Epidemiology of Aging
School of Medicine
aging; cognitive aging; cognition; cognitive decline; dementia; disability; epidemiology; hearing impairment; retinal; sensory
Experiences & Accomplishments
Bloomberg School of Public Health
Bloomberg School of Public Health
University of Indiana
Trained in the epidemiology of aging, Dr. Deal studies how hearing impairment and vascular factors and markers influence cognitive function in order to inform strategies for the prevention of cognitive decline and dementia in older adults. With no current treatments to alter the natural history of Alzheimer's disease and related dementias, public health prevention efforts are paramount and for delaying dementia onset. Characterized by progressive cognitive decline and culminating in loss of independence and mortality, dementia results in greater health care expenditures than any other chronic disease affecting older adults. Worldwide, 47 million older adults have dementia, and without the implementation of prevention strategies, this number is expected to nearly triple by 2050. To combat this challenge, my research is focused on quantifying how hearing impairment and vascular factors impact the aging brain and cognitive function, and to provide insight into mechanistic pathways involved. Two-thirds of adults over the age of 70 have a clinically meaningful hearing loss that may impact everyday communication, and may causally increase dementia risk through its effects of distorted peripheral encoding of sound on cognitive load, changes in brain structure/function, and/or reduced social engagement. Given existing but underutilized aural rehabilitative treatments, elucidation of the role and mechanism of hearing impairment in dementia and cognitive decline has the potential to identify targets for future clinical research and to ultimately to inform efforts to prevent these adverse outcomes in older adults. My methodological interests include the measurement of cognitive function in older adults with sensory loss, particularly how missing data and/or mode of cognitive testing, may bias cognitive test results in older adults with sensory function, as well as the estimation of trajectories of change in functional outcomes using data from large observational epidemiologic studies in the presence of informative drop-out.
Honors & Awards
Rising Star Award, American Geriatrics Society / National Institute of Health U13 Sensory Impairment and Cognitive Decline Workshop, Bethesda, MD (2017) Outstanding Teaching Faculty, Johns Hopkins Bloomberg School of Public Health (2016, 2019, 2020)
- Deal JA, Sharret AR, Albert M, Bandeen-Roche K, Burgard S, Thomas SD, Gottesman RF, Knopman D, Mosley T, Klein B, Klein R. Retinal Signs and Risk of Incident Dementia in the Atherosclerosis Risk in Communities Study. Alzheimer’s & Dementia. 2018 Nov 12. pii: S1552-5260(18)33562-3. doi: 10.1016/j.jalz.2018.10.002.
- Deal JA, Reed NS, Kravetz AD, Weinreich H, Yeh C, Lin FR, Altan A. Incident Hearing Loss and Comorbidity: a Longitudinal Administrative Claims Study. JAMA Otolaryngol Head Neck Surg. 2018 Nov 8. doi: 10.1001/jamaoto.2018.2876.
- Deal JA, Goman AM, Albert MS, Arnold ML, Burgard S, Chisolm T, Couper D, Glynn NW, Gmelin T, Hayden KM, Mosley T, Pankow JS, Reed N, Sanchez VA, Sharrett AR, Thomas SD, Coresh J, Lin FR. Hearing Treatment for Reducing Cognitive Decline: Design and Methods for the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Randomized Controlled Trial. Alzheimers Dement(NY). 2018 Oct 5;4:499-507.
- Deal JA, Betz J, Yaffe K, Harris T, Purchase-Helzner E, Satterfield S, Pratt S, Govil N, Simonsick EM, Lin FR. Hearing Impairment and Incident Dementia and Cognitive Decline in Older Adults: The Health ABC Study. J Gerontol A Biol Sci Med Sci. 2017 May 1;72(5):703-709. PMCID:PMC5964742
- Deal JA, Sharrett AR, Albert MS, Coresh J, Mosley TH, Knopman D, Wruck LM, Lin FR. Hearing Impairment and Cognitive Decline: a Pilot Study within the Atherosclerosis Risk in Communities Neurocognitive Study. American Journal of Epidemiology. 2015 May 1;181(9):680-90. PMCID:PMC4408947
Vitamin D Deficiency, Inflammation and Age-related disease in HIV-Infected Men
Changes in Sensorimotor Function as Predictors of Preclincial Alzheimer's Disease