Vitality Magazine Fall 2022

Secrets of SuperAgers

A new project aims to provide life lessons from the people who are redefining old age.

USC LEONARD DAVIS SCHOOL OF GERONTOLOGY

DEAN’S MESSAGE

“I could not be prouder of the collective efforts of everyone associated with our school and with all that we have achieved.”

Dear USC Leonard Davis School community,

As I begin my third term as dean of the USC Leonard Davis School of Gerontology, I think about how much has happened in the world and at the Leonard Davis School since I was first appointed dean in 2011. We have seen three United States presidents serve in office, we have experienced a worldwide pandemic, and we’ve crossed over into an era in which older adults now outnumber children.

During this time, the USC Leonard Davis School has reached several historic milestones. For instance, this past spring we once again celebrated our largest-ever graduating class. With more new and innovative program offerings, we’ve continually grown our student body year over year, which is a clear testament to how our education evolves to meet current and future needs in our field.

Our research programs also continue to grow and expand, in terms of both content and funding. We are well-positioned to make great advances in several research areas, ranging from precision aging and age tech to health disparities and the long-term impacts of the COVID-19 pandemic.

I could not be prouder of the collective efforts of everyone associated with our school and with all that we have achieved. Over the next five years of my term, I look forward to working with our students, faculty, staff, alumni, and friends to continue in our mission to promote healthy aging for everyone.

Fight On!

Pinchas Cohen MD Dean, USC Leonard Davis School of Gerontology

Photo: Stephanie Kleinman

BITES

AWARDS

Eileen Crimmins

USC Provost’s Mentoring Award; Election to the American Academy of Arts and Sciences

Kelvin Davies Nicolaus Copernicus Medal, University of Ferrara, Italy

Jon Pynoos

M. Powell Lawton Award, Gerontological Society of America

Bérénice Benayoun

R35 Maximizing Investigators’ Research Award, National Institute of General Medical Sciences

Ryo Sanabria Glenn Foundation for Medical Research and AFAR Grant for Junior Faculty; Larry L. Hillblom Foundation Start-Up Research Grant

Joshua Johnson

SPOTLIGHT

Teal Eich, assistant professor of gerontology and psychology, recently received research funding from the National Institutes of Health and the Alzheimer’s Association for her investigation into the role of gammaaminobutyric acid (GABA) in Alzheimer’s disease. Eich, who arrived at USC in 2019, is a cognitive neuroscientist whose research explores age-related changes to memory, cognition and executive functioning.

GABA is an inhibitory neurotransmitter, a chemical messenger that can block certain signals from being transmitted in the brain and spinal cord. Per the Cleveland Clinic, GABA is thought to play important roles in reducing stress and anxiety and improving sleep, while a shortage or imbalance of GABA levels is associated with several conditions, such as depression and other mood disorders. Studies using animals have indicated that GABA plays a critical role in memory by regulating neuronal activity in the brain’s hippocampus.

QUOTABLE

Part-Time/Adjunct Faculty Honor, Gerontological Society of America

“I’m very lucky to have had such wonderful colleagues ... I’m deeply humbled and grateful.”

— Kelvin Davies, Distinguished Professor Emeritus, during a Festschrift honoring his achievements and retirement hosted by the USC Leonard Davis School on September 9, 2022. Colleagues and former students discussed their work and shared how Davies helped shape their careers.

The California Southland Chapter of the Alzheimer’s Association named Eich a 2022 Research Grant recipient for her study of whether GABA levels can predict memory deficits in people at risk for Alzheimer’s. The award provides nearly $150,000 in research funding.

Eich also received an R01 grant from the National Institute on Aging to investigate the impact of sex on GABA, brain activity, and episodic memory in middle-aged and older adults at risk for Alzheimer’s. The grant provides more than $4 million in total funding over five years. — B.N

Photos: Natalie Avunjian, Stephanie Kleinman, John Skalicky

Gallery Exhibit Inspired by Nature

After a long pause during the pandemic, the Sophie Davis Art Gallery is pleased to present an exhibit by Seattle-based artist Maureen Mitchell, “Freedom to Fly,” showcasing 18 works of acrylic mixed media

It is Mitchell’s hope that her work “inspires a desire to reconnect to earth and nature, encouraging us to listen, respect and take greater care of our precious planet, so that in doing so we take care of ourselves, our future generations and fellow creatures.”

Per the artist’s statement, Mitchell’s process starts with taking hikes, sketches, and photographs and mixes elements from different pictures together. She then creates backgrounds from hand-painted paper monoprints, collaging them together and adding layers of acrylic glazes. The end product is a richly textured, highly colored 3-D effect.

When considering what it means to be an “older” artist, Mitchell shared, “I just turned 71, and I feel like I am just getting started! Getting older, it’s just so freeing. You stop thinking about what everyone else is thinking and focus on what comes from your heart.”

Housing Mitchell’s works, the Sophie Davis Art Gallery is a meditative place for students, staff, faculty, and community members to seek a moment of solace and connect with the beauty of nature.

Freedom to Fly will be on display through December 2022.

GLOSSARY Resilience

The process and outcome of successfully adapting to difficult or challenging life experiences.

- American Psychological Association

Metaverse A virtual-reality space in which users can interact with a computergenerated environment and other users.

- Oxford Dictionary

Myelin

An insulating sheath around nerve fibers that increases the speed at which impulses are conducted.

- Merriam-Webster Dictionary

POSTCARD

Artist Maureen Mitchell discusses her “Freedom to Fly” exhibit, on display in the Sophie Davis Art Gallery.

Photo: Nataiie Avunjian

BITES

IN THE MEDIA CBS This Morning

Living to 100: One island’s remarkable record of centenarians

“If you think about an athlete that wins lots of gold medals, you probably have to have the genetics. But then you have to have the training, et cetera, et cetera. So, I think that the genetics set you up, but they’re not gonna get you there alone. So then, the lifestyle, and particularly the food, is a key factor.”

– Professor Valter Longo

INTERVIEW

“Our study helps clarify the association between social stress and faster immune aging. It also highlights potential ways to slow down immune aging, such as changing how people cope with stress and improving lifestyle behaviors around diet, smoking and exercise.”

— Postdoctoral Scholar Eric Klopack, in a column for the Washington Post (via The Conversation) on how exposure to social stress can speed up the aging of the immune system.

U.S. News & World Report

Lives Cut Short: COVID-19’s Heavy Burden on Older Latinos

“A three-year reduction in life expectancy is huge in historical terms. We usually have not seen reductions this large except during times of war or major pandemics.”

– Postdoctoral Scholar Theresa Andrasfay

Los Angeles Times

USC researchers identify symptoms associated with increased risk for long COVID “These people are not able to do necessarily all the activities they would want to do, not able to fully work and take care of their families. That’s an aspect of this disease that needs to be recognized, because it’s not really as benign as some people think. Even people who have relatively few symptoms to start with can end up with long COVID.”

– University Professor Eileen Crimmins

Washington Post

A potential connection between dementia and air pollution

“The main point is we now realize that Alzheimer’s disease is very sensitive to environmental effects, including air pollution.”

– University Professor Caleb Finch

New York Times; Financial Advisor

To Pay for Longer, Later Retirements, Consult a “Financial Gerontologist” “When advising about retirement options, like whether to save money by moving to a different community, a financial gerontologist would consider factors like risk of social isolation, access to health care or opportunities for meaningful engagement in addition to only financial impacts.”

– Senior Associate Dean Maria Henke

Los Angeles Times

California’s seniors living in poverty struggle without retirement savings “Sometimes, people have enough where they don’t qualify for medical [needs], and they have to skim down to poverty and that’s emotionally difficult for them. ... People are more likely to become depressed and anxious related to the lack of support that they can have around these long-term care services.”

– USC Family Caregiver Support Center Director Donna Benton

Health Magazine

Omicron Boosters Could Save 90K Lives

This Winter — But Only if People Get Them “It’s not a strong belief, like ‘I’m not going to get boosted,’ is my sense. ... You definitely don’t have that kind of ease that you had at the beginning. And I just think a lot of people are done with it—a lot of people don’t go rush out and get their flu shot either, so I see it as a very similar thing.”

– Associate Professor Mireille Jacobson

Los Angeles Times

He’s America’s oldest competitive snowboarder at 76. Just try keeping up “Our conditions of living have improved. We’re less likely to have accidents and injuries than in the past. Our world is a healthier, safer world than it used to be. … Exercise science and the science behind competition have also improved over time, so that athletes just have more longevity than they’ve ever had before.”

– Associate Professor Jennifer Ailshire

Photo: Beth Newcomb

DISCOVERY

ScienceDaily

How the brain’s blue spot helps us focus our attention

“Due to its small size and its location deep in the brainstem, it was previously almost impossible to investigate the noradrenergic nucleus non-invasively in living humans. Fortunately, over the past years, animal research has revealed that fluctuations in pupil size are linked to the activity of the blue spot. Thus, our eyes can be regarded as a window to a brain region that long seemed inaccessible,”

– Professor Mara Mather

Consumer Reports

How Older Adults Can Meet Their Protein Needs

“While [protein drinks and enriched foods] may be high in protein, someone eating a predominantly plant-based diet would still need to be sure they were balancing protein sources to not be deficient in single amino acids that are considered essential.”

– Master of Science in Nutrition, Healthspan and Longevity Program Director Carin Kreutzer

Next Avenue

The Former Lead Singer of The Donnas Has a New Beat: Gerontology

– Brett Anderson, MSG ’22 Illustration: iStock/Naeblys

“Sometimes, members of the aging population don’t know how to obtain the medical or physical treatments they need because they don’t know how to get the processes started. I want to help them get set up with the resources they need. Once they can have stability in those areas, then we can focus on the emotional needs.”

Newly Identified Protein Connected to Alzheimer’s Disease Risk

CBS News featured research led by Pinchas Cohen on a newly discovered microprotein linked to Alzheimer’s disease risk that may provide a possible target for treatment.

The tiny “microprotein,” called SHMOOSE, is a encoded by a newly discovered gene within the cell’s energy-producing mitochondria. A mutation within this gene partially inactivates the SHMOOSE microprotein and is associated with a 30% higher risk for Alzheimer’s disease across four different cohorts. Nearly a quarter of people of European ancestry have the mutated version of the protein, according to Cohen and colleagues.

“This discovery opens exciting new directions for developing precision medicine-based therapies for Alzheimer’s disease, focusing on SHMOOSE as a target area,” Cohen said.

Brendan Miller, the study’s first author, said the findings highlight the importance of the relatively new field of microproteins. For decades, scientists have studied biology mostly by considering a set of 20,000 large protein-coding genes. However, new technology has highlighted hundreds of thousands of potential genes that encode smaller microproteins.

“The field of microproteins is still so new,” Miller said. “We don’t yet know how many microprotein genes are even functional, and the cost to study a potential microprotein one-by-one from a list of thousands is just too expensive and inefficient. The approach my colleagues and I used to detect SHMOOSE shows the power of integrating big genetics data with molecular and biochemical techniques to discover functional microproteins.”

The Hill, The Times (UK), Kaiser Health News, Telegraph (UK), Genetic Engineering and Biotechnology News, Technology Networks, Medical News Today, Neuroscience News, Mint (India), GenomeWeb, KFIam 640, MyNewsLA, Daily Mail, Talker, Annenberg Media, and Science Daily also covered the study, which was published in the journal Molecular Psychiatry in September 2022.

BITES

FINDINGS Advance Directives Associated With Lower Outof-Pocket Hospital Costs

Patients with advance directives spent significantly less money on end-of-life hospital care than those without them, according to a USC Leonard Davis study published in the Journal of Hospital Medicine.

Advance directives are legal documents that lay out the health care treatments a person would want to receive or skip. They are associated with greater chances of meeting end-of-life wishes, lower health care costs, use of fewer health care services and a lower chance of dying in a hospital.

This study is the first to focus on patient out-of-pocket hospital costs alone, which researchers theorized relate to the type of end-of-life choices — such as aggressive versus comfort care — that are specified in advance directives.

The researchers found that of those who had completed advance directives, 90% expressed a desire to limit care or to be kept comfortable, and 79% indicated that they wanted to have treatment withheld. Only 6% wanted to prolong life. Choosing to limit

care was significantly associated with lower out-of-pocket hospital costs.

In addition, among patients with the very highest out-of-pocket costs, those with advance directives spent around $100,000 less than those without them. On average, advance directives were associated with savings of $673 in out-of-pocket costs.

“The takeaway here is that you should complete an advance directive as early as possible,” said lead author Yujun Zhu, a doctoral student at the USC Leonard Davis School, noting that last-minute decisions can be high on emotion and short on thorough consideration, education and discussion: “Start when you are healthy, and revisit your choices regularly.” — O.B.

Article Outlines Characteristics of “Longevity Diet”

Examining a range of nutrition research— from studies in laboratory animals to epidemiological research in human populations — provides a clearer picture of the best diet for a longer, healthier life, said USC Leonard Davis School of Gerontology Professor Valter Longo.

In an article that includes a literature review published in Cell, Longo and coauthor Rozalyn Anderson of the University of Wisconsin describe the “longevity diet,” a multi-pillar approach based on studies of various aspects of diet, from food composition and calorie intake to the length and frequency of fasting periods. Longo and Anderson reviewed hundreds of studies on nutrition, diseases and longevity in laboratory animals and humans, and combined them with their own studies on nutrients and aging.

–Valter Longo, professor of gerontology and biological sciences, describing what the “longevity diet” could look like in real life.

The authors report that the key characteristics of the optimal diet appear to be moderate to high carbohydrate intake from nonrefined sources, low but sufficient protein from largely plant-based sources, and enough plant-based fats to provide about 30% of energy needs. Ideally, the day’s meals would all occur within a window

“Lots of legumes, whole grains and vegetables; some fish; no red meat or processed meat, and very low white meat; low sugar and refined grains; good levels of nuts and olive oil; and some dark chocolate. ”

of 11-12 hours, allowing for a daily period of fasting. Additionally, a five-day cycle of a fasting or fasting-mimicking diet every three to four months may also help reduce insulin resistance, blood pressure and other risk factors for individuals with increased disease risks.

Longo described what a longevity diet could look like in real life: “Lots of legumes, whole grains and vegetables; some fish; no red meat or processed meat, and very low white meat; low sugar and refined grains; good levels of nuts and olive oil; and some dark chocolate.” — B.N.

Study IDs Gene Variants Linked to Mobility Changes During Aging

USC Leonard Davis School scientists have discovered genetic variations in a mitochondrial enzyme that may contribute to agerelated changes in strength and mobility.

The research, published in eLife in May 2022, identifies specific genetic contributors associated with age-related muscle loss, a condition connected to a decline in quality of life, an increased risk of falls, and sarcopenia, which is the progressive loss of strength and performance that impacts up

to half of older adults.

Curran and colleagues discovered mutations associated with premature decline in mobility in the roundworm C. elegans.

The team, led by Professor Sean Curran, screened the roundworm C. elegans for genetic mutations that contribute to a buildup of oxidative stress, a process that can cause cell damage in muscle tissue. They found that mutations in a mitochondrial gene called ALH-6 were strongly associated with stress responses, specifically in the muscle. Over time, worms with these mutations displayed premature declines in mobility, with slower crawling and swimming.

Next, the team analyzed data from the U.S. Health and Retirement Study to see whether genetic variants in the human equivalent of this gene, called ALDH4A1, were also linked to age-related mobility changes. The researchers found that older adults with certain variations in the ALDH4A1 gene had slower walking speeds and reduced hand strength as they aged.

The study adds to previous USC Leonard Davis School research related to mitochondrial proteins and muscle mass and provides a model for understanding the complex role mitochondria play in organismal health over the lifespan.

“Building on our work in this way could help with identifying new predictors of age-related changes in muscle health and other age-related conditions,” Curran said.

“The takeaway here is that

should complete an advance directive as early as possible. ... Start when you are healthy, and revisit your choices regularly. ” –Yujun Zhu, PhD in Gerontology student, on the importance of completing advance directives and documenting care preferences.

$673

average amount of hospital out-of-pocket costs saved by patients with advance directives versus patients without them

you

Photo: courtesy Curran Laboratory

$1.8M

NIA funding over five years to improve representation and diversity in aging study

NEW DIRECTIONS

School Awarded Nearly $2M for Undergrad Research

The USC Leonard Davis School is diversifying participation in aging and health disparities research with a first-of-its-kind undergraduate training, education, and mentoring program.

The Gerontology Enriching MSTEM (GEMSTEM) to Enhance Diversity in Aging program is funded by a five-year, $1.8 million grant from the National Institute on Aging and is designed specifically to overcome longstanding financial, social support and professional barriers that have limited aging research opportunities for undergraduate students from diverse backgrounds.

The program will recruit undergraduates from within the USC Leonard Davis School and across USC, including transfer students from two- and four-year colleges that serve underrepresented minority students. In addition to paid research opportunities, it will provide gerontology education, professional

development, and a peer and community network.

“Meeting the needs of our increasingly older and diverse population will require greater efforts to attract talented students to aging research training and careers,” said principal investigator Sean Curran, vice dean and the James E. Birren Chair in Gerontology at the USC Leonard Davis School.

“The GEMSTEM program will increase representation and diversity in the biomedical aging workforce and our capacity for addressing persistent, and seemingly intractable, health disparities in aging.” — O.B.

FCSC

Receives Renewal

Grant, Innovation Award

The USC Family Caregiver Support Center (FCSC) has received a five-year, $8.5 million renewal grant for the Los Angeles Caregiver Resource Center (LACRC), as well as an award recognizing its program serving Persian/Farsi-speaking caregivers.

Among the plans for the LACRC’s next five years: more education for caregivers providing hands-on care to individuals with complex health issues, as well more flexible delivery options for support and education, said Family Caregiver Support Center Director and Research Associate Professor of Gerontology Donna Benton.

Another FCSC program, Ghofetegou Koneem for Caring Families (GKCF), was recently recognized with a 2022 Family Caregiver Services Innovation Award from the Los Angeles Alliance for Community Health and Aging. GKCF was developed to help Persian/Farsi-speaking caregivers in Los Angeles reduce their burden and manage their daily role in caring for loved ones with Alzheimer’s disease and related dementia. “Ghofetegou Koneem” means “talk to each other” in Farsi, a reference to the program’s informal, in-person support groups for caregivers. The program is funded by the Los Angeles Jewish Federation and is a collaboration between the Family Caregiver Support Center and Sinai Adult Day Health Care. — B.N.

Photo: courtesy of SmithGroup

Ryo Sanabria, assistant professor of gerontology, discussed their research on how cells respond to stress, how exposure to stress impacts aging, and how aging affects the ability to deal with stress.

Q: What is the main focus of your research at the Leonard Davis School?

A: I’m interested in the intersection between stress and aging. This includes how organisms respond to stress, how stress impacts aging, and how organisms respond to stress at the cellular level. Stressors that affect us at the cell level can include heat, oxidation, infection, caloric restriction, and more.

Q: What do we know about what happens to stress responses as we age?

A: Almost all currently known stress responses show functional breakdown during the aging process. Essentially, in aged organisms, exposure to stress is more deadly than in young organisms due to their decreased capacity to mount a response to the stress — in other words, older organisms are more sensitive to stress. The more you can recover from stress, the healthier you are, but with aging there is less response to and recovery from stressors. This raises the question of “If you can take a young person’s stress resilience and give it to an older individual, will the older individual be healthier?”

Q: Which parts of cells’ stress responses are you most interested in?

A: My lab has studied stress responses in three areas: the endoplasmic reticulum, which acts as a ”factory” for proteins, lipids, and other molecules within the cell; the mitochondria, where cells’ energy is produced; and the actin cytoskeleton, which helps cells keep or change their shape as needed. Each of these systems has unique ways to respond to stress and maintain their health and function.

Q: What’s coming next for research into how cells respond to stress?

A: Recent research has increasingly indicated that these stress responses can’t be studied in isolation. The cell is like a factory: If one part isn’t working right, that’s going to affect the rest of the cell and whether it can carry out its functions. We want to know how stress responses in one compartment can affect other compartments, as well as whether stress is communicated across different cells. For example, we are interested in identifying which specific neurons (the cells of the brain) are responsible for sensing stress and coordinating a wholebody response.

Photo: Stephanie Kleinman

VITAL SIGNS

–Jennifer Ailshire, associate professor of gerontology and sociology

Stress, Aging, and the Importance of Resilience

Stress, as well as the resilience needed to respond to life’s stressors, comes in many different forms and plays different roles in how we age. This year’s United Nations International Day of Older Persons observance was themed around stress and the resilience of older adults, especially women. During an International Day of Older Persons event hosted by the USC Leonard Davis School on September 30, 2022, several experts shared their perspectives on how to promote resilience.

BETTER WITH TIME

Professor Mara Mather discussed how emotional resilience can increase with age and how older adults demonstrate a “positivity effect,” paying more attention to and remembering more positive things versus negative things.

“It’s actually surprising, if you think about the challenges that people are facing as they

head into their 40s and their 50s – life gets harder. There are more responsibilities as people get into their 60s and 70s. They also are facing more of their friends and loved ones who are ill or might even have died,” she said. “So, there are lots of challenges, yet everyday emotion is improving.”

SOCIAL SUPPORT IS KEY

Associate Professor Jennifer Ailshire and Research Associate Professor Donna Benton both emphasized the importance of a strong social network for community and caregiving resilience. A supportive social network can protect against stress, from the stress of caregiving to the effects of environmental challenges such as air pollution.

“We need to support healthy aging not just at the individual level but at the community level,” Ailshire said.

Benton added that an increase in complex caregiving as well as more women bal-

“We need to support healthy aging not just at the individual level but at the community level.”

Photo: iStock/Nadya So

ancing work and caring for families means that we need to address caregiving at the public policy level to improve well-being and increase resilience in caregivers.

“We need support as part of resiliency,” she said. “We need policies that support leave to take time to balance work and family responsibilities.”

FINANCIAL RESILIENCE IN WOMEN

USC Leonard Davis School Board of Councilors members Kathleen Gilmore and MeiLee Ney discussed their careers in finance and the advice they had for women who want to become more resilient to economic challenges.

Ney especially emphasized the importance of continually seeking out knowledge and becoming more financially literate: “Competence and confidence feed off one another.”

Gilmore discussed how saving even a small amount of money regularly could have huge benefits, as well as finding mentors whose support aligns with one’s goals. “What we’re really talking about is investing in ourselves,” she said. “Pay yourself first; invest in your own human capital.”

EMBRACING CHALLENGES AND CHANGE

Alumna Brett Anderson MSG ’22, now an associate clinical social worker, discussed facing challenges head-on. She said her experience founding an all-female rock band, The Donnas, as a teenager in the male-dominated rock-and-roll industry helped her develop a “thick skin” and encouraged her to embrace challenges, which she also tapped into when she went back to school as an adult.

“You have to reappraise the way you think of failure,” she said. “It makes you more willing to take risks. It’s important to

put ourselves in situations where we’re not the experts.”

Fellow alumna Zora Benhamou MAG ’22, founder of HackMyAge.com and a “digital nomad” who has lived in many countries across the world, said that experiencing new places and societies has been a way for her to “seek discomfort” and feel more comfortable with tackling change.

“I’ve been constantly changing and adapting to new environments,” she said. “With each move it became a little bit easier, [and] I built some resilience.”

Recently, Benhamou worked with a group of volunteers to help Ukrainian refugees resettle in Poland. She noted that refugees’ resilience, and the support provided by the rest of the world, would make a difference in how the conflict affected Ukrainians for years to come.

“When you leave as a refugee, you are saying goodbye to family and friends and experiencing cultural differences very suddenly,” she said. “Their resilience is being challenged now, and only time will tell how it will impact health and well-being.” — B.N.

Learn more about stress and resilience by listening to the Lessons in Lifespan Health podcast at lifespanhealth.usc.edu.

BITES

Rachael Geary, Dialogue Society at USC member

USC Chapter of Dialogue Society Focuses on Outreach to Older Adults

USC is home to the newest chapter of Dialogue Society, a student-led organization focused on promoting meaningful dialogues about healthy, purposeful and mindful living and inspiring personal development. Joining forces with existing chapters at UCLA and UCI, the USC chapter focuses on student outreach to older adults, including those living in senior communities.

Since the chapter’s formation in 2021, the organization has held a variety of events relating to physical, mental, and social wellness. Fall 2021 was the first fully active semester, during which the organization held online events as well as Dialogue Society’s first in-person events since the beginning of the pandemic. Successful collaboration with the UCLA chapter resulted in two scamprevention workshops for seniors at Belmont Senior Living in Westwood and EngAGE at Piedmont Senior Apartments in North Hollywood.

“As technology becomes increasingly present in our lives, it is important to be aware of potential cybersecurity risks, so we educated the seniors about safe technology practices and gave them a chance to ask questions and share any past experiences they had with scams,” said USC chapter fundraising chair Sanjana Paye, major in quantitative biology and minor in science, health and aging.

Dialogue Society at USC has also held Storytelling Sessions. These workshops ask students and seniors to write short stories and share their stories with each other. The workshops have included prompts such as, “What advice would you tell your 16-yearold self?,” “Recall memories with a childhood friend,” and “Tell a story regarding your favorite song.”

“Seniors and students alike enjoy connecting and learning in this way with each other,” said Dialogue Society member

SERVICE

“Seniors and students alike enjoy connecting and learning in this way with each other.”

–

Photos: courtesy of Dialogue Society at USC

Rachael Geary, graduate student in visual anthropology.

Sharing stories with each other in an intimate setting allowed students and seniors to listen deeply to one another’s experiences, creating a space for stories of the past to live in the present. As seniors and students are relearning how to navigate in a world with COVID-19, being able to connect with seniors in this event, even virtually, creates a sense of calmness and community that many feel is needed now, said member Misa Belser.

Dialogue Society at USC started a new series of events in the 2022 Spring Semester, beginning with a workshop in collaboration with ORBIT, a student organization in the Herman Ostrow School of Dentistry of USC. Doctor of Dental Surgery and Master of Science in Gerontology student Jessica Kim, the chapter’s outreach director, connected Dialogue Society to ORBIT. The collaboration focused on older adult oral health and was hosted by Ivy Park at Culver City on March 19. In this event, participants were educated on how to maintain good oral health and hygiene. Ninety oral hygiene instruction (OHI) kits were gifted to all residents and caregivers at the center. The event was partly funded by the Graduate Student Government at USC, and OHI kits were sponsored by Oral-B and Crest.

Dialogue Society also collaborated with USC Advocates for Healthy Aging (AHA), a student volunteer organization aiming to enrich the lives of older adults in retirement communities, in organizing the Sticker Sale and Donation Drive at the Trojan Farmers Market.

“All PAWS/LA sticker revenue and donations were directly given back to PAWS/LA to help low-income seniors, veterans, and people disabled by illness keep and care for their pets,” said Secretary and Marketing Chair Keran Chen, major in Human Development and Aging. During a second collaboration with AHA, volunteers worked with the LA Food Bank to assemble food packages for low-income seniors of Los Angeles County.

The organization intends to hold new and varied events in the future. Upcom-

ing events include an older adult nutrition workshop, another oral health workshop in collaboration with ORBIT, and events in partnership with USC’s National Alliance on Mental Illness. Dialogue Society at USC encourages members to take the lead on events and pursue directions that are of personal interest to them, while keeping in mind the needs and interests of their senior communities. Students of any major who are interested in volunteering can find more information at dialoguesociety.us.

— Release courtesy of Dialogue Society at USC

This page and previous: Dialogue Society members teamed up with ORBIT, a dental student organization at USC, to provide oral hygiene kits and instruction to older adults at Ivy Park in Culver City on March 19, 2022.

A new project aims to provide life lessons from the people who are redefining old age.

uncovering the secrets of superagers

By Orli Belman

AT 96 YEARS OLD, SCULPTOR THADDEUS MOSLEY has never been more in demand. The Baltimore Museum of Art showcased five of his recent works as part of a traveling tour that is also scheduled to stop in Los Angeles. Mosley created three large sculptures for a 2020 display at Rockefeller Center, and he is the subject of a soon-to-open exhibition at the Louvre-affiliated Eugène Delacroix Museum in Paris.

In his Pittsburgh studio, Mosley creates abstract sculptures carved from salvaged wood through an improvisational process he compares to the jazz music he loves and listens to as he works.

“I have no intention of retiring as long as I’m physically able to work,” he said. “It’s just like music — you just keep playing, you just keep working. And it is something I like to do.”

In the art world, Mosley is regarded as a prolific innovator. In the gerontology world, the nonagenarian is recognized as something else. Mosley is a SuperAger. >>

Photo by Nate Guidry

MAYBELLE BLAIR AGE 95

Maybelle Blair is a both an athlete and an activist. She spent one season as a Peoria Redwing and is one of the few surviving members of the All-American Girls Professional Baseball League. Though her baseball career was brief, she never stopped fighting to give more women and girls the chance to play. She’s been called a force of nature for her tireless efforts on behalf of Baseball for All, a nonprofit organization that works to build gender equity by creating opportunities for girls to play, coach and lead in the sport. And her advocacy doesn’t stop there. Earlier this year, she came out as gay, revealing a secret she’s kept her whole life to help spare others the experience of living in the closet. Here is what she told the Los Angeles Times in August:

“My whole family came out and supported me. Thank goodness. Because I was worried. At my age, I didn’t know what they would think or if they would disown me, but it had to come out because I had to help, if I could, all these young girls so they wouldn’t have to go through what I had to go through. If I could just tell a few, I was very happy with that.”

“SuperAgers are not just people who have lived to old ages. They’ve lived to old ages with the social, physical and mental state of a much younger person,” said Jennifer Ailshire, associate professor of gerontology. “SuperAgers are the people who are redefining what old age looks like.”

Mosley cooks. He goes to jazz clubs. And he spends six to eight hours a day in his studio, maintaining a work ethic and positive outlook that show no signs of slowing.

“I celebrate life every day,” he said. “I am always eager to get here, and always eager to get to work.”

Researchers believe that learning from SuperAgers such as Mosley can provide some clues to help the rest of us live longer, healthier lives.

That is the goal of an ambitious new project at the USC Leonard Davis School that's supported by funding from the M Center of Excellence. The formal name is the Lifetime Circumstances Predicting Exceptional Longevity Project. Informally, the research team says they are working to uncover the secrets of SuperAgers.

“This project is going to try to reveal the realities of super-aging,” said University Professor Eileen Crimmins, who is co-leading the project with Ailshire. “We aim to examine the social, psychological and health characteristics of SuperAgers and produce insights into what works for different people and how society should best plan for future longevity.”

The project builds on earlier research the pair published that looked at the lives of exceptionally longlived Americans, a rare but growing subset of the U.S population that is expected to increase sixfold by 2050. One previous study looked at whether longer lives are healthier lives, and concluded that some centenarians and near-centenarians achieve exceptional longevity in relatively good health and without loss of functioning. Another study found that the oldest old are more satisfied with life, are better able to maintain social relationships with family and friends, and receive more social support than younger older adults.

Their previous and current research leverages nationally representative data sets collected over the past two to three decades. As more people have grown older, these data sets — including the Health and Retirement Study — have amassed a wealth of information on social, behavioral and psychological factors for people who have lived to be around 100 years old. The sets include data on specific life circumstances that include jobs, marriage, military service, traumas, family, community and support from friends.

Photo by Taylor Glascock/The New York Times

“Our focus now is on identifying psychosocial factors, including levels of satisfaction, happiness and social relationships, that can help provide clues to better aging,” said Crimmins. “While others have looked at the genetic factors linked to very old survival, we believe that also incorporating the social factors will provide insights as to why many people survive longer than average and can provide a roadmap for best practices and policies that can benefit current and future generations.”

Crimmins argues that incorporating social and behavioral factors alongside biological mechanisms is critical for making meaningful advancements in aging research and for promoting healthy longevity.

In fact, a 2020 study by Crimmins found that when it comes to our health as we age, social factors may play a stronger role than biological ones. Even when controlling for biological measurements — including blood pressure, genetic risk factors, mitochondrial DNA copy number and more — social differences such as education, minority status, psychological states and health behaviors, along with demographic factors such as age

and gender, explained most of the differences in aging outcomes between study subjects, she said.

For example, loneliness and isolation are associated with shorter lives and poorer health, while other evidence points to the brain-boosting benefits of playing an instrument or learning a second language. In addition, living with purpose, maintaining a healthy diet, exercising regularly and socializing with others have all been linked to longer, healthier lives.

These findings don’t surprise Los Angeles resident and SuperAger Frances Ito. At age 90, she gardens, hula dances, plays the ukulele and attends regular Bible study. She credits a mostly vegetarian diet, physical activity and social connections as being key factors in her longevity. She also believes a positive attitude is essential.

“I think it’s just [your] state of mind that really encourages you to be healthy,” she said. “I think if you are negative and self-talk about ‘Oh, I can’t do this’ or ‘Oh, I can’t do that,’ oh, boy — you’re in trouble.”

FRANCES ITO AGE 90

Whether she is walking, gardening, dancing, making music or films, Fran Ito never seems to stop moving. Her busy schedule of nonstop activities is both a fact and a philosophy. The Hawaii native began working in a pineapple cannery as a teen, spent 50 years as an office manager, and then began making movies in her late 70s. She says staying active is one key to longevity. Among her other tips: When it comes to family differences — “Get over it," she says.

“Family is so important. No matter how diverse they are in their thinking, politically or religiously, you still embrace your family. You should love them. If you can provide for them, you do. If you can encourage them, you do.”

Photo by Dario Griffin

NORMAN LEAR AGE 100

Lox and bagels, the love of his family, laughter and a life of invigorating work — these are what Norman Lear calls the keys to his healthy longevity.

The prolific producer, writer and director turned 100 on July 27, 2022, and still maintains an active professional, social and civic life. He reportedly has several TV shows in development, and he marked his centennial birthday by penning an opinion piece for The New York Times. In the essay, he reflected on his first century and called for people to work together going forward.

“Let us encourage one another with visions of a shared future. And let us bring all the grit and openheartedness and creative spirit we can muster to gather together and build that future,” he wrote.

A main mission of the SuperAger project is to disseminate the findings to a wide audience. A recently launched website includes interactive charts showing where centenarians are living and short videos featuring Ito and other SuperAgers in their daily lives.

The project also aims to gather relevant data and conduct additional studies to show how quickly centenarian populations are growing in countries around the world; understand whether there are countries where the oldest old are faring better than in others; and explore whether these longest-lived adults are happy, depressed, lonely or satisfied with life.

While earlier research underscored the importance of examining variation in the growing centenarian population, it was limited due to small sample sizes and lack of reliable records.

“Because there were few sources of data on the oldest old, and even less research on the psychosocial characteristics of the longest-lived, our understanding of longevity and quality of life was limited,” said Ailshire. “The current research benefits from better record keeping of births and deaths beginning around a century ago.”

According to the researchers, it will now be easier to investigate disputes like the recent dust-up over whether the world’s longest-lived person, France’s Jean Calment — who died at the age of 122 — was actually her daughter in disguise (she was not). Another benefit of the current project is that it delves beyond data and gleans life lessons directly from SuperAgers like Mosley. His advice:

“Believe in what you can do, because no one knows what your capabilities are. It is up to you to see how far you can go.”

Learn more about the Lifetime Circumstances Predicting Exceptional Longevity Project at: bit.ly/SuperAgersUSC

Photo by Chris Pizzello/Invision/AP

A Winning Partnership

BY BETH NEWCOMB

n February 11, 2022, two days before the Los Angeles Rams’ Super Bowl LVI win, Henrietta Dunlap-Mabin was already on the front porch cheering — for a team of eight volunteers who spent the day painting her mother’s house, landscaping the yard and installing new solar lights beside the front walk. The house also sported new kitchen cabinets, a spacious walk-in shower in place of the old bathtub, new handrails on the front and back steps, and numerous other safety-enhancing repairs that volunteers had completed on previous visits to the home in South Los Angeles.

“I can’t believe it,” Dunlap-Mabin said. “I’m amazed at what they can do.”

Dunlap-Mabin, 65, travels to Los Angeles from Las Vegas multiple times each week to care for her mother, 85-year-old Annie May Anderson, who faces challenges with mobility and dementia. As she worked to make the home safer for her mother, Dunlap-Mabin learned about the nonprofit Rebuilding Together, made up of more than 120 affiliates across the country that provide home repairs and modifications to help community members stay in their homes.

The extensive renovations to Anderson’s home were part of this year’s Kickoff to Rebuild, a partnership among Rebuilding Together, home improvement retailer Lowe’s, Omaze, and other community partners, including the USC Leonard Davis School of Gerontology,

Top: Leon Watts shows a new handrail installed by Rebuilding Together volunteers. Previous page and above: Rebuilding Together and volunteers provided critical repairs for 16 families in Los Angeles’ View Park neighborhood as part of Kickoff to Rebuild.

USC LEONARD DAVIS SCHOOL AND REBUILDING TOGETHER TEAM UP TO SERVE ANGELENOS IN NEED AND TEACH PROFESSIONALS HOW TO HELP OLDER ADULTS AGE SAFELY AT HOME.

Photos: courtesy of Eckel & Vaughan Group, Beth Newcomb

to provide essential home repairs for Los Angeles residents. In total, the Super Bowl–sanctioned event provided 16 families in Los Angeles with home repairs that included roof replacements, bathroom upgrades, kitchen installations, landscaping, window repairs and fresh paint.

The 2022 event was the first Kickoff to Rebuild for Rebuilding Together of the City of Angels (RTCOA), the Los Angeles affiliate of Rebuilding Together, which launched in 2020 with support from the USC Leonard Davis School. The affiliate is particularly focused on helping older Angelenos living in the areas surrounding USC age in place safely, said Leon Watts III, learning and development specialist for the school and a member of the RTCOA advisory board.

According to a 2021 survey by AARP, 77 percent of U.S. adults 50 and older want to remain in their homes for the long term, but more than a third of respondents also admitted that their home would probably need physical changes—from ramps and grab bars to extensive remodeling—to best support them as they got older. Watts and RTCOA executive director Zeeda Daniele found that many older adults in the area around the university were dealing not only with the challenges of health and safety at home, but also with challenges due to outside issues, such as gentrification, that affect their ability to age in place.

“One of the things we saw and recognized was that there was this marginalized population of seniors who have been living in this community and wanted to stay but were not being served,” said Daniele. “What Leon and I found is that they are fighting every day to stay in the community that they love, but their home is failing them in many instances.”

adults. The school is home to the USC Fall Prevention Center of Excellence (FPCE), which is led by Professor Jon Pynoos and is dedicated to promoting aging in place and independent living through research, training and technical assistance.

The center’s Executive Certificate in Home Modification (ECHM) is a suite of online courses designed for a variety of professionals who work directly or indirectly in the field of supportive home environments — from remodelers, contractors and project planners to program managers and occupational and physical therapists. The program, launched in 2004, was designed by Pynoos, USC Leonard Davis Senior Associate Dean Maria Henke, and FPCE Senior Learning and Development Specialist and ECHM manager Julie Overton. ECHM students receive not only the latest information on home modification research and products, but also instruction on funding strategies, policies and community planning.

Before joining the Leonard Davis School, Watts had owned a remodeling business for decades. Recognizing the need to add gerontology knowledge to his toolbox as his clients aged, he received his Master of Arts in Gerontology from the school in 2017. Following graduation, he joined the staff of the Fall Prevention Center of Excellence, where he first began working with the ECHM program.

The USC Leonard Davis School has a wealth of expertise in safety, fall prevention and home modification for older

“The whole design of the ECHM program was amazing to me,” Watts said. “I could see how important it is, and how it made a difference.”

In 2020, the USC Leonard Davis School and

Educating professionals to better serve individuals and communities

Left: Volunteers provide no-cost repairs, including roof replacements, bathroom upgrades, kitchen installations and landscaping.

Right: Home team NFL players help make Kickoff to Rebuild an engaging event for the host community each year.

Rebuilding Together created a partnership to provide the Executive Certificate in Home Modification program at a discounted tuition rate to Rebuilding Together affiliate staff. Since then, dozens of RT personnel have earned their certificates, with more than 2,000 program alumni to date. Affiliates throughout the nation use the course series to grow the Safe at Home program, which provides no-cost home modifications for people with mobility issues and other disabilities to improve accessibility, reduce falls, and facilitate aging in place.

“The ECHM program is gold for this organization. … The whole course was just fantastic,” said Terry Scott, program consultant for Rebuilding Together. Scott, who worked as a builder for 40 years, was a member of the first cohort of Rebuilding Together ECHM students. He praised the program’s broad scope, which includes not only information on aging and home safety, but also education on how professionals can better build partnerships with other organizations and identify resources for their businesses.

Scott added that he especially appreciated the program’s client-centric focus on acknowledging where people are and what needs they have, then finding creative and unique solutions to problems. It’s something he said he understands deeply after living with mobility challenges during his recovery from an accident, and he’s grateful that the ECHM program provides this kind of perspective to students. “We need to open our eyes and understand how people live every day,” he said.

Supporting contractors who work with Rebuilding Together in completing the ECHM program has greatly strengthened the organization’s capabilities, Daniele said.

“The ECHM program not only teaches them how to do a highly sophisticated design or redesign, it also talks

about ethics,” Daniele said. “It makes for a better service provider. It changes how they go about their business — the quality, the clarity, the transparency.”

There’s no place like home

Along with the professionals who complete the ECHM program, both Watts and Daniele said they would like to have USC Leonard Davis students become involved with Rebuilding Together. Student participation might involve volunteering, internships and employment opportunities in the future.

“This partnership between USC and Rebuilding Together presents opportunities for students to get some firsthand experience in seeing what older adults’ needs for their homes are like, and understanding the need for their professionalism when they graduate,” Watts said. “I find that any time you get the students involved with seniors, it inspires them. It makes them understand exactly why they’re taking their courses in gerontology.”

During the Kickoff to Rebuild effort, Watts served as the site captain for the Anderson home, leading a team of volunteers made up of employees from various Lowe’s locations. As the team finished the painting and landscaping and cleaned up the yard, Dunlap-Mabin thanked the volunteers, posed for pictures with them and joked that “the whole neighborhood would be jealous” of the home’s improvements.

She was especially excited for her mother to enjoy the refreshed porch, where she likes to sit in the evening and greet her neighbors on the close-knit block where she has lived for decades, adding: “She’s been a mom for everybody in this neighborhood.”

After installing safety updates in Annie May Anderson's kitchen and bathroom, volunteers painted the home's exterior and landscaped the front yard during the Kickoff to Rebuild.

Photos: courtesy of Eckel & Vaughan Group, Beth Newcomb

YOUR BRAIN ON

AIR POLLUTION

By Candace Pearson Illustrations by Jason Holley

Researchers across USC have joined forces to uncover the connection between the air we breathe and lifelong brain health.

ANOTHER BLUE-SKY MORNING dawns in Southern California as Jennifer Ailshire wonders whether she should hop on her bike and explore the San Gabriel Mountain foothills. At her home in Glendale, the USC gerontologist and sociologist clicks on the Air Quality Index on her laptop before deciding it’s safe to ride.

About 35 miles south, in Fullerton, Jiu-Chiuan Chen prepares for his daily run through his tree-lined neighborhood. When the USC physician and epidemiologist steps outside, he spots a gray-brown haze hugging the horizon. He checks the Air Quality Index on his phone and goes back inside.

In Culver City, Lauren Salminen considers the wisdom of hiking in the Santa Monica Mountains. She can see a misty scrim in the distance, but is that morning fog or smog? The USC neurology instructor decides this might be a day for yoga indoors.

These USC scientists—each an experienced researcher in brain aging—know that air pollution does more than ruin a good workout. Medical science has long recognized the impact of air pollution on the lungs, but now research at USC is helping define the environment’s

impact on the brain. Growing evidence links the longterm effects of dirty air to accelerated cognitive decline and dementia.

USC researchers, including Chen, hope to better understand the effects of the environment and of geneenvironment interactions on brain health. “USC has the perfect soil to grow this new area of research,” he says.

An Inspiration Point

The USC Children’s Health Study, launched in 1993 and now involving about 12,000 school-age children, is one of the nation’s largest and longest-running research projects on children’s respiratory health. Its researchers have contributed crucial data that have deepened understanding of lung health, including evidence that kids who live in more polluted areas have poorer lung function, reduced lung growth, and more asthma and lung damage than those in areas with less pollution.

When children move away from polluted neighborhoods, their lung function improves— a discovery that has inspired other scientists to ask: If L.A.’s bad air is affecting our breathing, what about our brains?

What they’re finding is critical, including who is most at risk. “The aging brain is vulnerable to air pollution,” says Caleb Finch, USC University Professor, expert on the biology of aging and co-principal investigator in the AirPollBrain Group. “For too long, the role of environmental neurotoxins in Alzheimer’s has been neglected.”

Within a few years of joining forces, Chen and Finch reported the first evidence that a critical Alzheimer’s risk gene—APOE4—speeds brain aging when it interacts with fine air particles.

In 2011, the colleagues received the first-ever National Institutes of Health grant to study the connections between air pollution and Alzheimer’s. Since then, about one-fourth of the 220 NIH-funded research grants focused on air pollution and dementia have come to USC.

Finch and Chen have also succeeded in attracting more than two dozen USC scientists to the AirPollBrain Group, crossing disciplines and schools to unite neuroscientists, environmental health experts, engineers, gerontologists, physicians, sociologists and more. The result: In 2018, the National Institute on Aging awarded USC researchers a five-year, $11.5 million grant to examine how urban air pollution contributes to an increased risk of dementia.

Small Particles Make a Big Impact

Air pollution wreaks havoc primarily through systemic inflammation, Finch says, which can lead to the formation of amyloid plaques—proteins that form between the brain’s nerve cells and are hallmarks of Alzheimer’s.

Researchers have fine particle pollution, also known as PM2.5, in their sights. The tiny, inhalable pollutants come from cars, power plants and coal and wood-burning fuel. The name derives from the size of the particles, which are smaller than 2.5 microns in diameter, or about 30 times smaller than the width of a human hair. But the impact, once inhaled, is huge.

The microscopic particles can pass directly through the nose into the lungs and may even slip through the blood-brain barrier, which is supposed to protect our brains from all invaders. “Pollution is breaking down our barriers,” says Megan Herting, a USC public health scientist whose lab uses advanced neuroimaging to study how the brain develops during childhood.

For reasons not yet fully understood, among women in their 70s and 80s, those who live in areas with high levels of air pollution are at particular risk for Alzheimer’s-like brain shrinkage compared with women who routinely breathe cleaner air.

But kids, of course, aren’t immune. USC studies have shown that even at relatively low levels, toxic air may alter the size of a child’s developing brain and boost the risk of cognitive and emotional problems in adolescence.

How Bad Is Our Air?

According to the American Lung Association, the Los Angeles–Long Beach region ranks first in the nation for ozone

Multiple factors influence the odds of an individual’s developing Alzheimer’s. “There’s no silver bullet—it’s a machine gun,” Finch says.

pollution and fourth in year-round fine particle pollution. Declines in pollution over the last 10 to 15 years both nationally and in L.A. have been a public health success story. “It shows that if we put our minds to it, we can make our environment a healthier place to live,” Ailshire says. In 2021, she and Finch, her colleague in the USC Leonard Davis School of Gerontology, reported in separate studies that showed a decrease in neurotoxic PM2.5 air pollution in humans and in laboratory studies.

In the last few years, Ailshire has seen some backsliding to unhealthy levels. “We have to be constantly vigilant,” she says. “We can’t get ahead of ourselves and declare a victory.”

Ailshire is particularly interested in the “social ecology” of air pollution—the intersection of socioeconomic and physical risks—driven by the fact that polluted air tends to be worse in poorer neighborhoods. “Air pollution isn’t just a physical characteristic,” Ailshire says. “It’s a social phenomenon produced by humans, for the most part.”

Finch has been studying brain health for decades. In experimental studies, he and his team have shown that air pollution damages some parts of the brain that also are vulnerable to Alzheimer’s disease. Multiple factors influence the odds of an individual’s developing Alzheimer’s. “There’s no silver bullet—it’s a machine gun,” Finch says. An individual’s risk can be a combination of several things, and air and chemical pollution are high on that list.

Tracking Pollution’s Impact Across the Lifespan

Within the Southern California Environmental Health Sciences Center at USC, program leaders Chen and Herting work at opposite ends of the age spectrum to pinpoint the environmental determinants of cognitive decline. Increasingly, evidence shows that older people are more likely to develop dementia if they live in places that have high levels of PM2.5. Chen’s research has shown that women in their 70s and 80s are particularly vulnerable to structural changes in the brain and memory loss, for reasons not yet fully understood.

Chen also has found that PM2.5 particles are tied to the disproportionate number of Black Americans affected by dementia, partly because people of color are statistically more likely to live in neighborhoods near

polluting facilities. Even when researchers accounted for the incidence of cardiovascular disease and other factors, Black women were twice as susceptible as non-Hispanic white women to dementia risk from air pollution. “That is a puzzle we still have to solve,” Chen says.

With regard to children’s brain development, Herting says, “One of the young brain’s most important jobs is creating efficient pathways.” These pathways are critical because they form the essential brain circuitry that supports future learning and life skills. Lately, Herting has been focusing on kids ages 9 and 10, ages at which, she says, brain cells proliferate and prune themselves as children head into adolescence. Herting’s team has demonstrated that kids exposed to noxious air have smaller areas in their brains associated with cognitive function and larger areas associated with emotion than those breathing less-polluted air.

Her work is part of the national Adolescent Brain Cognitive Development Study, the largest investigation of its kind in the U.S. “We’re adding the environmental factor, one of the least-investigated areas,” she says.

To understand the bigger picture across the lifespan, Chen and Herting collaborated with Salminen, instructor of research neurology at the USC Mark and Mary Stevens Neuroimaging and Informatics Institute, to create the ENIGMA-ENV Working Group. “We know things like air pollution can increase dementia risk and vascular problems decades after exposure,” Salminen says. “But we have so much to learn about the processes that underlie those changes.”

Together, they are pooling brain scans from more than 60,000 people worldwide, who span all ages and range from being in good health to having neurological disorders. The scientists rely on geospatial technology to map each participant’s home location and pollution exposure.

This global study builds on the success of the ENIGMA Consortium, an international medical network of neuroimaging researchers studying major diseases of the brain, led by USC Stevens Associate Director Paul M. Thompson. “The ENIGMA-ENV Working Group is a truly global quest to identify environmental factors that help or harm our brain,” says Thompson, one of USC’s leading Alzheimer’s researchers. “Comparing data worldwide should reveal what factors help our brains develop and age and what protects us against mental illness, which may ultimately guide public health policy.”

With this big-picture effort, USC is reaching beyond its Los Angeles roots to examine air pollution across all ages and sources. “We’re excited to be able to get more specific about what we mean when we say ‘air pollution,’” Salminen says.

Protecting Ourselves Now and Beyond

What can we do to protect our brain health? Moving away from highly polluted areas may be the ultimate protective strategy, but that option isn’t open to everyone. So USC scientists are on the hunt for other defenses.

In a study published in August 2020, Chen and his fellow authors looked at the protective powers of eating fish loaded with omega-3 fatty acids. “We found that women with higher blood levels of omega-3s had larger volumes of white matter in their brains,” he says—even women living in locations with higher PM2.5 levels. White matter, most of the brain’s volume, represents a vast system of neural connections. Its loss is considered an early marker of Alzheimer’s disease. Next, Chen and Finch plan to expand their search for pollution counterbalances into supplements such as vitamins B, C and E. But they do not expect that any potential formula will be one-size-fits-all.

The data generated at USC could have lasting implications for clean air standards and other regulations. Chen would like to see laws restricting placement of assisted living facilities near freeways, much as is done now with schools. Herting wants air pollution facts to empower people to make their own decisions, “including who they want to elect to represent them on this life-critical issue,” she says.

Herting moved to Los Angeles from Oregon, where she was an avid runner. She’s mostly given that up. Before the birth of her daughter in December 2021, she was studying the locations of day care centers and schools in relation to L.A.’s roadways.

When Finch arrived at USC in 1972, the federal Environmental Protection Agency was just two years old, and L.A. was infamous for its thick, hazy air. For decades, officials warned the public to stay indoors on high-smog days. Finch searched the L.A. Basin for a place with cleaner skies, eventually landing in northern Pasadena.

He lives there still and considers that health decision as important as the ones he makes about diet and exercise. When he drives, he keeps his car vents closed. A little self-protection goes a long way, he says, “but you can’t walk around the city with a scuba tank filled with oxygen on your back.”

In many ways, he’s optimistic about the future, inspired by the energetic brain-health collaborations at the university. “I could not imagine,” he says, “being able to do this kind of multidisciplinary work anyplace outside USC.”

By Beth Newcomb

Future Lives of Older Adults

They won’t be your grandparents’ golden years. Tomorrow’s older adults will have very different lifestyles, thanks to advancements in health, technology, education and more. Several experts from the USC Leonard Davis School of Gerontology share what they feel will be the most important advances for daily life in the future.

Medicine: Powered by Personalization Following successes in genetically tailored cancer treatment, we are on the cusp of exciting new fronts in fighting other diseases of aging with genomic-based personalized interventions, says USC Leonard Davis School Dean Pinchas Cohen. The ability to capitalize on large data sets allows us to begin to predict who might be at risk for certain conditions and to target treatment and prevention efforts accordingly.

In addition, the discovery of microproteins, including those encoded in the smaller mitochondrial genome, have introduced new possibilities for treatments for diabetes, obesity and more.

“If you think about everything you know about biology, science has tried to explain [everything] by the existence of 20,000 genes, which is what people believed until recently are the number of large

USC LEONARD DAVIS EXPERTS SHARE THEIR IDEAS OF WHAT THE COMING YEARS MAY BRING.

genes in the genome,” Cohen says. “In fact, microproteins represent hundreds of thousands of additional, recently recognized novel, small genes, which will reshape how we understand science.”

Community: Embracing Intergenerational Living

“Age-restricted communities — communities solely for older adults — are increasingly seen as outdated. They miss the many benefits of vibrant, age-diverse communities,” says Paul Irving, USC Leonard Davis visiting scholar and senior fellow at the Milken Institute.

“What kind of society are we building — a society that encourages understanding and collaboration and appreciation of others, or a society that reinforces the divides that already challenge America?” Irving asked in an interview with Rethinking65.com. “I would make the case that bringing older and younger Americans together enhances the lives of both age groups, and in the mix increases the likelihood of collaboration, mutual understanding and appreciation.’’

Intergenerational, age-friendly communities promote interaction between younger and older people, according to Irving. The relationships that result can reduce loneliness and social isolation for both age groups, he adds.

“I strongly believe in the value of diverse environments. Diversity has been America’s great strength, and it still is,” Irving says. “We know that diversity in communities and institutions holds great potential. And it is time to include age in the diversity matrix. I’m excited to see more and more enlightened leaders doing just that—designing and building and planning in ways that integrate different races, cultures and age cohorts.”

Money: Taking Aging Into Account

With people not only living longer lives but also working longer, and perhaps embarking on encore careers, planning for one’s financial future will need to be informed by the realities of aging. That’s where financial gerontology comes in.

Cynthia Hutchins MAG ’13, director of financial gerontology at Bank of America, said in an interview with Financial Advisor that financial gerontologists are trained to “ask the right questions of their clients, the more probing and personal questions that are outside the realm of the financial.” She noted that this includes taking into consideration health issues, where they want to live, whether they want to continue to work part time, and how they want to spend their leisure time.

Through a certificate program launched in 2015 with Bank of America, the USC Leonard Davis School has taught this holistic perspective to nearly 1300 financial advisors thus far. USC Leonard Davis Senior Associate Dean Maria Henke explained to Financial Advisor that trained financial gerontologists know how to explore the deeper issues regarding aging and finances, from asking about caregiving wishes to noticing potential indicators of dementia or financial abuse.

“When advising about retirement options like whether to save money by moving to a different community, a financial gerontologist would consider factors like risk of social isolation, access to health care or opportunities for meaningful engagement, in addition to financial impacts,” Henke said.

ALONG WITH GIVING PEOPLE THE ABILITY TO MEET OR “TRAVEL” IN THE METAVERSE, RESEARCH INDICATES THAT VIRTUAL REALITY HAS THERAPEUTIC POTENTIAL FOR ANXIETY, PAIN, LONELINESS AND MORE, SAYS DEAN PINCHAS COHEN.

Food: Tailored Diets for Longevity

The increased push for personalizing medicine based on individual characteristics will likely one day include nutrition, allowing people to learn what type of diet will best suit their unique needs, including their genetics, says Professor Sean Curran.

“I think everybody knows somebody who’s done a fad diet that had amazing results — and then similarly either tried that diet themselves or knows someone who did the exact same diet, only to find it didn’t work at all,” Curran says. “The reason that the results were different was because of the genetic makeup of the individual. So I think this is a new way of thinking about personalized medicine, but taking it from a personalized diet standpoint. Rather than prescribing a one-size-fits-all diet, [we’re] looking at the genetic makeup of an individual and then one day being able to prescribe to them: ‘Here are the types of food that you should avoid, and here are the types of food that you should increase consumption of on a daily basis.’”

We’ve learned more about the general characteristics

of the optimal diet for longevity, which includes parts of the Mediterranean and Okinawan diets, incorporates a daily 12-hour time window for eating, and also recommends periodic, short fasting-mimicking diets a handful of times each year, says Professor Valter Longo. These recommendations can easily be adapted to individuals based on sex, age, health status and genetics, he adds. For instance, in order to counter frailty and loss of lean body mass, people over age 65 may need to increase not only protein intake, but also the variety of animal-derived foods they consume.

For people who are looking to optimize their diet for longevity, Longo says it’s important to work with a health care provider who specializes in nutrition on personalizing a plan focusing on smaller changes that can be adopted for life.

“The longevity diet is not a dietary restriction intended to only cause weight loss, but a lifestyle focused on slowing aging and on minimizing frailty, which can complement standard health care—and, taken as a preventative measure, will aid in avoiding morbidity and sustaining health into advanced age,” he says.

Connection: Virtual Reality for Socialization, Health Care and More

It’s not just for video games: Virtual reality and the metaverse could one day have a myriad of important applications for nongamer older adults.

The concept of the metaverse was popularized in the science fiction novel Snow Crash, by Neal Stephenson, where the term refers to a digital universe that can be accessed through virtual reality. This digital environment can give users the feeling of being present with someone who’s not physically there, something that has immense possibility for older adults who are experiencing social isolation, says Dean Pinchas Cohen.

Along with giving people the ability to meet or “travel” with friends and family in the metaverse, research indicates that virtual reality has therapeutic potential for anxiety, pain, loneliness and more, Cohen says. When paired with the use of sensors or wearable tech, it can also create a more immersive environment for brain exercise and reminiscence therapy and can augment telehealth services.

“For older adults facing mobility challenges and loss of social connections, virtual reality and the metaverse could become a key method for staying engaged with their social network and keeping mentally active,” Cohen says.

For Older Adults and Tech, Access

Is Key

Contrary to stereotypes, older adults are embracing technology. The pandemic-related rise in older adults’ use of smartphones, tablets and apps continued in 2021, according to an AARP tech trends report. Devices carried in pockets, worn on wrists and installed in homes are helping today’s tech-savvy older adults maintain connections, prevent falls, stay active, detect disease, get rides, order food and more.

But access and affordability still prevent many from benefiting from technology innovations. Professor Kate Wilber is working to bridge this digital divide. She leads a team evaluating California governor Gavin Newsom’s efforts to expand technology adoption among older adults. She’s also surveying telehealth usage among older adults at home and in skilled nursing facilities. Here’s what she’s learned so far:

Broadband is essential.

“People not only need to have some kind of device, they also need to have broadband, and it needs to work. We’ve seen that there is lack of access to broadband in parts of the U.S., especially in rural areas. This is an essential service, and we need to do a better job of providing it across the nation.”

Hardware is not enough.

“If you hand somebody a box with a computer in it and say, ‘Here you go — you’re now going to go on the other side of the digital divide,’ they’re not. How do we help people learn? We need to do a better job helping people learn, including improving cultural competencies required for trainers. We also need to be sensitive to a variety of different uses that people want. This means being person-centered and engaging the people who will be the end users, and understanding what’s most effective for them.”

The future is bright.

“There are so many exciting innovations that are rolling out. We need to build on what we’re learning and to make them better and more effective to help those on the wrong side of the digital divide connect.” — O.B.

Population Health

in a Pandemic

By Constance Sommer

When the Covid-19 pandemic hit, administrators at Contra Costa Health Plan noticed a distressing trend: Their Latino patients seemed to be getting sicker than patients of other ethnicities. So the public health plan for the Northern California county asked USC researchers to analyze their raw data to see what they might find.

What Mireille Jacobson learned when she started crunching the numbers on Covid outcome disparities surprised both her and the health officials: Latinos were more likely to test positive, more likely to be hospitalized and more likely to die of Covid than white, Black or Asian patients in the same health system. “We didn’t understand the magnitude of the differences between Latinos and other groups,” said Jacobson, associate professor of gerontology at the USC Leonard Davis School of Gerontology. “Putting a number to it was kind of alarming.”

For years, USC Leonard Davis researchers have studied U.S. health and health disparities. They’ve charted with dismay how American life expectancy has slid further and further behind that of residents of other wealthy nations. Recently, they’ve been finding that the Covid pandemic, and Americans’ response to it, has introduced new complications and made that gap wider still.

“We’ve gotten progressively worse than other highincome nations over a substantial period of time, probably since 1980,” said Eileen Crimmins, who holds the AARP Chair in Gerontology at the Leonard Davis School of Gerontology. “And now, with the pandemic, it’s just getting much worse.”

The main reason, pre-pandemic, Crimmins said, was a decrease in the rate of improvement in death from cardiovascular disease. In an article published last year in Nature Aging, Crimmins and colleagues found that increased life expectancy among a majority of wealthy countries was lower between 2011 and 2017 than in the six previous years, in large part due to decreases in the rate of decline in cardiovascular disease. But in the United States (as well as in Iceland), there was actually a decrease in life expectancy during that period.

The reasons for that, Crimmins said, are structural and political: lack of a strong social network; a health care system that works for those who can get into it, but

Addressing the continuing Covid-19 pandemic, which has lowered life expectancy and widened health disparities in the U.S., calls for preventive behaviors and policy change, say USC researchers.

leaves others struggling to access even basic medical care; the easy availability of guns, which leads to more firearm deaths; and the opioid epidemic, which has resulted in “deaths of despair.” Obesity plays an additional role in decreasing cardiovascular health, Crimmins wrote in the paper.

“Many people think we have good health and long life expectancy in the United States,” she said in a recent interview. “But we are not nearly as good as our peers.”

Thanks to Covid-19, U.S. life expectancy has decreased even further. In 2020 alone, the virus decreased American life expectancy by 1.31 years—from 78.74 years to 77.43 years— wrote Theresa Andrasfay, a postdoctoral scholar at the Leonard Davis School, in an article published in JAMA Network Open in June 2021. In a subsequent study published in PLOS ONE in August 2022, Andrasfay and her co-author, Noreen Goldman of Princeton University, found that the decrease in life expectancy appears to have continued through 2021, despite the availability of Covid-19 vaccines.

But Andrasfay and Goldman found significantly worse outcomes for Blacks and Latinos. They reported that while life expectancy for whites dropped by .94 years in 2020 due to the Covid-19 virus, for Latinos it dropped by 3.03 years and for Blacks by 1.9 years.

“We think it’s a combination of a lot of social factors,” Andrasfay said, noting that one particular challenge those populations faced was working in essential jobs that increased their exposure to the virus. Also, many people in those populations came into the pandemic with ailments like diabetes and risk factors such as obesity that made them more susceptible to serious illness, she said.

“We still don’t fully understand why the Black and Latino populations were infected more,” Andrasfay said. “It seems to be a confluence of many factors that puts

them at higher risk.”

Pre-pandemic, the life expectancy gap between Blacks and whites had been narrowing. “But then Covid erased those gains,” she said.

The pandemic also nearly erased the “Latino paradox,” so called because Latinos in the U.S. have historically had similar or better health outcomes than whites, even though they have lower average income and education levels. But diabetes and other chronic health conditions had been on the rise in this population, Andrasfay said. Usually, such issues would take decades to impact mortality risks, but Covid accelerated that process, she said.

And then there was the fact that many Latinos worked at the kind of low-income jobs that couldn’t be done from the safety of their homes. That “suddenly became a risk factor for mortality in a way that hadn’t really existed in the past,” Andrasfay said.

Like Andrasfay, Jacobson found the Latino population to be particularly at risk. Her study of racial and ethnic differences in Covid-19 testing and outcomes included data on more than 84,000 adults at Contra Costa Regional Medical Center who were enrolled in that county’s Medicaid managed care plan.

Jacobson and her colleagues, however, controlled for various risks, like preexisting health conditions, demographics and neighborhood factors. The Latino patients still fared worse than the other groups, even though they were disproportionately younger. “This tells us that going forward, for future pandemics, this is going to be a particularly vulnerable group,” Jacobson said of the research, which appears in the American Journal of Preventive Medicine.

After vaccines became available, Contra Costa officials asked the USC researchers to study strategies for getting reluctant patients to take the jab. The result,

U.S. life expectancy at birth decreased by 2.2 years from 78.8 in 2019 to 76.6 in 2021.

Non-Latino whites lost 2 years on average, while non-Latino Blacks lost 3.5 years and Latinos lost 3.7 years.

(Andrasfay and Goldman, 2022)

Only 69.2% of U.S. adults age 18 to 49 are fully vaccinated against Covid-19 , while 82.3% of individuals age 50 to 64 and 92% of those over 65 are fully vaccinated.

(Centers for Disease Control and Prevention, August 2022)

“Can financial incentives and other nudges increase COVID-19 vaccinations among the vaccine hesitant?

A randomized trial,” was released last fall as a National Bureau of Economic Research working paper and was published this year in the journal Vaccine.

Jacobson first tried a tack that had often proved successful in the past with the flu vaccine: offering people modest sums of money in exchange for vaccination.

It didn’t work. “I don’t think we appreciated how strong the reluctance was,” she said. The monetary “nudge” strategy, however, worked for researchers in Sweden with the same vaccine, she said.

“But here, there were very strong beliefs about not taking this vaccine, for a variety of reasons,” she said. “One was a political belief, [and] another was a kind of safety fear because of how quickly the vaccines were developed.”

In fact, she said, Trump voters in particular became even less likely to get a vaccine when offered a financial incentive to do so. She speculated that people wondered, “Why do they have to pay me to do this? I knew something was wrong with this.”

As part of the same work, they also tried different types of public health messaging and created an easy online process to schedule vaccinations. The health system did even more, throwing “vaccination fairs” and rolling out a free ice cream cart. Nothing seemed to meaningfully change the behavior of the vaccine hesitant.

“It was really, really sad,” Jacobson said.

In the end, there was only one tool the health system didn’t try, but that’s because it’s one best enacted by governments or employers: mandates. Jacobson has come to believe that mandates are the only way to ensure community-wide inoculation. “We need stronger approaches if we think [getting vaccinated] is for the greater good,” she said. “We need things like ‘You can’t come into this store if you’re not vaccinated’ or ‘You can’t work at this job unless you’re vaccinated.’”

Andrasfay, Crimmins and colleagues looked at how personal behaviors might reduce the spread of the virus. In a paper published in the January 2022 issue of the American Journal of Public Health, they reported that people who practiced certain social distancing measures could significantly reduce their likelihood of getting Covid, even when transmission rates were high. For instance, they found that people who reported attending gatherings of more than 10 people were 40% more likely to get Covid than those who didn’t. Even attending small gatherings increased the risk of Covid diagnosis by 30%, the researchers found.

“The takeaway here is that even if you’re in an area where there are high Covid cases, if you choose to limit your social interactions, it helps reduce your risk” of contracting the virus, Andrasfay said.

Even if you have gotten Covid once and it was mild, you should try to avoid getting it again, Crimmins said. In 2010, Crimmins and colleagues studied the health of people who were in utero during the 1918 flu pandemic. Those whose mothers were exposed to the virus when they were in utero were more likely to have heart disease when they were elderly than those who were not exposed to the virus in utero.

Crimmins said that the Covid pandemic, as well, may “have long-term effects on people that will be subtle all their lives, but [that] can have a substantial effect in terms of the population having worse health over time."

For researchers, it’s ironic and more than a little frustrating to see anyone taking such a threat casually, she added. “For decades, we’ve spent a lot of time and money trying to save lives by doing extraordinary things, and spending extraordinary money to keep people alive,” and such innovations receive a lot of attention, Crimmins said. “But the adoption of robust, evidence-based public health policy, as well as more people engaging in simple preventive behaviors, might have a bigger impact on population health than anything else right now.”

By Beth Newcomb Illustrations by Davide Bonazzi

USC RESEARCH SHOWS HOW TRAUMATIC INJURIES INCREASE THE BRAIN’S “BIOLOGICAL AGE” AND HIGHLIGHTS THE NEED FOR EARLY MONITORING.

THE POPULAR APHORISM states that “age is just a number,” but USC Leonard Davis–led research shows how calculating the biological — as opposed to chronological — age of the brain of the brain could be a powerful tool in screening for brain health issues, including dementia, even before symptoms occur.

While one’s chronological age increases with the passage of time, biological age doesn’t always match what’s on the calendar, says Andrei Irimia, assistant professor of gerontology, biomedical engineering, quantitative biology and neuroscience at USC. This includes the specific biological age of the brain, which, like the rest of the body, can be affected by both innate characteristics (such as genetics) and lifestyle factors (ranging from diet and exercise to substance abuse and stress).

“The concept of brain age helps us to understand and to quantify how aging occurs at different rates in different people, even though such people might be of the same chronological or calendar age,” Irimia says.

BRAIN INJURIES

CAN HAVE PROFOUND ACUTE EFFECTS

Irimia’s work has demonstrated that biological brain age can vary dramatically based on whether or not an individual has suffered a traumatic brain injury (TBI). A study he published in GeroScience in July 2022 shows just how much a TBI can affect the brain’s biological age.

The study analyzed magnetic resonance imaging (MRI) data from more than 100 individuals ages 20–83 who had suffered a TBI, with scans taking place one week and six months post-injury. These scans were compared to MRI data from thousands of healthy individuals of various ages, who provided a reference for normative brain aging. The result: On average, individuals who had experienced a TBI also had a brain age that was significantly older than their calendar age.

Several signs of brain aging can be seen via MRI, Irimia explains. The model that he and his doctoral student Nahian Chowdhury used was trained on scans from more than 3,000 healthy individuals. This model can predict brain age based on brain anatomy features, including the amount of brain shrinkage, or atrophy, in different brain regions.

Not only did TBI correlate with an increase in brain age, but this increase also appeared to happen very quickly, Irimia says. Most of the gap between chronological age and biological brain age was seen during the acute phase — that is, in the days immediately following the injury — with less brain aging occurring in the period between the one-week and six-month scans.

“Whatever happens in the brain after concussion is very dynamic very early on after injury,” Irimia says. He adds that these data pro-

vide important evidence supporting what critical care neurologists and emergency room doctors have suspected for a long time: “The most critical time to act therapeutically after concussion is often very early on, because that’s when the largest changes take place.”

OLDER ADULTS FACE PARTICULAR RISKS

The study also illuminated how older adults who experience a TBI exhibit a greater degree of brain aging than younger TBI patients after the same period of time.

“Older adults sustaining TBIs face a significantly higher risk for having a biological brain age that’s much older than expected,” Irimia says. “On average, it turns out that an adult over 60 who sustains a mild TBI typically has a biological brain age that increases by five to 10 years as a result of their concussion, whereas younger adults exhibit a smaller gap between their chronological and biological ages.”

Older adults are at highest risk of TBI, which compounds their challenge of experiencing more injury-related brain aging than younger adults.

According to a report from the Centers for Disease Control and Prevention, adults ages 75 years and older had the highest numbers and rates of TBI-related hospitalizations and deaths in 2019, accounting for about 32% of TBI-related hospitalizations and 28% of all TBI-related deaths. Falls and motor vehicle crashes are two of the leading causes of TBI-related hospitalizations among older adults.

TBI can be particularly dangerous for older adults, especially as symptoms can be related to other conditions such as cognitive

impairment, which may not be immediately identified. In addition, certain medications more likely to be prescribed to older adults, such as blood thinners, may increase the risk of brain bleeding following a TBI. Such bleeding can lead to more severe injury, or even death. Previous studies by Irimia and colleagues have shown how older age and brain bleeds are associated with greater white matter degradation and cognitive decline following a mild traumatic brain injury.

QUANTIFYING BRAIN AGING VIA MYELIN

Another study led by Irimia, published in Frontiers in Neurology in June 2022, illustrates how damage from even a mild TBI can be mapped across the entire brain and describes a powerful new approach for quantifying brain health during aging.

The study — the first, Irimia says, to measure post-TBI demyelination noninvasively in the brains of living patients — used MRI scans to measure the amount of myelination in the brains of TBI patients. Specialized algorithms developed by the team were then used to analyze scans, quantify myelination levels, and study how these levels change over time.

Myelin is a substance that surrounds the long branches, or axons, of neurons throughout the brain and nervous system. Much like the protective sheath on an electrical wire, myelin acts as an insulator to improve the conduction of electrical signals that travel along the axons to connected cells and send messages to different regions.

“Myelination is very important because, in certain settings, it can be used as a surrogate measure of how well and how fast the

Myelination Decreases After TBI

Even when mild, traumatic brain injuries can result in significant loss of myelin at a much faster rate than seen in typical brain aging alone. Below, solid red indicates a higher concetration of myelin in healthy brains, while the faded red in brains of TBI patients indicates dramatically lower myelin throughout the brain.

exchange of information between brain areas is taking place,” Irimia explains. “On brain MRIs, myelination decreases may be an indication that the brain is aging and that communication between brain areas may be degrading.”

By examining myelin levels in both healthy individuals and TBI patients, Irimia and his team discovered that, even when mild, TBI resulted in significant demyelination, or loss of myelin, at a rate much higher than that seen in typical brain aging. The effects were seen in various regions of the brain, with some areas losing as much as 30% of their MRI-detect-

able myelination in the six months following an injury.

“One reason this is important is because the risk for neurodegenerative disease after TBI is paralleled by demyelination,” Irimia says. “We see this in Alzheimer’s disease, in multiple sclerosis, in Parkinson’s disease and in normal aging. The severity of myelin loss with age in certain brain regions can be a proxy for aging-related brain diseases.”

In recent years, research has continued to highlight the increased risk for dementia and other illnesses following TBIs. The ability to measure myelin levels noninvasively in patients who have

experienced brain injury could provide a powerful screening tool for doctors. Such approaches could help determine who is most at risk for long-term negative effects following a concussion, even before symptoms of neurodegeneration appear.

“Our findings raise the question of whether the severity of demyelination after mild concussions could be used as a prognosticator of risk for neurodegenerative diseases after TBI,” Irimia says. “What we suspect is that the more severe the demyelination seen after TBI, the higher the risk for neurodegenerative disease.”

Brain with

TBI damage

Healthy brain

Image: Nahian Chowdhury/Irimia Lab

IDENTIFYING AND ADDRESSING LONG-TERM RISKS

Irimia’s recent work highlights the need not only for effective brain injury prevention, but also for early detection and treatment, especially in individuals at particular risk for negative long-term consequences of TBIs.

As researchers across the world study how brains age and how to assess risk for age-related diseas-

es and neurodegeneration, Irimia predicts that some of the most powerful tools being developed will combine personalized genetic information, such as polygenic risk scores used for Alzheimer’s disease, with detailed anatomical information that can be extracted from noninvasive brain scans. If coupled with advancing research on biomarkers and treatments for neurodegenerative diseases, the results could make a huge difference for patients.

“We will very likely have better

risk assessment for disease based not just on polygenic risk score calculations but also on synergizing these with estimates of brain age, myelin content and other descriptors that could be derived from MRI,” Irimia says. “By combining all of these, we will hopefully see an improvement in estimating the risk for these diseases such that treatment and prevention can start before symptoms arise. That would be very exciting.”

Signs of Concussion & Mild TBI

Some signs of mild traumatic brain injury may be difficult to spot, especially in older adults, and TBI symptoms and recovery can be different from person to person. Anyone who may have had a concussion/mild TBI should see a health care provider right away.

Thinking and Remembering

Attention or concentration problems

Feeling slowed down, foggy or groggy

Difficulty understanding and thinking clearly

Problems with short-or long-term memory

Motor Skills, Hearing and Vision

Headaches

Dizziness or balance problems

Feeling tired, no energy

Hearing and vision problems

Nausea or vomiting (early on)

Emotion/Mood

Anxiety or nervousness

Irritability or easily angered

Feeling more emotional

Sleep Sleeping more than usual or less than usual

Trouble falling asleep

Sadness

Source: Centers for Disease Control and Prevention

By Beth Newcomb • Photography by Stephanie Kleinman

Balancing Support & Independence

Adria Navarro spent most of her childhood years in Southern California, living in a diverse household that included as many as four teenage foster youth at one time. She was introduced to the profession of social work as she saw the foster youth working through their needs with their assigned caseworkers, an experience that would prove to be formative for her when she first considered a career in health care.

“During a visit to a college career center, I learned that I could support and care for others, as I knew social workers did, within the field of health care. ‘Wow,’ I thought, ‘this is what I want to do!’” says Navarro. She has now been a licensed clinical social worker for more than three decades, all while working in health care settings along the continuum of care.

Navarro received her bachelor of arts in social welfare from California State University, Long Beach in 1981 and earned a master’s in social work from San Diego State University in 1983. She went on to work for Kaiser Permanente in San Diego as a social worker in home health, hospice and continuing care. While there, she helped launch a geriatric assessment clinic and worked on a team with a geriatrician, a nurse practitioner and a clinic coordinator to support older adults and connect them with services appropriate for their needs. She continued this mission as a clinical services coordinator at Huntington Hospital in Pasadena.

ADRIA NAVARRO PHD ’11 NOT ONLY CONNECTS OLDER ADULTS WITH COMMUNITY RESOURCES BUT ALSO PROMOTES THEIR SELF-DETERMINATION.

SEEKING INNOVATION IN GERONTOLOGY

After more than two decades of frontline experience helping her teams serve the needs of older adults, Navarro realized she could offer more to the field if she were able to teach and assist with building evidence on what interventions were beneficial to functionally impaired older adults.

“Given my experiences serving those most vulnerable in this demographic, I wanted to develop the skills to contribute more to the field,” Navarro says. “Residing in Los Angeles near USC, I was fortunate to guest lecture and attend continuing education at the Leonard Davis School of Gerontology. These experiences kept me informed and involved in some of the important discussions within the field.”

It was also during this time that various colleagues kept asking Navarro if she had ever met Professor Kathleen Wilber, Mary Pickford Foundation Chair in Gerontology at the USC Leonard Davis School, because of their common interests in the well-being and safety of older adults.

“I remember I was getting off an escalator at an American Society on Aging conference when I saw Kate Wilber,” Navarro recalls. “We met up there, and I was able to explain my goals for returning to school for a doctorate.”

Wilber, who became Navarro’s mentor during her PhD in Gerontology program, is the director of the Secure Old Age lab at the USC Leonard Davis School. Her expertise in elder abuse prevention and long-term services and support for older adults helped Navarro delve further into issues surrounding elder justice.

“Dr. Wilber recognized value in my experiences and saw my commitment to serving older persons,” Navarro says. “I had assessed elder mistreatment situations in my social

work practice, in clinical supervision, and I’d worked in collaboration with Adult Protective Services (APS), but I hadn’t been able to focus on evidence about what interventions and policies were needed for the field.”

As a nontraditional student, Navarro appreciated that she was encouraged and empowered by the Leonard Davis School and by Wilber in particular.

“I experienced how Dr. Wilber pays attention to the goals and skill set of [each] student,” she says. “We have different strengths and are in different stages of our educational

with other professionals and in clinical supervision for decades. I began appreciating through conversations with members of the Elder Abuse Forensic Center team just how critical it could be in reviewing alleged elder abuse cases [and] discerning if elder abuse had occurred,” Navarro says. “Now, I find myself thinking about what is needed to improve access to diagnostic excellence for vulnerable persons, so professionals across many different disciplines can have a deeper understanding of how to serve their client or patient. I see this as a component of elder

journey. I came in as a mature student, and I felt that my experiences in health care gave me a good foundation upon which to continue to learn and grow as a gerontologist.”

EVALUATING DECISION-MAKING CAPACITY

During her PhD program, Navarro had the opportunity to work as an evaluator for the Los Angeles County Elder Abuse Forensic Center, an interprofessional and interagency collaboration founded to help resolve complex cases of alleged elder abuse in the county. She says it inspired her to think more about the complex domain of decision-making capacity — a person’s ability to make reasoned decisions regarding their medical, legal, financial or other everyday living choices — and how this factors into providing the greatest quality in care planning and intervention.

“I realized that capacity was something I had been discussing

justice … [and] so critical to what interventions are going to be appropriate for someone.”

After receiving her PhD in 2011, Navarro conducted research and taught graduate social work students as an associate professor at Azusa Pacific University. She was also appointed assistant clinical professor in the Keck School of Medicine of USC Department of Family Medicine, which led to her consulting with the National Center on Elder Abuse and the Administration for Community Living.

Navarro is co-founder of the USC Verdugo Hills Hospital’s Community Resource Center for Aging (CRCA), launched in 2020. Staffed by social workers specialized in serving older adults, the center helps older people with quality of life by improving awareness and access. Callers are linked to a robust network of community-based services and support. Through options counseling, the

"I CAME [TO THE USC LEONARD DAVIS SCHOOL] AS A MATURE STUDENT ... MY EXPERIENCES IN HEALTH CARE GAVE ME A GOOD FOUNDATION UPON WHICH TO CONTINUE TO LEARN AND GROW AS A GERONTOLOGIST."

staff assess each individual’s functional abilities and, to the extent possible, incorporate self-determination in care planning.

Navarro is also active in organizations such as the Pasadena Village, National APS Association, Gerontological Society of America and the National Association of Social Workers (NASW). Through her work in the community, as well as in educating future and current social workers, she says she hopes to “enhance our society’s response when assistance and even protections are necessary to maintain an older person’s preferences, well-being and safety.”

ESTABLISHING U.K. COLLEAGUES

To promote the use of professional decision-making evaluations in California, Navarro began exploring assessment tools and the use of evaluations in legal decisions. She served on the U.S. Department of Justice’s Capacity Work Group, during which time she found variability across states, with several

that sanction social workers to provide capacity evaluations.

In California, legislation requires evaluations to be conducted by psychologists and physicians. Navarro predicts that with the state’s burgeoning older population, sanctioned professions will need to be expanded. Social workers are the largest providers of mental health services in the state, employed within many institutions of care, she explains. Her vision is to see licensed clinical social workers, with proper training and competence, evaluating decision-making capacity in health and legal matters. “Just looking at the rising number of Californians experiencing symptoms of dementia, we continue to see more situations where this type of evaluation is so critical,” she says.

Navarro’s interest in decision-making capacity will now be international, with the support of a prestigious 2022 Fulbright Scholar Award. The Fulbright U.S. Scholar Program offers more than 400 awards in upwards of 130 countries

Navarro co-founded the USC Verdugo Hills Hospital’s Community Resource Center for Aging (CRCA), which launched in 2020.

for U.S. citizens to teach, conduct research and carry out professional projects around the world. As part of her award, Navarro will spend three months at the University of York in the United Kingdom to teach and review the practices of social workers in evaluating older adults' decision-making capacity.

“I hope to learn more from U.K. researchers, and persons impacted, about their systems and policies that utilize social workers to evaluate the functional ability of older persons,” she says. “My goal from this cultural exchange is to return with fresh input for directly serving older adults in our state, as well as increasing my ability to further elder justice through greater education and training for the professional evaluation of decision-making capacity.”

Navarro hopes that in this next phase of her career she can help shape how social workers and other professionals connect with one another and work together to appropriately serve older adults, while preserving self-determination to the greatest extent possible. “We know that working together across disciplines leads to better outcomes,” she says, and the interprofessional components of the gerontology profession support these practices and ideals.

“I am fortunate and feel so privileged to have studied at the Leonard Davis School and to be part of an amazing community, one with such a rich foundation of resources,” she says. “My journey would not have arrived at this juncture if it wasn’t for my education at USC.”

NOTES

Above: GERO 489 students took a kayaking tour of the Nosara River to stay active and to see Costa Rica’s environmental protection practices in action.

STUDENTS

Surf, Sun, Support and Sustainability

Kiana Hernandez ’22 kicked off her summer surfing in the ocean, practicing yoga on the beach, kayaking down a river, ziplining above forest trees, and enjoying fresh seafood meals.

But this was no vacation. Hernandez, who is now earning her master of science degree in gerontology, was a student in GERO 489: Finding the Key to a Long and Healthy Life in Nicoya, Costa Rica.

Led by Professors John and Julia Walsh, the class of 13 students traveled to Nicoya, Costa Rica, to gain an on-the-ground understanding of why Costa Rica has one of the longest-lived populations in the world. Although Costa Rica is a poorer country overall than the U.S., its residents can expect to live almost two years longer than their U.S. counterparts.

Photos: courtesy of GERO 489 students

Nicoya, a peninsula in the northwestern part of the country, is one of the five original “Blue Zones,” a term popularized by author Dan Buettner that refers to regions of the world where people seem to live longer, healthier lives than average. In Nicoya’s case, the proportion of centenarians has been reported to be around three and a half times the global average.

“Students were able to downshift into that ‘Pura Vida’ mindset,” said John Walsh, the assistant dean of education and a professor at the USC Leonard Davis School. “They visited with the farmers who grew the fruits and coffee they ate and drank and connected to the local community and environment in a meaningful way.”

The curriculum included meeting doctors with Costa Rica’s far-reaching national health care system — more than 80% of the population is vaccinated against COVID-19 — and emphasized Costa Rican history, foodways, sustainability practices and cultural traditions.

It also included surf lessons. The Nicoya region is famous for its waves, and John Walsh, an avid surfer, says the body movement and connection to nature the sport provides can improve both physical and mental health.

“I’ve been surfing since I was 10, and it’s exhausting, calming and beautiful all at the same time,” said Walsh. “I’m proud to say that 11 of our 13 students tried surfing in Costa Rica, and they all learned to stand up on the board.”

At the conclusion of the course, students created a website and Instagram account showcasing their activities and the lessons learned. For Hernandez, the most valuable takeaway was understanding the power of family connections.

“No one is ashamed to live in intergenerational homes, and it is no wonder that children are very compassionate toward each other and older adults,” she said. “This trip was a prime example of why Blue Zone communities are so important to study.”

— O.B.

Instructors John and Julia Walsh with GERO 489 students in front of Arenal Volcano in La Fortuna, Costa Rica.

Students visited an Equipos Básicos de Atención Integral de Salud (EBAIS) clinic, one of the public health care clinics located throughout Costa Rica.

“We are pleased to have Belmont Village and the USC Davis School, the national leader in aging education, policy and research, teamed up to help prepare our country’s future leaders in senior housing.”

Belmont Village Establishes First Industry-Created Endowed Scholarship

Board of Councilors members Patricia Will and Mercedes Kerr have arranged for the first industry-created endowed scholarship at the USC Leonard Davis School. Will, the founder and CEO of Belmont Village Senior Living, and Kerr, the president of Belmont Village, have been active and supportive board members for several years. The Belmont Village Senior Living Endowed Scholarship Fund will support students studying senior housing who plan to work in the industry in the United States.

“We are thrilled to support Leonard Davis School students interested in senior housing,” said Will, who founded Belmont Village, L.P., in 1997 with the aim of creating a place that would “foster a sense of independence in each of [the] senior residents, no matter where they were in life.” A highly decorated senior living industry executive, Will was recently honored with a Lifetime Achievement Award by McKnight’s Senior Living.

“We are pleased to have Belmont Village and the USC Davis School, the national leader in aging education, policy and research, teamed up to help prepare our country’s future leaders in senior housing,” Kerr said. Prior to joining Belmont Village as president in 2019, Kerr was executive vice president of business development at Welltower, Inc. She was appointed to Governor Gavin Newsom’s Stakeholder Advisory Committee, which was formed in response to the creation of California’s Master Plan for Aging in 2019. Kerr serves on the committee alongside Donna Benton, research associate professor of gerontology and assistant dean of diversity and inclusion at the Leonard Davis School.

“I’m very grateful to Patricia and Mercedes for their leadership, partnership and generous support,” said Dean Pinchas Cohen. “The Belmont Village Senior Living Endowed Scholarship will make a big difference in the lives of future Leonard Davis School students [and] senior housing and its residents for decades to come.”

If you would like more information on how to help provide student support at the Leonard Davis School, please call David Eshaghpour at (213) 740-1360. — D.E.

Photo: Bob Ross Photography

Hanson-Thorell Awards Support New Studies on Diet and Health

USC researchers are looking into whether the composition of our diets and the amount of food we eat can impact heart and brain health as we age. As recipients of the 2021 Hanson-Thorell Family Research Awards, Instructional Associate Professor Roberto Vicinanza and Assistant Professor Joseph Saenz will each receive $25,000 in funding for one-year pilot projects exploring these nutrition-related topics.

Vicinanza will examine whether following a Mediterranean diet can positively affect mitochondrial function and markers of oxidative stress, and potentially predict the risk for cardiovascular events in older adults.

“This study will provide new insights on the role of mitochondrial-derived peptides — MDPs and oxidative stress in patients with cardiovascular diseases and propose MDPs as potential novel biomarkers for Mediterranean diet adherence and response,” said Vicinanza.

Saenz, holder of the Leonard and Sophie Davis Early Career Chair in Minority Aging, will investigate whether experiencing late-life food insecurity negatively impacts cognitive function. His study focuses on older adults in Mexico and can have important implications for global health and policy.

“Addressing food insecurity may improve cognitive health among older adults, particularly in low- and middle-income countries that are rapidly aging and seeing increases in dementia,” said Saenz.

The Hanson-Thorell Family Research Awards support USC Leonard Davis School faculty members as they explore new avenues of research, providing a foundation that leads to further grant support for their work. Supported in part by USC Leonard Davis Board of Councilors Chair Shari Thorell and her husband, Bob, the awards originated with funding from Shari’s father, former Board of Councilors Chair Al Hanson. — O.B.

FIGHT ON!

Dean Pinchas Cohen poses with USC Leonard Davis School students and their parents during the Trojan Family Weekend Dean’s Breakfast, held at Moreton Fig on October 7, 2022.

Photos: Beth Newcomb, Stephanie Kleinman

Assistant Professor Joseph Saenz

Instructional Associate Professor Roberto Vicinanza

CAMPUS CELEBRATION

More than 200 graduates of the USC Leonard Davis School’s undergraduate, master’s and PhD programs were celebrated during USC’s 139th Commencement on May 13, 2022, marking a return to traditional campus ceremonies. Dean Pinchas Cohen noted that the Class of ’22 was the largest in school history, adding: “I know you will continue our school’s tradition of service, innovation and success. ... I look forward to living in the future you create for all of us.”

Zora Benhamou MAG ’22

Photo: Anna Sokol for @HackMyAge

The Dean’s Circle

When you donate to the USC Leonard Davis School, you partner with us in the pursuit of excellence. Your support allows students to explore and engage further in their studies, advances our work to provide outreach and advocacy for older adults, and helps provide faculty scientists the best resources to conduct groundbreaking research. Please show your commitment to our students and mission by making a gift of $500 or more to the USC Leonard Davis School, and join the Dean’s Circle today.

THANK YOU AND FIGHT ON!

Photo: Stephanie Kleinman

3715 McClintock Avenue Los Angeles, CA 90089 gero.usc.edu

UPDATE YOUR INFORMATION

Sign up to receive year-round USC Leonard Davis School of Gerontology news, including online Vitality content and our monthly Aging Is Happening email newsletter, at gero.usc.edu/stay-connected.

Nonprofit Org. U.S. Postage PAID

Santa Ana, CA Permit 4849 FOLLOW