As it receives $2 million in new National Institute on Aging (NIA) funding for another five years of operation, the University of Pennsylvania’s Population Aging Research Center (PARC) is also reorganizing itself and its investigative agenda across a wider range of health issues in aging populations around the world.

The 25-year-old PARC was originally established as an activity within the larger Penn Population Studies Center (PSC) that is part of the School of Arts & Sciences (SAS). It traditionally pursued a narrower focus on the economics, demography and health disparities of elder care. But it has been steadily growing toward becoming more of a sister center to PSC.

Major changes

Now, as its new funding cycle starts, PARC is making a series of major changes to facilitate its further reach across campus. Instead of just SAS, PARC will now operate under the aegis of both SAS and Penn’s Perelman School of Medicine (PSOM).

It has also established a new co-director position filled by Norma Coe, PhD, of Perelman, who joins Hans Peter Kohler, PhD, of SAS, in running the Center. Both Coe and Kohler are LDI Senior Fellows.

“The new PARC relationship with the Perelman School was a mutually beneficial partnering,” said Coe, an Associate Professor at Perelman’s Department of Medical Ethics and Health Policy. “The level of interest and number of researchers across Penn involved in aging and health issues has increased greatly in recent years and there has been more of a gravitation toward PARC. We now have 50 affiliated researchers, about a third of whom are PSOM faculty.”

Broad partnership with LDI

Another part of the changes at PARC is a new level of partnership with LDI providing access to the Institute’s campus-wide infrastructure of expertise and data sources.

“We’re doing a lot of data sharing and are interested in getting Medicare claims and other data that both LDI and PSOM have invested heavily in,” said Coe. “These new partnerships and new infrastructure will enable us to expand what we do as well as the number of researchers doing it. The aim is to develop new interdisciplinary opportunities for research at Penn.”

LDI Executive Director Rachel Werner, MD, PhD, said, “We’re excited about ramping up the LDI connection with PARC in ways that bring in new disciplines and resources directly relevant to PARC’s expanded goals.”

In the area of dissemination, an LDI-led core will establish and maintain PARC communication channels, disseminate policy-relevant research results to targeted audiences, train PARC researchers in media skills, and help guide PARC’s annual stakeholder conference.

People lose their ability to live on their own and to take care of themselves — a fact of many people’s lives that, from a public policy standpoint, we seem to be content ignoring at the moment.

Norma Coe

Two new areas of research focus for PARC are long-term care for older adults and cognition/Alzheimer’s. Coe, whose 2005 PhD dissertation at MIT was “Long-Term Care and the Elderly,” has been focused on this particular issue throughout much of her career. She joined Penn in 2017 from being the Director of the Center for the Study of Health in Public Policy at the University of Washington School of Public Health.

Long-term care

About long-term care, she notes, “People lose their ability to live on their own and to take care of themselves — a fact of many people’s lives that, from a public policy standpoint, we seem to be content ignoring at the moment.”

“Over the last five years, there have been some individual PARC researchers working on their own projects related to long-term care and Alzheimer’s, but neither of these topics has been a Center priority; now they will be,” said Coe. “Researchers are really interested in pursuing these areas, and we want to support that with our pilot grants. One of the two grants funded in this current round of funding includes home health care.”

COVID-driven research

She pointed out that in the related nursing home area, the COVID-19 pandemic has created new needs for research.

“If you think about aging research, you can’t ignore COVID,” she said. “It has huge implications that will be impacting us forever. What does it do to fertility rates? What does it do to retirement savings? What does it do for long-term care? What does it do to marriages? We don’t want to think about this as just ‘getting through the pandemic.’ Rather, we want to  understand the long-lasting effects and how we should be thinking about them from a wider perspective.”

“To start with,” Coe continued, what we’re seeing across the country is that current nursing home regulations and quality metrics don’t correlate with keeping COVID-19 out of nursing homes. Staffing issues have really come into the spotlight. Recent NBER research shows that even after visitors were locked out of nursing homes as a coronavirus safety measure, seven percent of the cellphones in nursing homes were observed in more than one nursing home. Staffers were moving back and forth between nursing homes. That’s an issue to be thinking about if your network of nursing homes is so connected through your staffing.”

In an earlier study, Coe herself investigated this issue and found 20% of nursing home staffers were working second jobs, often moving between different nursing homes.

Alzheimer’s disease

In the other new priority area — Alzheimer’s disease and related dementias (ADRD) — the goal, said Coe, is to “bring together more people who are working on these topics and make it so the collective is stronger than the individual researchers themselves. We want to increase the chance for researchers to  meet and talk and learn from each other about opportunities to deal with this disease — which, of course, we’ll be doing virtually for now.”

Coe and Kohler are kicking off the new phase of PARC history by holding “listening sessions” that enable researchers to define what they hope to achieve through their PARC relationship, as well as suggestions on how best to do that.