Melinda Power TabsBio Dr. Power is broadly interested in issues of aging. Her research focuses on identifying and understanding modifiable risk factors for cognitive decline, dementia, and dementia-related brain changes in older adults. Her current work considers how environmental pollutants or toxins contribute to accelerated cognitive deterioration in older adults and the complex relationship between lifecourse risk factors and cognitive health. With funding from NIH and DOD, she is also currently exploring race/ethnic disparities in the incidence and diagnosis of dementia and the impact of traumatic brain injury and military service on dementia risk. Dr. Power also has an interest in epidemiologic methods and useful statistical approaches, particularly causal inference and econometric methods. ExpertiseExpertise: AgingEnvironmental and Occupational HealthEpidemiologyChronic DiseaseBiostatisticsHealth DisparitiesPreventionEducation: Bachelor of Arts (Psychology), Boston College, 2004 Doctor of Science (Epidemiology and Environmental Health), Harvard School of Public Health, 2012 Post-Doctoral Fellowship (Epidemiology), Johns Hopkins Bloomberg School of Public Health, 2012-2015 Teaching: PubH 6247 - Design of Health Studies PubH 6248 - Epidemiology of Aging Institutes and Centers: Autism and Neurodevelopmental Disorders Institute (ANDI), Affiliated Faculty ResearchResearch: Dr. Power is currently working on several funded projects: Air pollution, Alzheimer's Disease and Related Outcomes. Ambient air pollution exposure is a promising target for interventions to prevent or delay Alzheimer’s disease and related dementia. While the existing evidence linking ambient air pollution exposures to cognitive health and dementia is suggestive, it is insufficient to justify action. Thus, we propose to estimate associations between ambient exposure to U.S. EPA-regulated criteria air pollutants and components of particulate matter air pollution with incident Alzheimer’s disease and related dementia and related outcomes, overall and in potentially susceptible subgroups .Ultimately, our work may lead to recommendations or interventions to reduce ambient air pollution exposure to specific pollutants for the purpose of preventing or delaying Alzheimer’s disease and related dementia. Principal Investigator: Melinda C. Power, ScD (GWU) Funding Agency: NIH/NIEHS, NIA Project Period: 09/2018-08/2022 Closing the gap between observational research and randomized trials for prevention of Alzheimer's Disease and dementia. Launching randomized controlled trials (RCTs) for Alzheimer’s disease (AD) prevention is an urgent public health priority. Although cardiovascular risk factor management is among the most promising intervention strategies, there is considerable uncertainty about the optimal eligibility criteria, intervention details, duration, or outcome assessments. Many major trials targeting AD prevention have been disappointing. One possible reason for these disappointments is that observational research has not provided enough information to anticipate whether a proposed RCT would succeed. This proposal takes advantage of recent advances in causal methods for data integration to overcome the previous barriers and develop a simulation model leveraging all of the information from diverse data sources, including cohorts, clinical administrative data, and registry information. Ultimately, we will use this model to simulate effects of hypothetical trials and thereby provide specific guidance for development of effective RCTs for AD prevention. Principal Investigator: Melinda C. Power, ScD (GWU), M. Maria Glymour, ScD (UCSF) Funding Agency: NIH/NIA Project Period: 09/2018-04/2023 Evaluating impact of recent federal policy changes on hospice utilization among patients with Alzheimer’s Disease and Related Dementias. Substantial evidence suggests that early and sustained access to hospice services, resulting in moderately long duration of hospice care, helps ensure high QOL for both ADRD patients and their caregivers. Therefore, decreased access to hospice, which may manifest as decreased rates of use, shorter length of stay (LOS), and higher rates of live discharge, would adversely impact QOL for ADRD patients and their families. Recent changes to the Medicare hospice benefit provide a unique opportunity to understand how differences in the structure and implementation of hospice insurance benefits impact ADRD patients’ hospice uses. Our findings can be used to inform how insurance benefits can be structured and implemented in a way that maximizes the opportunity for hospice care for ADRD patients at the end-of-life and will have translational impact when considering other patient populations with long or unpredictable end-of-life trajectories. Principal Investigator: Melinda C. Power, ScD (GWU) Funding Agency: NIH/NIA Project Period: 02/2019-12/2020 Race/ethnic disparities and the incidence and over- or under-diagnosis of Alzheimer's Disease and related dementia in the United States. At the national level, there has been significant interest in addressing U.S. health disparities in Alzheimer's disease and related dementia. Although there is growing evidence to suggest race/ethnic disparities in dementia exists in the U.S., much of the evidence of disparities is indirect or comes from geographically- localized studies that may not be generalizable to the experience of Americans as a whole. Furthermore, there is little evidence to indicate whether disparities are widening or shrinking over time. Thus, the aims of this proposal are to (1) describe race/ethnic disparities in the incidence of experiencing Alzheimer's disease and related dementia at the national level in the U.S. and examine the extent to which race/ethnic disparities in incidence have changed over time, and (2) describe race/ethnic disparities in over- or under-diagnosis of prevalent Alzheimer's disease and related dementia in the medical setting at the national level in the U.S. and examine the extent to which race/ethnic disparities in under- or over-diagnosis have changed over time. Principal Investigator: Melinda C. Power, ScD (GWU) Funding Agency: NIH/NIA Project Period: 05/2017-04/2020 Late Life Consequences of TBI and Military Service: A Population-Based Study. TBI has been widely investigated as a risk factor for AD in civilian and military samples. Some studies suggest an association, while others do not; still others report a relationship between TBI and non-AD dementias. TBI and military service are considered independent risk factors for greater medical and psychiatric morbidity, functional disability, and mortality in older adulthood. Still, some research suggests military service can have positive associations with health that last into late life. There is tremendous individual variability in the late life associations of TBI and military service, and risk and protective factors for these important outcomes remain poorly understood. The goal of our interdisciplinary proposal is to comprehensively examine the chronic health consequences of TBI and military service. Principal Investigator: Kristen Dams-O'Connor, PhD (Mt. Sinai) Funding Agency: DOD Project Period: 09/2017-08/2021 PublicationsPublications: Selected publications: Gianattasio, KZ, Wu, Q, Glymour, MM, Power, MC. (2019) “Comparison of methods for algorithmic classification of dementia status in the Health and Retirement Study.” Epidemiology 30(2): 291-302. Power, MC, Mormino, E, Solden, A, James, BD, Lei, Y, Armstrong, NM, Bangen, KJ, Delano-Wood, L, Lamar, M, Lim, YY, Nudelman, K, Zahodne, L, Gross, AL, Mungas, D, Widaman, KF, Schneider, J. (2018) “Combined neuropathological pathways account for age-related dementia risk.” Annals of Neurology, 84(1):10-22. Power, MC, Lamichhane, AP, Liao, D, Xu, X, Jack, CR, Gottesman, RF, Mosley, T, Stewart, JD, Yanosky, JD, Whitsel, EA. (2018) “The association of long-term exposure to particulate matter air pollution with brain MRI findings: the ARIC study.” Environmental Health Perspectives. 126(2):027009. Power, MC, Tingle JV, Reid, RI, Huang,J, Sharrett, AR, Coresh, J, Griswold, M, Kantarci, K, Jack, Jr., CR, Knopman, D, Gottesman, RF, Mosley, TH (2017). "Midlife and Late-Life Vascular Risk Factors and White Matter Microstructural Integrity: The Atherosclerosis Risk in Communities Neurocognitive Study." J Am Heart Assoc 6(5). Power, MC, Weuve, J, Sharrett, AR, Blacker, D, Gottesman, RF (2015). "Statins, cognition, and dementia-systematic review and methodological commentary." Nat Rev Neurol 11(4): 220-229. Weisskopf, MG, Sparrow, D, Hu, H, Power, MC (2015). "Biased Exposure-Health Effect Estimates from Selection in Cohort Studies: Are Environmental Studies at Particular Risk?" Environ Health Perspect 123(11): 1113-1122. Power, MC, Kioumourtzoglou, MA, Hart, JE, Okereke, OI, Laden F, Weisskopf, MG (2015). "The relation between past exposure to fine particulate air pollution and prevalent anxiety: observational cohort study." BMJ 350: h1111 Power, MC,Tchetgen Tchetgen EJ, Sparrow, D, Schwartz, J, Weisskopf, MG (2013). "Blood pressure and cognition: factors that may account for their inconsistent association." Epidemiology 24(6): 886-893. Power, MC, Weisskopf, MG, Alexeeff, SE, Coull, BA, Spiro Iii, A and Schwartz, J (2011). "Traffic-Related Air Pollution and Cognitive Function in a Cohort of Older Men." Environ Health Perspect 119(5): 682-687. Please click here for an up-to-date list of all of Dr. Power's publications.