Research Focus Areas

A core function of PHS is to stimulate, facilitate, and conduct research on social determinants of health. Below you will find past and current research projects supported by PHS. Contact us for more information about any of the projects or to be connected with the investigators.

Stress Disorders and Dementia in the Danish Population

There is an association between stress and dementia. However, less is known about dementia among persons with varied stress responses and sex differences in these associations. We used this population-based cohort study to examine dementia among persons with a range of clinician-diagnosed stress disorders, as well as the interaction between stress disorders and sex in predicting dementia, in Denmark from 1995 to 2011.

This study included Danes aged 40 years or older with a stress disorder diagnosis (n = 47,047) and a matched comparison cohort (n = 232,141) without a stress disorder diagnosis with data from 1995 through 2011. Diagnoses were culled from national registries. We used Cox proportional hazards regression to estimate associations between stress disorders and dementia. Risk of dementia was higher for persons with stress disorders than for persons without such diagnosis; adjusted hazard ratios ranged from 1.6 to 2.8.

There was evidence of an interaction between sex and stress disorders in predicting dementia, with a higher rate of dementia among men with stress disorders except posttraumatic stress disorder, for which women had a higher rate. Results support existing evidence of an association between stress and dementia. This study contributes novel information regarding dementia risk across a range of stress responses, and interactions between stress disorders and sex. Read the published journal article here. To learn more about the Danish Register and Biobank, please email the PHS Data Core for more information.

Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Center (SAGE)

The NIH has long recognized the necessity to aggressively leverage emerging methodologies like precision medicine, digital health, biomedical data science and virtual reality & simulation based interventions approaches to ameliorate health disparities in racial and ethnic minorities. However, relatively fewer efforts have attempted to conduct trans- disciplinary aging research integrating biological, social and behavioral sciences utilizing emerging methodologies. The overarching goal of the proposed Stanford Aging and Ethnogeriatrics Transdisciplinary Collaborative Center (SAGE) is to increase the diversity of the aging research workforce by mentoring new leaders in aging research and promoting advances in behavioral and social sciences aging research using emerging methodologies including precision medicine, digital health, biomedical big data science and virtual reality and simulation based interventions. By identifying, mentoring and supporting (through dedicated pilot funds and methodological and recruitment support) junior investigators from underrepresented groups (SAGE Scientists) we propose to create a culturally sensitive and culturally competent research workforce focused on promoting equity in healthcare and mitigating disparities in diverse older populations using emerging methodologies. To learn more about this initiative, contact VJ Periyakoil.


The Role of Cognitive Decline on Retirement Decisions: A Mendelian Randomization Approach

We explore whether cognitive decline in working years has a causal impact on retirement age. To do so, we use the Health and Retirement Study and apply an instrumental variable approach with a genetic risk score as an instrument (referred to as a Mendelian Randomization approach). After demonstrating that the genetic risk score meets reasonable criteria to be used as an instrument, we find that, though the study is underpowered, there is suggestive evidence that early forms of cognitive decline may indeed be causally related to earlier age of retirement. Plans are in motion to expand the study in a large data sample with more statistical power.  You can access the full article here. For more information on this project, contact Amal Harrati.


Precision Aging and Dementia for all Races and Ethnicities (PADRE)

PHS Faculty Fellow VJ Periyakoil was awarded supplemental funding from the National Institute on Aging to support a one-year exploratory study investigating potential metabolic and bio-molecular factors associated with Alzheimer's disease and related dementias. The PADRE project will examine differences among Hispanics and Caucasians living with dementia and utilize the findings to inform precision aging interventions. PADRE is an expansion of the SPHERE initiative. For more information on the SPHERE Program, please visit the SPHERE website.