the coming senior boom. The gap between what we know and what we need to know to optimally treat older people continues to grow.
Nowhere is this need more pressing than in end-of-life care. Our OPTIONS study, funded by the National Institute of Nursing Research, focuses on how older patients with end stage renal disease and their spouses make decisions at the end of life. One of the fascinating findings from this study of 315 couples is that most people have little idea about the conditions under which their spouses would want to continue dialysis. These results are troubling because physicians typically rely on next of kin to make these decisions, yet important because they identify an area ripe for intervention.
As we seek to better understand the mechanisms of successful aging, it is exciting to be at UMDNJ, where colleagues from medicine and behavioral science can easily work together. Two university-wide events for faculty involved in research in aging are already on the calendar and will lay the groundwork for future collaborations across the University’s campuses.
Rachel Pruchno earned her PhD in human development and family studies from Pennsylvania State University in 1982. Before joining the SOM faculty in 2004, she held several positions, including director, Initiatives on Aging, and director, Center for Work and Family, at Boston College, and director, Center on Aging, at Bradley University. Dr. Pruchno is an expert on family care-giving, physical and mental health in adulthood and later life, and end-of-life decision-making. She has served on editorial boards of the Journal of Gerontology: Social Science, the Journal of Gerontology: Psychological Sciences, and The Gerontologist, and has led major committees of both the Gerontological Society of America and Division 20 of the American Psychological Association.