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Apr 26
Headshot of Julie Zissimopoulos with name and title

Associate Professor Julie Zissimopoulos: the impact and economics of Alzheimer’s

By Alzheimer's and Dementia, Lifespan Health, Podcast, Policy

Julie Zissimopoulos is an associate professor in the USC Price School of Public Policy and the co-director of the Aging and Cognition Initiative at the USC Schaeffer Center for Health Policy and Economics, where she’s also a senior fellow and the director of two NIA-funded centers that support innovative social science research on dementia.

She recently spoke to us about her research using economic insights to better understand the impact of Alzheimer’s disease on individuals, families, caregivers, and society.

On the demographics of Alzheimer’s disease

“People are living longer than ever. So, for example, today about 50 million Americans are aged 65 and older. It was about half that in 1950. And by 2050, the US census projects about 20% of the population will be 65 and older. And age is one of the foremost risk factors for Alzheimer’s and other dementias. So what does this mean for our future? Well, it means that without new treatments or innovations or ways to prevent or delay Alzheimer’s and dementia, the number of persons living with this disease will be about 12 million by 2050.

The risk of Alzheimer’s is really a risk at older ages and it rises dramatically with age. So for individuals 65 to 79, about 7% of them will have dementia. But in your eighties, the risk of dementia is about 20% prevalence. And by 85 and older, if you live that long, about 40% of those persons will have Alzheimer’s. It’s also much higher for women than men. And that difference is not explained just by the longer lifespans of women compared to men. It’s also about one and a half to two times higher for Blacks, Hispanics, American Indians, and indigenous Americans compared to whites. And we know a little bit about what explains some of the differences by race. Some of its explained by education and prevalence of chronic conditions that are associated with a higher risk of dementia, like hypertension and diabetes, but it does not explain it all.”

On cognitive assessments at wellness visits

“We collected data from a nationally representative sample of older Americans to understand better their use of annual wellness visits and the cognitive assessments. And what we found that was only about a quarter of them who received an annual visit also reported receiving a cognitive assessment. And this was higher for beneficiaries who were in Medicare Advantage-type plans versus those who were in the traditional Medicare plans. And this might have an important indication that these traditional benefit plans, the Medicare benefit plans, where there’s direct service-related payment for a set of bundled services, like at the annual wellness visit, may not be a very efficient way to increase our cognitive assessments. We also, I think, have some opportunities to improve our policy around cognitive assessments. Right now there’s no guidance about what constitutes a cognitive assessment or how it should be performed. So a clinician can use a structured tool, which we have many of, or they might just ask the beneficiary, the patient if they’re concerned about their memory. And so all of these factors may affect whether we are actually providing good early detection or not.”

On the costs of Alzheimer’s

“Along with the incredible health toll that Alzheimer’s and dementia takes on a person and their families, it also takes an incredible, tremendous financial on the person who’s living with dementia and their family. Alzheimer’s disease leads to cognitive decline slowly destroying brain functioning. It also leads many to behavioral and psychiatric disorders and declines inability to self-care, functional status. And all of this is extremely, extremely costly. So we estimated the costs for all the persons with Alzheimer’s disease, other medical care costs in long-term care costs, and it’s about $200 billion. But that’s only a partial portion of the costs. So as I mentioned persons with dementia need a lot of care and much of this care is provided by family members, unpaid care. And if you value the hours of family members caregiving, that’s about a hundred billion dollars So we’re talking about over $300 billion in costs of care for dementia. And this is more than the cost of cancer and heart disease combined.

There is a growing literature… looking at what are these impacts on the unpaid care provided by family members and other caregivers. And there’s very consistent evidence that there is negative health effects, particularly on mental health. Caregiving for a person with dementia, particularly as the disease progresses from mild symptoms to severe is a very stressful type of caregiving. There’s a very long arm of financial impacts. For spouses, wealth is consumed to pay for long-term care. So care in a facility such as a nursing home can cost anywhere between $50-100 thousand a year. And most families don’t qualify for Medicare that reimburses for the cost of long-term care. And for adult children who are caregivers, there are impacts on their work productivity, their ability to maintain work in the labor force on their income. We don’t have, as a nation, national family leave policies to support and pay for time away from work for caring for older family members with dementia or other conditions.”

On the need for policy changes

“I think one important policy change is we need solutions to support family caregivers in the workplace, compensation programs. But this isn’t going to be enough. Demographic trends suggest that family caregiving as the main source of care is likely not sustainable. People are having fewer children and they are more Americans with dementia. So we really need an insurance system to cover long-term care. The current system does not function well who, who take it up, tend to only be those at high risk with very high healthcare costs. So we need to be a little innovative here, maybe consider a voluntary auto-enrollment in long-term care insurance with an opt-out much like what has worked well in the retirement savings market. Medicare could also help; we had a new benefit of Part D that covers drug expenditures and protects against very high out-of-pocket spending for those beneficiaries with high drug expenditures. This was very successful. Medicare could do something similar for long-term care, but it will be very costly. So we will need to figure out who will pay, how we will finance this and, and, and who is going to bear the costs of this. Will it be the younger generation through taxes on, say, health insurance premiums? If so, how are we going to make sure that they don’t bear the full burden?”

On future research goals

“I’m very interested in continuing to try to understand how drugs for our chronic conditions are affecting our risk of Alzheimer’s. Looking at anti-diabetics right now, and some of those drugs that are potentially increasing the risk of Alzheimer’s and dementia. I’ve been working on understanding and reducing barriers to early detection, how we might improve that and have some real impact there. And then there are many policy changes that are happening to Medicare, new benefits and Medicare advantage and these could all impact the care and quality of life for persons living with dementia. And it’s important for us to understand what care systems best serve the needs of those individuals, protect against financial impacts for them and their families.”

On the importance of social science research

“…Social science has a lot to offer in terms of identifying opportunities to reduce risk, reduce disparities in risk and improve quality of life and care, and really reduce financial burden. And at the USC Schaeffer Center for Health Policy and Economics and in collaboration with the school of gerontology, we have two NIH-funded centers that support grant awards and mentorship opportunities for social science scholars who are interested in this area of research. Through efforts like this and growing this area of research, I think we can make an immediate impact while we hopefully wait for clinical development of that drug that everyone is hoping for.”

Mar 30
Headshot of Marc Vermulst with name and title

Assistant Professor Marc Vermulst: the role of genetic mutations in human aging and disease

By COVID-19, Lifespan Health, Podcast, Research

Marc Vermulst, PhD, is an assistant professor of gerontology at the USC Leonard Davis School, who focuses on the role of genetic mutations in human aging and disease. He recently spoke to us about how his research into transcription errors, essentially copying mistakes, aims to strengthen vaccines and delay or prevent diseases.

On transcription errors

…when you go from DNA to a protein, there’s a short intermediate molecule that needs to be created, and that is an RNA molecule. And so conceivably you can make the wrong proteins … if a mistake occurs in the process of making an RNA molecule and that process is called transcription. So we study how frequently mistakes occur when RNA molecules are generated and what type of impact that has on aging and disease.

When I first started this project the reason why it hadn’t been studied much was because there was no technique capable of actually finding them, so it was something that we just could not see.  So what my lab did is was we designed a novel tool, a molecular biology tool, that allowed us to find these transcript errors across the entire genome. So it was this massive improvement, and suddenly we could observe things that were previously unobservable and what we discovered with it was that these errors are really, really frequent and when they happen, there are a couple of impacts that they have.

The most important one probably is that they result in incorrect proteins and those proteins tend to fold in the wrong way. Proteins are large 3D molecules. In order to function, this long molecule needs to fold in a particular structure. And when you make a mistake in the generation of that protein, because of a transcript error, the protein tends to misfold and as it turns out, misfolded proteins are a key component of numerous age-related diseases, including Alzheimer’s disease, Parkinson’s disease, amyotrophic lateral sclerosis. All of these diseases are caused by misfolded proteins. So, what I think that we really found is a new component of the etiology, the origin of all of these diseases.

… transcription errors occur a hundred to a thousandfold more frequently than genetic changes. So most of the mistakes that occur in proteins are not due to genetic changes, they are due to these transcript errors.

One of the things I’m really interested in is the occurrence of age-related diseases for example Alzheimer’s and Parkinson’s disease. And one of the major questions is why do people get these diseases? There are families that have a mutation that makes them more predisposed to getting these diseases, but that really only explains five to maybe 15% of all of the cases. The remaining 85 to 95%. We really have no clue why these people get these diseases. So what I’m trying to do is I’m trying to explain these remaining 85%.

Because all of these diseases are caused by misfolded proteins, and transcription errors cause these misfolded proteins, I think that we have found a new mechanism that can cause these diseases. And if the mechanism is indeed correct that means we can now do something about it. So it’s really about finding the origin of the disease itself in order to be able to design medicine for it. That’s one of the major goals. We’re also asking when aging actually happens.  We have reason to believe that the events that lead to aging can occur many, many years earlier, probably decades. And perhaps in certain cases, the pace of aging is actually set in our twenties or thirties. And that’s one of the things we’re trying to prove as well,

On COVID-19

… one of the reasons why viruses become resistant to vaccines or to drugs is because there is always one viral particle that happens to get a mutation that allows it to be resistant. So one of the major things people want to know about viral particles and different kinds of viruses is how fast do mutations accumulate in the genome of these viruses. And they want to do that for two different reasons. First of all, they want to know that because they want to be able to predict how quickly viruses might get resistance to certain treatments or vaccines. The higher the mutation rate, the faster that would happen. Secondly, they want to be able to predict what type of viruses might erupt in the future. So we now know that for example, that a coronavirus has a certain genetic composition, but that composition might be completely different next year or the year afterward. So by doing these mutational analyses, we’re able to predict hopefully what the virus might look like in the future. So we can better prepare for an outbreak in 2022 or 2023. It’s been a really rewarding project.  So the reason why I got into it is because of my interest in genetic mutations and that’s a key component of the viral particles.

We’ve used this super powerful big data tool to study how the virus mutates inside cells and we have a couple of different goals with it. First of all, we want to determine how quickly these mutations actually happen. Right? So that will give us an answer as to how quickly viral particles might come up with mutations that make it resistant to certain pigments and vaccines. And we’ve already heard in on the news that new mutant versions of the virus have come up, right. , it’s a strain from Brazil, there’s a strain from England that are more virulent and more dangerous and the initial coronavirus. So that is one of the consequences of the genetic changes.

The virus has a key protein that it needs to make in order to produce the envelope of the virus itself, all kinds of surface proteins and these proteins are essential. So certain genetic changes will destroy those proteins, and that will result in the death of the virus. So if we do a massive analysis of the entire genome of this virus, and we do that over time, what will find is that there are mutations present everywhere on the viral genome, except for those few spots where the mutation kills the actual virus.

So by virtue of looking at locations in the genome, or finding them where mutations do not occur, we can find these Achilles heels of the virus. And that would allow us to guide the development of vaccines to that specific spot. … if we target the vaccine to a spot that cannot be mutated, that means that the virus has two choices. It can either be destroyed by the vaccine or a treatment itself, and in an effort to try to get out of it, it could mutate that position of its genome, but in doing so, it will kill itself, so it’s a no win situation for the virus. That is one of the goals of this project also.

Feb 25
Headshot of Hussein Yassine with name and faculty title

Dr. Hussein Yassine: Uncovering links between nutrition, genes, and risk for Alzheimer’s disease

By Alzheimer's and Dementia, Lifespan Health, Podcast, Research

Dr. Hussein Yassine is a professor of medicine at the Keck School of Medicine at USC and is uncovering links between nutrition, genes, and risk for Alzheimer’s disease. He spoke to us about his research on APOE4, omega-3s and inflammation in the brain.

On APOE4 and Alzheimer’s risk

So APOE is a gene on chromosome 19. It exists in the population in three different forms. The two form, not very common, the three form, the most common and the four form, which makes about 20% of the population. The four form, if you get one copy from your parents, your chances of getting Alzheimer’s disease increased two to four times. If you inherit two copies, meaning you get one copy from mom and one copy from dad,  your chances of getting Alzheimer’s, or the odds ratio, goes to 12 times, meaning an APOE4 E4 homozygote, uh, 50% of those homozygotes by the age of 80 will have Alzheimer’s disease.

On the work of his lab

My lab is working to understand whether omega-3s can slow down cognitive decline in people at high risk of Alzheimer’s disease, based on APOE4. We are working on three different fronts. One, we have basic science models where we study the brains of APOE4 targeted replacement mice. We use brain imaging to study labeled DHA brain uptake in the human brain, and we do clinical trials where we give people omega-3 supplementation and look at outcomes.

On omega-3 supplements versus dietary interventions

At this point in time, we do not have high quality evidence to suggest that supplements make a difference. But we know from landmark observational cohorts, for example, the Framingham in the US, the Triple C in France, the Rotterdam in the Netherlands, and many others that people who consume at least one serving of fatty fish per week have lower risk of developing Alzheimer’s disease. In contrast trials that have involved omega-3 supplements have not panned out. And as we discussed, omega-3 supplements might be too late to be given to patients with neurodegeneration because they may not reverse neuronal death. Giving omega-3s to the general population may prove to be very difficult because the majority of people do not develop Alzheimer’s. So we need more research before we can recommend supplements. In addition, we don’t know exactly what kind of supplements we should be providing, the exact dose, the composition that duration. More research is needed to figure out those questions.

On what can people do to reduce Alzheimer’s disease risk

I think timing is key. I think if you know that you are at increased risk based on family history or APOE4 genotype  nutritional and lifestyle interventions during middle age will provide you likely the most benefit. Our research and others suggest that between the ages of 45 and 65, those at risk individuals should be on certain lifestyle modifications, whether it is at least one serving of fatty fish per week, or some good exercise regimen. We’re not talking about marathon running, maybe three times a week, 15 minutes per day is good enough. Lifestyle modifications, no smoking, reduced consumption of simple sugars to avoid complications of diabetes and obesity, increased intake of green leafy vegetables, which are enriched in polyphenols and antioxidants, good sleep, listening to music, certain forms of meditation, or in some individuals praying. And, uh, all of these factors, we know that have positive effect on mitigating or decreasing the chances of getting Alzheimer’s.

One additional factor that I did not discuss is hypertension or blood pressure control.  Blood pressure is known as a silent killer, because people have blood pressure, but they don’t know that they do so. Blood pressure control, diabetes control, cholesterol control in middle age together with these lifestyle changes can really pay dividends decades later. Once people start having symptoms and we’re talking now 60 to 80, they often come to us and they’re talking to us about omega-3 intake, about all these changes. And unfortunately at this time, the interventions are not very effective.

On the most important points  Dr. Yassine hopes people understand from  his research?

The biggest takeaway is that there is a life-course risk of Alzheimer’s disease risk in APOE4 carriers that starts shortly after birth. But mainly it takes decades before symptoms start. We know from imaging studies, between the ages of 20 all the way to 60, that the APOE4 brain is compensating to maintain cognition. Once this compensation fails, APOE4 carrier brains starts deteriorating, and you see signs of neurodegeneration and Alzheimer’s dementia. Our research emphasizes the importance of a healthy lifestyle, which includes sufficient omega-3 consumption, defined as at least one serving of fatty fish per week, lifestyle factors such as exercise, sleeping, music, meditation, family connections, combating depression, and social isolation, and social isolation is a problem now with COVID. And in addition to that, not smoking and reducing the amount of simple sugars consumed to reduce diabetes and cardiometabolic risk. Those interventions, we all know that they are critical, but our research suggests that there’s a critical time to do these interventions during middle age, to prevent the progression to Alzheimer’s at the age of 65 to 75. Once patients develop this disease, those interventions become less effective. So this is the greatest takeaway from the research we are doing.

On his message to young people

So my message to young people is that if you have a family history of Alzheimer’s disease, or that you know that you are an E4 carrier, plan in advance. Learn about the risks of Alzheimer’s disease, learn about the risks of carrying the APOE4 genotype and get informed, because we have cutting-edge research to help you out in preventing the risks of this disease early on.

On the importance of Alzheimer’s research

Up to 25% of individuals carry APOE4. So in a room of a hundred people, 25 people will have one copy of APOE4, that’s enormous. And they make the bulk, up to 50%, of patients with Alzheimer’s. We have so many APOE4 carriers in the community, and I think more research in this area is very important to the future of mitigating or changing the risk of Alzheimer’s disease. We should start early and we should try the best we can to prevent this disease because we know once it happens, it’s very difficult to treat.

On how to reach Dr. Yassine

If anybody listening to the podcast has family members with Alzheimer’s disease, they are concerned about being an APOE4 carrier and would require more advice or perhaps participate in any of our trials. Please feel free to email me. My email is hyassine@usc.edu, and you can look me up at the USC directory website and I’m happy to help.

Dec 17
Headshot of John Tower with name and faculty title

Professor John Tower: the roles of sex differences and mitochondria on aging

By Lifespan Health, Mitochondria, Podcast, Research

John Tower is a professor of biology and gerontology. He spoke to us about his research on the roles of sex differences and mitochondria in aging.

Highlights from our conversation:

As you may know, in humans, women live longer than men. And the reason for that is not entirely understood and also malfunction of the mitochondria, which is also called the powerhouse of the cell is, directly implicated in aging and multiple aging-related diseases, including Parkinson’s disease and Alzheimer’s disease and cancer. And so we’d like to understand at a very basic level, why does the mitochondria malfunction during aging and does this, or does this not have, uh, is this related to, or a result of sexual differentiation of the male and female?

While there’s no consensus in the aging field on pretty much anything. But, I would say at this point, antagonistic pleiotropy is the most favored model for how the genetics of aging works across species. And the idea is that genes can be beneficial in one context, but detrimental in another context. Specifically they’re likely to be beneficial early in life, promoting things like differentiation and growth and sexual reproduction and in the long term, the same genes are detrimental and have a cost during aging.

I’ve made a complete about face, from thinking that sexual differentiation was not important, to thinking that well, maybe sexual differentiation is actually causative to a large part in the aging process. In other words, in differentiating the male and the female, you set up the situation for sex specific trade-offs between reproduction and aging, and some aspects of these trade-offs are common between the male and the female. And some of them are unique to either the male or the female in that there are pathways that promote a reproduction, but then have a cost for the long-term maintenance of the animal. That’s the kind of antagonistic pleiotropy my lab is focusing on right now which is the idea that a gene can be beneficial to one sex, but detrimental to the other, or a gene could be detrimental to each sex in different ways

Across species, we see a decrease in mitochondrial gene expression and mitochondrial gene function during aging and the relevance to sex is that the mitochondria is transmitted to offspring only through the mother. And so this means natural selection can only optimize mitochondrial gene function for the female. This means that the male inherits a mitochondria that is less optimal for his physiology than, than it might be. And so what we see is that mitochondria isolated from female mammal tissues function better than mitochondria isolated from males consistent with this hypothesis. And so this may be one reason why females tend to live longer than males

I think what I would expect is we’re going to see sex-specific interventions in aging and aging-related diseases,  even diseases common to the male and the female, like Parkinson’s and Alzheimer’s,  that having an intervention that’s tailored, to the male or the female will be more efficacious.

Nov 23
Headshot of Kerry Burnight with name and title

Alumna Kerry Burnight: Leveraging technology to help older adults

By Careers in Aging, Lifespan Health, Podcast, Technology

Dr. Kerry Burnight is the chief gerontologist at GrandPad, the creators of an internet-connected tablet designed specifically for seniors. She spoke to us about how the device aims to combat loneliness and abuse and about the sense of purpose that powers her gerontology career.

Selected Quotes

On being a gerontologist

“To this day, if anybody asks me what I do I say I’m a gerontologist // a person who studies aging. And our goal is to try to make aging a better experience for all of us. And then people are right on board. So I think there’s like a million different ways to express your gerontology ness. And I honestly feel so like the world is the oyster of undergrad master’s and PhD gerontologist and the only thing that will hold you back is not going for it.”

On using technology to address loneliness

“And so, all things being constant being lonely or socially isolated would put you at greater risk for elder abuse and exploitation, but also at significantly greater risk for cognitive impairment for stroke for heart disease and even mortality. So you’re 25% more likely to pass away than those who are not lonely and something. //And so I was thinking, gosh, you know, maybe technology could help us.”

On providing a vulnerable senior with a GrandPad

“He was able to connect with all of us but without any of the scammers are perpetrators and so he was a guy who listened to jazz music and he loved to listen to it on his GrandPad and we did all these video calls and the reason it was so helpful is because it was so different.”

On considering seniors in technology research and development

“Standard technology creates technology targeted and built for those in their 20s and 30s// It was never designed intelligently and to honor you to honor your autonomy. //Many organizations are all about “training seniors” and it’s so silly. If you even take one step back and you think, don’t train them. It’d be like saying let’s train people to wear size two pants. No, you need to make size six pants and size eight pants and size 20 pants not shove people into the tiny pants.”

“Einstein says that the greatest sophistication is simplicity and it’s true, like the hardest thing in the world that you can do is to create something simple and it’s not because seniors are less than. It’s because we have listened. The best thing of my job is that I employ a group of seniors ages 86 to 106 who are called our grand advisors and every step of the way. It is just by listening of what matters and what doesn’t matter to people.”

On the flexibility of a gerontology degree

I say you can literally do anything you’re interested in because aging is living// My aspect now is human connection and technology. But, if you’re interested in food, you’re interested in transportation, if you’re interested in entertainment…basically, in my opinion, any facet of being a human in this time of demographic revolution needs a gerontologist to really be thinking at it in a systematic way from what it means from an aging perspective.

On the importance of stepping up to help older adults

“All you have to do is spend time with older adults and then you realize you don’t have the luxury of being shy because it’s not about you, it’s about what you can do to serve.

And actually it was a senior who told me that one time I was speaking, there was a crowd of 1000 and I was getting nervous. And so this older person said to me, ‘you need to get out of your way’. And I got really struck me that I was the one like I’m scared to talk in front of people. I don’t want to, blah, blah, blah. Get out of your way because if you’re going to help aging and our own aging, then you better get to work.”

Sep 30
Headshot of John Walsh with name and faculty titles

Professor John Walsh: The Challenges and Opportunities of Teaching Online

By COVID-19, Lifespan Health, Podcast, Technology

Professor John Walsh, vice dean of education at the USC Leonard Davis School joins Professor George Shannon, holder of the Kevin Xu Chair in Gerontology for a conversation on how teachers and students can make the most of online instruction and discuss how our life experiences can help us meet this challenging moment in time, both in the classroom and outside of it.

Quotes from this episode:

John Walsh

On isolation

Many students are feeling isolated right now and it’s obviously forced isolation and they just want to connect. The premed class I’m teaching right now,  I have 50 students. And, and so here we are, two weeks into the semester and class ends at the hour 50-minute mark, and I’m having, 10 to 15 students stay afterward just to hang out and, talk about anything. And they just want to feel connected and, that’s a good thing because we got to help them through this.

On always learning

I always tell my students that I’ve never stopped being a student and that I always want to keep learning. And, so I will deliver a lecture, we’ll get centered on a topic and philosophically, I know from my reading and from looking at websites or watching videos about how what we’re discussing applies to furthering society or helping you in the workplace. But I love hearing the actual application from students where they’re down, boots on the ground, and they’ve experienced this. And they may even say,” those guideline or those principles are all good,  however, in my experience… ” And, and then you put that in your back pocket… and then you use that in future lectures. I’m constantly learning and I tell the students,, I don’t know everything and I really want to learn from you.

On online classrooms:

Well, I think this is a game-changer. It was forced down our throats with a pandemic, but this is a game-changer. We, as a program have always been a leader at USC in terms of online education and we can’t stop being a leader.  We just got to keep up on it.  These platforms do offer a level of interactivity that we weren’t utilizing before.

On collaborative exams

I was just so amazed and so excited watching the active learning that went on during these collaborative exams. I know now that when we are back in session, // I’m going to be sitting there in the auditorium, I’m going to break people up into groups of six or seven, and they’re going to do the collaborative exam right there in the auditorium because it’s, I think it’s a really cool way to learn.

George Shannon

On his transition from elevator repairman to successful actor to USC professor

I was 55 years old. I didn’t have an undergraduate degree. So I spent two years in undergrad getting my undergraduate degree because I had hundreds of units where they were scattered all over in different things that I had touched upon. And then I went into the master’s program and did that in two years and was accepted into the PhD program. And so yeah, so that’s a long-winded way of saying there are, there are lots of things that you can do that come to an unexpectedly. I always say, if someone opens a door for you, don’t slam it in their face, go walk in and see what’s going on, because it might be an opportunity that can change your life in a very positive way as it did for me.  I had four kids and a couple of wives and lots of bills and, and  I survived all of that because I  didn’t turn my back on something that I had never thought of before.

If something presents a change or a mode that you’re not expecting, it may be something that can lead you to something that’s even more exciting that gives your life more meaning. People ask me if I’m thinking about retiring and I’m astonished. Of course, I’m, first of all, astonished that I’m 80 years old, but secondly, I’m further astonished that anyone would think that I would ever consider retiring as long as I  have my faculties about me and I’m able to perform. Because life is an endless performance as long as it lasts.

On online classes

in some ways, from my perspective, I like Zoom because I have on the screen the 40 or 50 students, so I may have in class and I can pick them out and ask them specific questions instead of being in the auditorium where they’re all trying to hide in the back of the room. And so I, I find there are some really some positives from this experience.

Jun 01
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Dean Pinchas Cohen: COVID-19 Risk Factors and Research Directions for Older Adults

By COVID-19, Lifespan Health, Podcast, Research

Pinchas Cohen, USC Leonard Davis School dean and a professor of gerontology, medicine and biological sciences, joins Chief Communications Officer Orli Belman in a conversation about COVID-19 risk factors and research directions, with a focus on how research focused on delaying aging processes hold promise for improving outcomes for older adults.

Quotes from this episode

On the relationship between age and mortality rates

“Older adults are so much more dramatically affected by this terrible pandemic. While of course middle-aged people and young people are affected by this and their rate of infection can be very high, the mortality of younger people is very, very small, but rises dramatically as people age.”

On vaccine response rates and older adults

“We all know that vaccines are the number one goal for the biomedical industry right now, but some of you may or may not be familiar with the fact that vaccines are extremely efficient in young people, but among older adults, the response to vaccination is sometime very ineffective. For example, flu vaccine has a non-responsiveness rate that approaches 50% in older adults, which are of course the group that needs it the most.”

On the need to develop cytokine storm blockers

“When people look at what actually causes people to perish from COVID 19, it’s not so much the viral pneumonia that they suffer from, but rather something known as a cytokine storm that the body responds to the virus was this secretion of inflammatory cytokines like, something called interleukin six and TNF alpha and interferon, which the body then responds to with really shutting down of the lung and eventually death. So the development of blockers of this cytokine storm, are going to be critical. And that’s an area that geroscience has been leading for many years.”

On the importance of  gerontology and geroscience research

“Post-COVID-19, I think that gerontology education will only become more important. Furthermore, research on the policy and social impact of the pandemic will be prioritized. Our leaders, our thinkers will continue to be at the forefront of that. Research into geroscience, particularly immunosenescence and inflammaging will be a major goal for the National Institutes of Health. Prevention of chronic disease, which has been really the biggest risk factor for older adults will return as a national priority.”

On how coronaviruses differ from influenza viruses

“Coronaviruses are quite different from influenza viruses. They’re biologically unique, very separate. Also, influenza viruses affect primarily the airways, while coronaviruses can attack various parts of the body, but they’re deadly when they end up attacking the lungs, which influenza does not. Influenza predisposes the lungs to bacterial infections, which could be lethal. But they’re quite distinct. That’s why there are limited lessons that we can learn from influenza when it comes to COVID 19. But we do have enough previous knowledge to allow us to deal with this crisis and for future crises.”

On the roles of age, genetic and underlying conditions

“Young people get infected just as easily as old people. The difference is that many young people have a completely asymptomatic course that they’re able to have the virus go through their system, develop antibodies, and never have any sign or symptom. The genetic determinants of who is going to get illness as opposed to who’s going to remain asymptomatic is something that we totally don’t understand. Obviously having poor health is important..but there’s also going to be genetic reasons why some people develop or don’t develop severe disease and then whether or not you’re going to survive, you know, be really sick and, and get better, whether you’re going to have a very, very bad outcome.”

On what matters most

“At a time of great global uncertainty, what matters most is clear now than ever before. Health matters, older adults matter, science and especially geroscience matter. I think that this is going to be a challenging year ahead of us, but together we will prevail.”

May 11
Photo of Tyler Evans with name and titles

Humanitarian and Adjunct Associate Professor Tyler Evans: COVID-19

By COVID-19, Lifespan Health, Podcast

Throughout his career, Dr. Tyler Evans ‘02 has been on the front lines of major disease outbreaks around the globe. He was in South Africa at the height of the AIDS crisis and he treated Ebola patients in Sierra Leone. He just joined the New York City Emergency Management Department as the chief medical officer for the COVID-19 branch.

The USC Leonard Davis School “Impact Maker” joined Professor John Walsh to discuss the current pandemic, global health, and how students can best serve populations in need.

Quotes from this episode

On how we were not prepared for COVID-19
“Folks in public health, especially in the communicable disease world, knew that the greatest sort of threat to society was not necessarily going to be war; it was going to be a microbial onslaught. And if the infrastructure is there, I’m not saying it’s not bad, but the risk is definitely mitigated. And we were not there. I mean, we’re getting better now. but we were not ready.”

On health disparities and vulnerabilities
“When we look at variability, even between states and certainly even within states and within cities, and when you look at the granularity, you’re going to see a lot of differences, and those differences, I think, really highlight the disparities that naturally exist throughout this country.”

“I’m sitting here in a tennis field hospital with incredibly sick people, but they all have what we refer to it as the social determinants of health. They all have a number of chronic comorbidities. They’re people that historically don’t have great access to healthcare. So there are a lot of factors involved that have led them to be more vulnerable for adverse consequences.”

“We can’t move forward in life being afraid to come outside. We can’t move forward in life being afraid to touch other people. I do think that the shelter-in-place measures were a good thing. I don’t think that we completely thought out all of the unintended consequences on the most vulnerable populations in the U.S. and abroad when it comes to food insecurity when it comes to other kinds of chronic diseases or access to care.”

On how we are all in this together
“I think, hopefully, it’ll kind of bring us all together; more solidarity across the world to better understand that we are really all in this together. Despite the fact that the term is a little cliché, I think that if people really listen to what that means, they will grasp onto it and really understand how we focus so much on differences, but the reality is we really are all potentially impacted by this.”

On how students can help and find meaning in their work
“There are a lot of opportunities to get involved, not just for COVID, but for the prevention or management of other diseases. You don’t have to be a physician. You can be a student. But you’ve to find ways where your contribution is not just meaningful to you. I’ve had a number of really meaningful and translatable, sort of transformational experiences throughout my own life, but we also have to ensure that we’re giving back to society when we’re doing these internships or whatnot. So finding something that might not be as glamorous but could truly be meaningful and helpful is good. You might be having to create a database or code, or help to develop infrastructure. A lot of the developments are not as sexy and cool and exciting as people think they are. But all of those parts ultimately end up leading to our ability to save lives. So finding your niche, finding something that you’re really good at, and doing it, and contributing is important.”

“For the students that are watching this, it’s so important that throughout your career, whether it’s in medicine or public health, or whatever field you decide, to just try to really do the right thing. Try to lead your career with your moral compass and ultimately try to impact populations that need it the most. And I assure you that ultimately your lives, both professionally and personally, will be very rich and meaningful.”

“So the world needs you guys to help populations that are in need, whether it’s now, or whether it’s building it, or whether it’s in acute management. Like I said, it’s not just healthcare systems, it’s economics… there’s so many intersections in our globalized world. And as long as folks really lead with their moral compass, I think they’ll have a very meaningful life.”

Mar 24
Headshot of Cary Kreutzer with name and titles

Associate Professor Cary Kreutzer: Covid-19 tips for grocery shopping and healthy eating

By Health and Wellness, Lifespan Health, Nutrition, Podcast

Cary Kreutzer, associate professor of gerontology and pediatrics and the director of the USC Leonard Davis School’s master of science degree program in Nutrition Healthspan and Longevity, joins Chief Communications Officer Orli Belman in a conversation about how to eat healthy, shop smart, reduce stress and stay connected through food as we practice social isolation due to the Covid-19 virus.

Cary Kreutzer quotes from this episode:

On staying connected through food

“I think as we all are sequestered to our homes and may or may not be with extended family, using whatever sources of media to make those connections with family members and reaching out to them to either have them on the line as you’re preparing an old family recipe or having them on the line as you’re enjoying a meal and feeling as if they’re there with you at that meal are all great ideas of how you can bring family in.”

On what food items to have on hand

“I think as we try to eat more at home, or are in a position where we need to be eating more at home, and are less able to make quick trips to the grocery store, which probably isn’t a smart idea, [we should be] looking for foods that have a longer shelf life: those that need to be refrigerated, those that we can store in our freezer, or even looking to canned goods that we can have as a backup plan should we need to grab for those items.”

On canned fruits and vegetables

“A vegetable is a vegetable, and they all are going to provide vitamins and minerals. [In terms of] the processing of frozen and the processing of canned vegetables or fruits, we lose minimal amounts of nutrients in that processing. Many items are either quick-canned or quick-frozen and we’re losing very little nutritional value. … For those that worry about their salt intake, my only caution I would say for canned foods would be to rinse the foods that are canned, that can be rinsed. Many foods like soups or even sauces, you can now buy low salt versions of those just as a way of decreasing and salt intake.”

On choosing prepacked fresh produce

“I would choose bagged or fresh fruits and vegetables that are in containers, whether it’s a bag or whether it’s plastic containers. I’ve toured those food preparation sites where lettuce and other foods are put together, and they’re very sanitary with their practices. In a grocery store, we don’t know whether people are carrying this virus while they’re shopping. If you’re going to buy loose carrots and your plan is to cook those carrots, I think you would be fine. But I would not buy something like a raw head of lettuce that I was going to rinse and then chop and put in a salad. I would probably stick to bagged lettuce just to be safe.”

On safe supermarket shopping strategies

“I would suggest trying to limit the number of times you’re going to a store right now. … It is probably is prudent to try to get what you need once a week, or longer if you can do that. And definitely have a shopping list. Sometimes if it’s the store I always go to, I’ll try to write things on my list in the order of where I pretty much know they are in the store: all the dairy together, all the canned foods together, all the breads together, meats together so that I can quickly get through that list. … [If you can’t find an item], find someone who you can ask where to find that item so that you can get in and get out quickly.”

On take-out food

“With picking up food or even having food delivered, try to stay focused on warm foods that you can reheat in the oven or heat up to 180 degrees, which is a warming temperature in the oven. I would only use raw ingredients that you’re preparing at home to add to those foods. And I definitely would throw out any packaging that comes with those foods. I’d use my own dishes. I would also throw out bags or plastic or things that they come in and make sure I wash my hands well because we do know that the virus can live on some surfaces longer than others.”

On staying hydrated

“Avoid foods that cause you to be dehydrated; coffee, as a natural diuretic, as well as alcohol can be dehydrating. Try to focus more on water. Herbal teas are good. You can add squeezed fruit or frozen fruit to a juice if you need to add some flavor for those. With diabetes, you need to watch the amount of sugar-sweetened beverages you’re consuming. So limit the juices; while those are good in terms of nutritional value, they’re usually pretty high in sugar, and a little bit every day is really all we should be consuming.”

On ways to avoid stress eating

“I think, for all of us, being aware and recognizing that this can be stressful and coming up with plans for activities … to think of ‘What are all the things that I’ve been putting off that I can do around the house?’  [such as] weeding, or planting my garden a little bit earlier. Thankfully, we’re not restricted with our ability to go out. That could be riding bikes, that could be going for a walk. It doesn’t have to be intense exercise. … In my neighborhood, there were some neighbors that were going to have a meet and greet. Many of us have seen the video of Italy and people on their balconies singing together. In my neighborhood, that there were people that were going to go out on their porch and just wave to one another across the street. … You can use all types of social media, whether it’s calling friends or family on phones now we can do video chats, we can do Skype through our computer. So lots of ways to connect with other people. I would also say, I know for my religious affiliation, they have sent lots of ideas of how I can stay connected to my religious beliefs and not feel alone. So, reach out to those resources that are provided for whatever your religion may be and work on trying to destress your environment.”

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