By Maria Immekus
Photography by Eric Wuster, Right Touch Photography LLC
From left, Joon Lee, Anantha Shekhar and MaCalus Hogan listen as Orland Bethel addresses the audience at the 19th annual Vanscoy Winter Academy.
More than 350 alumni and friends of the University of Pittsburgh attended the 19th annual Vanscoy Winter Academy on Feb. 13 to hear insights from renowned Pitt researchers who are exploring the complex and evolving field of healthy aging. The speakers addressed numerous longstanding factors that influence health span, not just lifespan. These include genetics, lifestyle and environment, among others.
This year’s event, held in Naples, Fla., featured presentations from Pitt Health Sciences experts, including Aging Institute Director Toren Finkel, Assistant Professor of Medicine Aditi Gurkar, School of Public Health Dean Maureen Lichtveld, Professor and Vice Chair for Research of the Department of Epidemiology Caterina Rosano, David Silver Professor and Chair of the Department of Orthopaedic Surgery MaCalus Hogan, Professor of Physical Therapy Jennifer Brach, and Orland Bethel Professor in Spine Surgery Joon Lee.
“Aging is a major topic for biological research, medicine and clinical care for the future. During the last decade of most people’s lives, they are deprived in terms of function, vitality, physical capability and resistance to illness,” said Anantha Shekhar, senior vice chancellor for the health sciences and John and Gertrude Petersen Dean, School of Medicine. “So, how can we prolong our lifespan and health span so we can age proportionally? At Pitt, we are building programs to answer these questions to address this critical societal problem.”
What do we know about aging healthily?
Finkel and Gurkar, internationally renowned scientists affiliated with Pitt’s Aging Institute, kicked off the event by tackling a central question: Is age really a predictor of our health?
Ultimately, age is just a number, they said. Well, sort of.
“Aging is regulated, not random. It is inevitable. This gives us hope, though, because if we can understand that process in more detail, we can think about how we can modulate it with a specific intervention,” Finkel said.
When most people think of their age, they usually consider the number printed on their passport or driver’s license—not how they feel or how well they can physically execute daily activities.
Take Gurkar’s grandfather, for example. He was mentally and physically fit, climbing six flights of stairs every day and helping her with her math homework after school. At the age of 83, he was diagnosed with cancer. Three months later, he died. Her grandmother also lived to 83, but she was bedridden the last several years of her life and suffered from memory loss.
So, why do people age differently?
Is healthy aging influenced by our genetics or our environment? (Hint: It’s both). Genes account for less than 25 percent of what determines longevity, but researchers note a complex interplay between genes and a person’s environment.
Finkel explained that age is the single greatest risk factor for many diseases, including Alzheimer’s disease, cardiovascular disease and even cancer. For example, by age 70, a person’s risk for a cardiac event increases sevenfold. However, a smoker is only three times more likely to have a cardiac episode.
Gurkar’s lab is on a mission to improve human health span by answering the question: How do we define biological age? If we can assign each individual an “aging fingerprint,” we can intervene with a personalized treatment plan.
Early results from her lab indicate that aging is modifiable. Gurkar’s team is working to develop a blood test that would predict whether someone will be a healthy ager or a fast ager. Ultimately, the tool could be used in middle-aged individuals to predict their aging trajectories, which health care providers could then use to tailor interventions.
“Wouldn’t you want to be young forever?” Gurkar asked. “Or, at least, young forever-ish?”
The importance of resilience
The second portion of the event shifted to the epidemiology of brain resilience as we age, with Rosano, who is also associate director for clinical translation at the Aging Institute. Born with a hearing disability, Rosano had her hearing restored in her 20s. However, the experience gave her early insight into the physical and psychological effects of such a deficit and how they might be overcome.
“This experience has had a profound impact on my work. But it did one important thing—it convinced me that the brain can drive resilience,” she said.
Brain remodeling occurs continuously with age, she said. A dynamic system is more likely to adapt to changes, which is a good thing—because we can make changes as we age to improve our resilience. In a mobility resilience study that assessed 2,300 individuals age 65 or older, Rosano found that adults who walked faster also had more of the neurotransmitter dopamine and were more likely to remain independent. The association between dopamine and walking speed also held up under other conditions, including walking on uneven surfaces and walking while performing an attention task. The work demonstrates that the brain retains plasticity later in life and offers insights into how to tap into its capacity for resilience.
The team plans to continue to assess connections among regions of the brain to further identify how the brain is modifiable throughout life.
Maintaining mobility across the lifespan
The third portion of the program addressed aging in a more traditional sense: the importance of retaining—or, for some, regaining—mobility as we age.
Impaired walking is associated with higher health care costs, more frequent hospitalizations, loss of independence, reduced quality of life and cognitive impairment.
Brach, a physical therapist and clinical scientist, shared findings from a unique Pitt program called “Walk This Way” that focuses on the timing and coordination of walking movement to help older adults retain their walking expertise, enabling them to go farther, faster. “At Pitt, we are focusing on the quality of the movement versus quantity of movement. Remember, it’s not practice makes perfect—it's perfect practice makes perfect.”
Paying it forward for orthopaedic research
In 2014, Orland Bethel, founder of Hillandale Farms, began to feel severe pain in his hips and lower back. He was diagnosed with spinal stenosis, a narrowing and squeezing of the nerves and spinal cord that is often associated with aging. He consulted with six surgeons, and all of them recommended intensive surgery, which he was reluctant to undergo. Then he found Lee, who offered him a less invasive option that was ultimately effective in relieving Bethel’s pain. That initial operation was followed by a second procedure to relieve incapacitating neck pain.
In appreciation, Bethel and the Orland Bethel Family Foundation have made generous donations to help Pitt expand understanding of musculoskeletal aging.
“Public perception for aging is generally low—there is no ribbon or awareness campaign.,” Lee said. “Orthopaedic disability is not just an inconvenience but a disease we need to address.”
Bethel’s initial $25 million gift created the Orland Bethel Family Musculoskeletal Research Center (BMRC) at Pitt, and his additional $18.5 million gift created a biobank within the BMRC. The resource will give researchers—locally and globally—access to a first-of-its-kind encyclopedic data repository to accelerate discovery of biomarkers and therapeutic targets, enhancing understanding of musculoskeletal diseases and improving patient outcomes through precision medicine. Lee now holds the Orland Bethel Chair in Spine Surgery.
“If we can collect enough tissues from enough patients to narrow down treatment options that are more objective and more detailed, imagine what we can accomplish.” Lee said. “Without vision, we don’t have a result. Progress doesn’t happen in a vacuum. It comes down to collective interest and the philanthropy of believers.”
About the Vanscoy Winter Academy
Over two decades, this event has become an anticipated tradition for the University, drawing hundreds of attendees from across the country each year.
Thanks to a major commitment in 2022 from Gordon J. Vanscoy (PHARM ’84, KGSB ’91) and his wife, Bethann, the event will be held annually in Naples for the subsequent two decades. The Vanscoys’ history of philanthropy to the University includes the creation of a fund to support the Dr. Gordon J. Vanscoy School of Pharmacy White Coat Ceremony, establishment of the Vanscoy Endowed Chair and support for numerous undergraduate and graduate scholarships.