Harvey Cohen

Overview:

Dr. Cohen's research program includes clinical research relating to aspects of the pathways to functional decline and reilience with aging, geriatric assessment, and cancer and anemia in the elderly.

Pathways to functional decline are being explored through the NIA funded Claude Pepper Older Americans Independence Center, and includes studies of the contributions of age related physiologic change, in particular changes in inflammatory parameters, comorbid diseases and conditions, environment, genetics, and the interactionas among them. Data are derived from several current studies as well as previously collected data sets from the Established Populations for Epidemiologic Studies of the Elderly (EPESE), National Long Term Care Survey, and the Chinese Longevity Study (with Dr. Zeng Yi). Previous work has demonstrated the important contributions of age related inflammation and coagulation activation to functional status. He is Co-PI of the Pepper Center Physical Performance Across the LifeSpan (PALS) study, which is a longitudinal cohort study of community dwelling adults from age 30-90+and includes functional measures and biomarkers on inflammation and metabolism.
 
Geriatric assessment approaches have been studied in a number of randomized and controlled studies and work is now concentrating on the application of Comprehensive Geriatric Assessment tools to the evaluation and treatment of elderly patients with cancer. This is an extension and continuation of a long standing interest in geriatric oncology. Previous studies have elucidated age-related patterns of disease presentation, treatment approaches, clinical trials, survivorship, quality of life, impact of comrobidities and functional outcomes. Dr. Cohen was co-chair, and now member of the Cancer in the Older Adult Committee of the Alliance for Clinical Trials in Oncology (ALLIANCE). A number of active studies and ongoing data bases aree being utilized to address these questions.


Anemia in the older adult is being addressed through an NIA funded U01 consortium (Dr. Cohen Co-PI). the current main study is an observational study followed by a pragmatic treatment trial for anemia in older adults with CHF, in collaboration with the Cardiovascular Research Network (CVRN) of the Health services research network (HSRN) 

Positions:

Walter Kempner Distinguished Professor of Medicine, in the School of Medicine

Medicine, Geriatrics
School of Medicine

Professor of Medicine

Medicine, Geriatrics
School of Medicine

Emeritus Director, Center for the Study of Aging & Human Development

Center for the Study of Aging and Human Development
School of Medicine

Faculty Research Scholar of DuPRI's Center for Population Health & Aging

Center for Population Health & Aging
Institutes and Provost's Academic Units

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1965

State University of New York, Brooklyn

Grants:

Quantifying the genomic consequences of chronic social stress for accelerated aging

Administered By
Institutes and Provost's Academic Units
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

IPA-Rick Sloane

Administered By
Center for the Study of Aging and Human Development
Awarded By
Durham Veterans Affairs Medical Center
Role
Principal Investigator
Start Date
End Date

Mentoring Intervention Development in Fall and Fracture Prevention

Administered By
Medicine, Geriatrics
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

Cognitive Changes and Brain Connectivity in Age-Related Macular Degeneration

Administered By
Center for the Study of Aging and Human Development
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

PACTTE-Partnership for Anemia: Clinical and Translational Trials in the Elderly

Administered By
Duke Clinical Research Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Black-White differences in physical and cognitive aging among older breast cancer survivors in the Thinking and Living with Cancer Study

Authors
Bethea, TN; Zhai, W; Zhou, X; Ahles, TA; Ahn, J; Cohen, HJ; Dilawari, AA; Graham, D; Jim, H; McDonald, BC; Nakamura, ZM; Patel, SK; Rentscher, KE; Root, JC; Saykin, AJ; Small, BJ; Van Dyk, K; Mandelblatt, JS; Carroll, JE
MLA Citation
Bethea, Traci N., et al. “Black-White differences in physical and cognitive aging among older breast cancer survivors in the Thinking and Living with Cancer Study.” Cancer Epidemiology Biomarkers & Prevention, vol. 32, no. 1, 2023, pp. 201–02.
URI
https://scholars.duke.edu/individual/pub1566715
Source
wos-lite
Published In
Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology
Volume
32
Published Date
Start Page
201
End Page
202

Multimorbidity in patients with monoclonal gammopathy of undetermined significance.

Monoclonal gammopathy of undetermined significance (MGUS), a precursor to multiple myeloma, is present in over 5% of adults aged 70 and older, a population with a high prevalence of multimorbidity. MGUS is often diagnosed incidentally when patients seek care for unrelated conditions. Our study sought to examine patterns of multimorbidity among MGUS patients, as overall health may impact patient care and the prioritization of MGUS surveillance. We examined patterns of comorbidities in 429 patients diagnosed with MGUS (2007-2015) and 1287 matched controls. Twenty-seven conditions were defined at diagnosis/index date using algorithms developed by the Centers for Medicare and Medicaid Chronic Conditions Warehouse. Patterns of common comorbidities were identified individually, in dyads and triads, and compared between MGUS cases and controls. We conducted a latent class analysis to identify comorbidity patterns among cases only. We also examined comorbidity patterns among a subset of 32 MGUS cases who progressed to cancer during the study period. The most common comorbidities among both MGUS cases and controls included hypertension and hyperlipidemia. Anemia (cases: 43%; controls: 16%) and chronic kidney disease (CKD; cases: 36%; controls: 18%), and dyads and triads containing those conditions, were more common among cases. Latent class analysis identified three classes of comorbidity among MGUS cases: hypertension-hyperlipidemia plus anemia and CKD (31%); low comorbidity burden (17%); and hypertension-hyperlipidemia alone (52%). The higher prevalence among cases of anemia and CKD, which may be involved in the pathogenesis of, or surveillance for, MGUS, warrants additional investigation.
Authors
Epstein, MM; Zhou, Y; Castaneda-Avila, MA; Cohen, HJ
MLA Citation
Epstein, Mara M., et al. “Multimorbidity in patients with monoclonal gammopathy of undetermined significance.” Int J Cancer, vol. 152, no. 12, June 2023, pp. 2485–92. Pubmed, doi:10.1002/ijc.34476.
URI
https://scholars.duke.edu/individual/pub1566910
PMID
36799553
Source
pubmed
Published In
Int J Cancer
Volume
152
Published Date
Start Page
2485
End Page
2492
DOI
10.1002/ijc.34476

Toxicity risk score and clinical decline after adjuvant chemotherapy in older breast cancer survivors.

BACKGROUND: Chemotoxicity risk scores were developed to predict grade 3-5 chemotherapy toxicity in older women with early breast cancer. However, whether these toxicity risk scores are associated with clinically meaningful decline in patient health remains unknown. METHODS: In a prospective study of women aged 65 years and older with stage I-III breast cancer treated with chemotherapy, we assessed chemotoxicity risk using the Cancer and Aging Research Group-Breast Cancer (CARG-BC) score (categorized as low, intermediate, and high). We measured patient health status before (T1) and after (T2) chemotherapy using a clinical frailty index (Deficit Accumulation Index, categorized as robust, prefrail, and frail). The population of interest was robust women at T1. The primary outcome was decline in health status after chemotherapy, defined as a decline in Deficit Accumulation Index from robust at T1 to prefrail or frail at T2. Multivariable logistic regression was used to examine the association between T1 CARG-BC score and decline in health status, adjusted for sociodemographic and clinical characteristics. RESULTS: Of the 348 robust women at T1, 83 (24%) experienced declining health status after chemotherapy, of whom 63% had intermediate or high CARG-BC scores. After adjusting for sociodemographic and clinical characteristics, women with intermediate (odds ratio = 3.14, 95% confidence interval = 1.60 to 6.14, P < .001) or high (odds ratio = 3.80, 95% confidence interval = 1.35 to 10.67, P = .01) CARG-BC scores had greater odds of decline in health status compared with women with low scores. CONCLUSIONS: In this cohort of older women with early breast cancer, higher CARG-BC scores before chemotherapy were associated with decline in health status after chemotherapy independent of sociodemographic and clinical risk factors.
Authors
Ji, J; Sun, C-L; Cohen, HJ; Muss, HB; Bae, M; Sedrak, MS
MLA Citation
Ji, Jingran, et al. “Toxicity risk score and clinical decline after adjuvant chemotherapy in older breast cancer survivors.” J Natl Cancer Inst, vol. 115, no. 5, May 2023, pp. 578–85. Pubmed, doi:10.1093/jnci/djad029.
URI
https://scholars.duke.edu/individual/pub1564909
PMID
36762832
Source
pubmed
Published In
J Natl Cancer Inst
Volume
115
Published Date
Start Page
578
End Page
585
DOI
10.1093/jnci/djad029

Corrigendum to 'Perioperative neurocognitive and functional neuroimaging trajectories in older APOE4 carriers compared with non-carriers: secondary analysis of a prospective cohort study' (Br J Anaesth 2021; 127: 917-928).

Authors
Browndyke, JN; Wright, MC; Yang, R; Syed, A; Park, J; Hall, A; Martucci, K; Devinney, MJ; Shaw, L; Waligorska, T; Moretti, EW; Whitson, HE; Cohen, HJ; Mathew, JP; Berger, M; MADCO-PC Investigators(†),
MLA Citation
URI
https://scholars.duke.edu/individual/pub1567633
PMID
36878808
Source
pubmed
Published In
Bja: British Journal of Anaesthesia
Volume
130
Published Date
Start Page
646
DOI
10.1016/j.bja.2023.02.009

Ageing and physical resilience after health stressors.

The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is associated with increasing exposure to multiple stressors and declining capacity to respond to health stressors. Resilience is defined broadly as the ability to resist or recover well from the adverse effects of a health stressor. In ageing-related study designs of physical resilience after a health stressor, this dynamic resilience response can be observed as changes in repeated measures of function or health status in various domains important to older adults. Methodologic issues in selecting the study population, defining the stressor, covariates, outcomes, and analytic strategies are highlighted in the context of an ongoing prospective cohort study of physical resilience after total knee replacement surgery. The article concludes with approaches to intervention development to optimize resilience.
Authors
Colon-Emeric, C; Schmader, K; Cohen, HJ; Morey, M; Whitson, H
MLA Citation
Colon-Emeric, Cathleen, et al. “Ageing and physical resilience after health stressors.” Stress Health, Mar. 2023. Pubmed, doi:10.1002/smi.3241.
URI
https://scholars.duke.edu/individual/pub1568082
PMID
36879359
Source
pubmed
Published In
Stress Health
Published Date
DOI
10.1002/smi.3241
Walter Kempner Distinguished Professor of Medicine, in the School of Medicine

Contact:

Profile

https://scholars.duke.edu/person/harvey.cohen

Email

harvey.cohen@duke.edu
2509 Blue Zone Duke Clinic, Center for Aging, Trent Drive, Durham, NC 27710
Duke Box 3003, Durham, NC 27710