Caring for the Aging Brain
Geriatrician Heather Whitson, MD, is the Duke School of Medicine Distinguished Professor in Neuroscience, the director of the Duke Center for the Study of Aging and Human Development, and the co-director of the Duke-UNC Alzheimer’s Disease Research Center. “For me, the true north is to help people maintain function, independence, quality of life, and resilience,” she says.
Duke has the longest continually funded aging center in the country; it’s been funded since 1955. And in 2021 we became a federally funded Center of Excellence for Alzheimer’s Disease Research.
One of our big themes is neuroscience. We’re thinking about protecting the brain and understanding what exposures and events across the lifespan are impacting the aging brain — for example, brain trauma or stroke, chronic inflammation, toxic exposures.
Issues that we used to think of as “below the neck,” we now understand have brain consequences as well: metabolic and cardiovascular disease, the gut microbiome, infection, menopause. We’re looking for opportunities to treat Alzheimer’s disease and other dementias before the disease is obvious. By the time a person is having trouble with thinking or memory, there have been changes happening in the brain for at least a decade.
We are also thinking about resilience. Aging research has often focused on negative things like disability and frailty, and now we’re moving toward understanding the opportunities to help people bounce back after health stressors or other life stressors. Our tools are better than ever to be able to understand that resilience — both molecular and cellular tools and also data tools such as machine learning and bioinformatics to handle complex data.
A third area we’re excited about is reimagining the health system for older patients. They need sustained outpatient management, support with decision-making, lots of communication, attention to goals of care, and coordination. The current system does not lend itself to that. Re-engineering the health system is going to take health care providers, economists, and people who think like industrial engineers.
What Comes Next:
- Neuroscience: Using New Technologies to Understand the Brain
- Medical Education: Training Students to be Change Agents
- Vaccines: Fine-tuning Immune Response
- Health Equity: Addressing Disparities in Pallative Care
- Cancer Research and Care: Personalized and More Effective Therapies
- Epidemiology and Population Health: Reaching Beyond Our Walls
- Integrative Immunobiology: Unraveling the Mysteries of the Human Immune System
- Genomics and Precision Health: Using Genetic Tools to Prevent Disease
Story originally published in DukeMed Alumni News, Fall 2024.
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