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Michelle Odden is an Assistant Professor of Epidemiology in the College of Public Health and Human Sciences. She is also a member of the Center for Healthy Aging Research. She received her M.S. and Ph.D. in Epidemiology from University of California, Berkeley in 2006. In 2011, Odden came to OSU after a postdoctoral fellowship at the University of California, San Francisco. She has recently received funding from the NIH Mentored Research Scientist Development Award. With this award, Odden will identify the strongest risk factors for cardiovascular disease in a National Institute for Health-funded cohort study of elders. She will also incorporate computer simulation of cardiovascular disease to identify the most promising interventions for this disease.
My research aims to prevent chronic disease and disability in older adults. In my career, I aim to better characterize the processes of functional decline that accompany normal aging, and distinguish this from preventable disease. I also strive to improve our understanding of the heterogeneity of the aging process, and to enable health care providers to make more informed treatment decisions, based on a holistic and comprehensive understanding of the unique needs of their patients.
Older adults are living longer and healthier lives than ever before. If you look at the change in median life expectancy over the past century, it is shocking. In 1900, the average life expectancy was around 47 years, in 1950 it was around 68 years, and in 2000 it was around 77 years. The current median life expectancy is approaching 79 years. This is important because it means that ‘old age’ is a moving target. It also means that historically, older adults have comprised a smaller proportion of the population than in the present era. This has resulted in less research on chronic disease prevention in older adults compared with younger adults, simply because there weren’t as many older adults living with chronic disease in prior decades. Older adults have also been understudied due to concerns about their safety and well-being. Taken together, this has resulted in a gap in the evidence on chronic disease prevention in older adults – my research aims to close this gap, by including older and frail adults in studies that account for their unique needs and safety.
My current research focuses on cardiovascular prevention in older adults, specifically those aged 75 years and older. I have two grants to help support this research. The first, from the National Institute on Aging (K01AG039387) aims to compare the population-level impact of novel and traditional risk factors for cardiovascular disease in adults aged 75 and older. The second, from the American Heart Association Western States Affiliate (Clinical Research Program) aims to evaluate the current guidelines for blood pressure and lipid control in older adults.
I’m interested in cardiovascular prevention because it is the leading cause of morbidity and mortality in adults aged 75 and older, yet the available evidence demonstrates that it may be inappropriate to extrapolate results from middle-aged and young-old adults to older elders. Some specific traditional cardiovascular risk factors – such as total cholesterol, hypertension, and obesity - appear to have weaker associations with cardiovascular events in older persons compared with younger populations. We recently conducted a study in which we found that there was a differential association between blood pressure and mortality across levels of self-reported walking speed in older Latino adults. Walking speed is a great marker of physiologic age because it integrates function across multiple systems – musculoskeletal, cardiorespiratory, sensory, and even mood/motivation. We found that the faster walkers looked more like younger adults – elevated blood pressure was associated with increased mortality. In contrast, in the slower walkers, elevated blood pressure was not associated with increased mortality. This suggests that the reasons for elevated blood pressure in older, frail adults may indicate changes in their physiology and alter their risk of hypertension-related adverse events. This is just one example of why we need more research in older, frail adults because they often do not respond to risk factors and treatments in the same way as younger adults do. Another special consideration is that the risks of adverse effects from treatment and polypharmacy are increased in older populations who often have multiple comorbidities and poor functional status. The balance between treatment benefits and risks is particularly unclear in older adults on multiple medications.
In summary, I aim to conduct research that will improve the quality of life and well-being of older adults. It is my goal to add “life to years” and not simply “years to life” that older adults can expect to live.
Odden MC, Covinsky KE, Neuhaus J, Mayeda ER, Peralta CA, Haan, MN. The Association of Blood Pressure and Mortality Differs by Functional Status in Older Latinos. J Gerontol A Biol Sci Med Sci. 2012. Epub. PMID: 22389463 doi: 10.1093/gerona/glr245
Odden MC, Coxson P, Moran A, Lightwood J, Goldman L, Bibbins-Domingo K, The Impact of the Aging Population on Coronary Heart Disease in the U.S. Am J Med. 2011; 124:827-33. PMID: 21722862 doi: 10.1016/j.amjmed.2011.04.010