Led by Stephen Wegener, Ph.D, this research group focuses on projects that have the potential to improve function and quality of life and reduce disability following injury or illness. These projects include research on cognitive, behavioral, psychological and health care system factors that affect outcomes following injury.

The Agrawal Lab is focused on the medical and surgical treatment of otologic and neurotologic conditions. Research is focused on the vestibular system (the inner ear balance system), and how the function of the vestibular system changes with aging. Particular focus is given to study how age-related changes in vestibular function influence mobility disability and fall risk in older individuals.

The Center on Aging and Health pursues creative approaches to solve the important health and health care problems for an aging population. Research in our center involves population-based and clinical studies of the causes, correlates, and consequences of aging-related conditions, including frailty, disability, and social isolation. We house four distinct research working groups: the Frailty and Multisystem Dysregulation Working Group; the Family and Social Resources Working Group; the Cognitive and Sensory Functions Working Group; and the Biostatistics, Design and Analysis Working Group. We provide key infrastructure, such as the statistical data core, that supports clinical- and population-based research and education with expertise in research with older adults.

Improved acute stroke care means that more patients are surviving. Unfortunately, up to 60 percent of stroke survivors suffer disability in arm or leg use, and 30 percent need placement in a longer term care facility. Recovering motor skills after stroke is essential to rehabilitation and the restoration of a meaningful life. Therefore, there is an urgent need to develop innovative new approaches to rehabilitation. Most recovery from motor impairment after stroke occurs in the first month and is largely complete by three months. Improvement occurs independently of rehabilitative interventions (for example, physical and occupational therapy), which predominantly target function through compensatory strategies that do not constitute true recovery. Dr. Zeiler and his team are conducting research to uncover how to augment and prolong this critical window of time.

Research in the Kimberly Skarupski Lab focuses on depression, geriatric medicine, psychiatry and the behavioral sciences. Recent studies have investigated various aspects of cognitive decline in biracial older adult and urban older adult community-based populations. Additional studies have investigated depression symptoms, disability and worship practices in older adults, with particular attention to racial disparities in these areas.

The primary area of statistical expertise in the Qian-Li Xue Lab is the development and application of statistical methods for: (1) handling the truncation of information on underlying or unobservable outcomes (e.g., disability) as a result of screening, (2) missing data, including outcome (e.g., frailty) censoring by a competing risk (e.g., mortality) and (3) trajectory analysis of multivariate outcomes. Other areas of methodologic research interests include multivariate, latent variable models. In Women's Health and Aging Studies, we have closely collaborated with scientific investigators on the design and analysis of longitudinal data relating biomarkers of inflammation, hormonal dysregulation and micronutrient deficiencies to the development and progression of frailty and disability, as well as characterizing the natural history of change in cognitive and physical function over time.

David Hackam’s laboratory focuses on necrotizing enterocolitis (NEC), a devastating disease of premature infants and the leading cause of death and disability from gastrointestinal disease in newborns. The disease strikes acutely and without warning, causing sudden death of the small and large intestines. In severe cases, tiny patients with the disease are either dying or dead from overwhelming sepsis within 24 hours. Surgical treatment to remove most of the affected gut results in lifelong short gut (short bowel) syndrome. The Hackam Lab has identified a critical role for the innate immune receptor toll-like receptor 4 (TLR4) in the pathogenesis of necrotizing enterocolitis. The lab has shown that TLR4 regulates the development of the disease by tipping the balance between injury and repair in the stressed intestine of the premature infant. Developing an Artificial Intestine A key goal is to create, in the laboratory, new intestines made from patients’ own cells, which can then be implanted into the patient to restore normal digestive function. This innovative design could transform child development and quality of life in necrotizing enterocolitis survivors without the risks of conventional donor transplant.

Our laboratory conducts basic and translational research aimed at better understanding the pathogenesis of multiple sclerosis (MS) and the role of the immune system in CNS disease, particularly the processes that drive progressive disability such as neurodegeneration and remyelination failure. We currently have three parallel research programs: 1. Metabolism as a modulator of MS: We are studying how basic metabolic pathways regulate the immune system and how these pathways might be exploited to protect neurons and myelin-forming oligodendrocytes from injury. 2. Identifying pathways by which nitric oxide (NO) and other free radicals cause neuronal and axonal damage. Our lab is identifying specific signaling pathways initiated by NO and other free radicals that can be targeted by drugs to produce neuroprotection. 3. Modulating the innate immune system in MS: In collaboration with others at Johns Hopkins, we are studying ways to enhance the reparative functions of microglia while preventing maladaptive responses. This work has identified bryostatin-1 as a potential drug that may be re-purposed for this task.

Research in the Rita Kalyani Lab examines the decreased physical functioning observed in patients with diabetes as they age. Through several ongoing epidemiological cohorts, we are investigating the association of high blood glucose and high insulin levels with accelerated muscle loss, and possible contributions to the physical disability observed in diabetes. We are currently involved in clinical studies that aim to understand the underlying mechanisms for these associations and to facilitate the development of novel strategies to prevent muscle loss and disability in people with diabetes.

Five to 35 percent of spine fusionprocedures fail, even when using the gold standard treatment of grafting bone from the patient's own iliac crest. Fusion failure, otherwise known as pseudoarthrosis, is a major cause of failed back surgery syndrome (FBSS) and results in significant pain and disability, increasing the need for additional procedures and driving up health care costs. The ultimate goal of the Spinal Fusion Laboratory is to eliminate pseudoarthrosis by using animal models to study various strategies for improving spinal fusion outcomes, including delivery of various growth factors and biological agents; stem cell therapies and tissue engineering approaches.