‘Silver tsunami’ requires aging expertise

Carolina researchers address complexities of an older population, including health care, labor dynamics and assisted living.

Close-up image of the hand of a younger person holding the hand of an elderly person.
Carolina's collaborative research is making significant contributions to a broad spectrum of aging research to address the "silver tsunami." (Adobe Stock)

Penny Gordon-Larsen is the Carla Smith Chamblee Distinguished Professor of Global Nutrition at the Gillings School of Global Public Health and Carolina’s interim vice chancellor for research.

According to the World Health Organization, every country in the world is experiencing growth in both the size and the proportion of older adults in their population. By 2030, one in six people across the globe will be 60 years or older, and by 2050, the world’s population of adults over 60 will double.

In our own country, the aging of the Baby Boomer generation has been called “the silver tsunami” for the accelerated rate at which adults are maturing past 65. Carolina researchers are addressing the many complexities arising from our aging population, from health care to labor dynamics to assisted living. They are making discoveries and building the evidence base to support healthy aging and improve quality of life across the life course.


The national Center for Excellence in Assisted Living, which has focused on advancing the well-being of people who live and work in assisted living through research, practice and policy for more than 20 years, made its new home at Carolina in February with the name CEAL@UNC.

The center is based within the School of Social Work and supported by the Office of the Vice Chancellor for Research’s Sheps Center. CEAL@UNC will be led by Sheryl Zimmerman, who also serves as the co-director of the Sheps Center’s program on aging, disability and long-term care. Research at the new center will ensure that aging adults have access to high-quality supportive care, which will enable them to age with dignity and respect. The School of Social Work hosted a reception to celebrate the announcement of CEAL@UNC that drew people from across the University, the state and the country and highlighted the significant impact of this exciting center for excellence.

Add Health

Another OVCR center that has addressed the many facets of aging for decades is the Carolina Population Center, which hosts several population-based cohort studies that follow individuals across the life cycle, including the Cebu Longitudinal Health and Nutrition Survey, the China Health and Nutrition Survey and Add Health — the largest and most comprehensive longitudinal study of its kind in the nation. The study began with more than 20,000 adolescents surveyed in 1994-95. Since then, researchers have been collecting data about the participants’ lives through early adulthood and now into middle age.

Add Health is co-directed by Robert Hummer and Allison Aiello, and collaborators include sociologists, psychologists, epidemiologists, physicians and methodologists from RTI International, the University of Vermont and Exam One. Add Health researchers study cognitive, mental and physical health of study participants with attention given to disparities in health outcomes across racial and ethnic, socioeconomic and gender groups. The project’s current research focuses on data collection about rising health risks in middle age and beyond.

Cardiovascular disease

Cardiovascular diseases are the most common cause of death and disability in the state of North Carolina and nationally. The spectrum of these diseases is enormous, including more common afflictions such as hypertension and atherosclerosis (which can cause heart attacks and strokes). Some rare types can severely affect otherwise healthy young individuals. Researchers are still assessing genetic and environmental factors that contribute to heart disease.

To address those unknowns, the UNC McAllister Heart Institute has assembled many talented investigators who study various aspects of heart disease. The institute fosters interaction and collaboration between basic scientists and practicing clinicians, resulting in innovative research projects that provide immediate benefits to patients and foundational discoveries to help even more patients in the future.

The cardiovascular epidemiology program at the Gillings School of Global Public Health is an international leader in studies of the development of heart disease, a major legacy of Gerardo Heiss, the W.R. Kenan Jr. Distinguished Professor and researcher who passed away in 2022. Some of the program’s most significant datasets are hosted at the Collaborative Studies Coordinating Center, including the Atherosclerosis Risk in Communities Study and the Hispanic Community Health Study/Study of Latinos. These cohort studies, with long-term follow-up, provide rich data to understand the diverse etiological factors that underpin healthy aging, ranging from molecular and genomic to social determinants of health to acculturation. The program also includes innovations like drone access to defibrillators.

Physician scientists in the School of Medicine are addressing basic causes of the spectrum of heart diseases, developing novel diagnostic technologies to prevent the worst from happening, working with colleagues in the Eshelman School of Pharmacy to develop new therapeutics that treat the entire range of diseases and translating the best of this combined research to improve patient care.

Penny Gordon-Larsen sitting at a desk and smiling for a photo.

Penny Gordon-Larsen, UNC-Chapel Hill’s interim vice chancellor for research, wrote that Carolina researchers are “making major inroads to ensure healthy aging for all.” (Megan May/UNC Research)

Methodological innovations

Carolina researchers lead in advancing understanding of cognitive aging and neuroscience. The Human Neuroimaging Group in the College of Arts and Sciences’ psychology and neuroscience department is a notable example. Kelly Giovanello is using functional MRI to understand how cognitive and neural processes mediate memory and change with healthy aging and neurodegenerative diseases like Alzheimer’s.

Tanya Garcia in the College’s biostatistics department uses cutting-edge statistical methods to estimate the progression of neurodegenerative diseases in very large datasets with highly correlated data. There is innovative and translational research also occurring across campus in the Center for Aging and Health; the Thurston Arthritis Center;  and the Geriatric Oncology Program in the Lineberger Comprehensive Cancer Center. In particular, the Vector Core and the light microscopy facility foster novel approaches to understanding how cells communicate with each other, increasing our understanding of biological aging and potential biomarkers for early detection of aging-related diseases. There is also the work of Jason R. Franz in the joint department of biomedical engineering’s Applied Biomechanics Laboratory, which focuses on the neuromuscular biomechanics of human movement and seeks to identify engineering solutions to help people avoid falls and age gracefully.


For years, Kenan-Flagler Business School’s Jim Johnson has been researching and publishing scholarly work addressing “disruptive demographics,” which are changes to the population makeup that will have ramifications across not only health care but also business.

For companies, Johnson suggests that far more agility and flexibility in the workplace will be required to accommodate a considerable number of employees affected by the “silver tsunami” — including the Boomers themselves, who are more likely to continue working past 65, and the more than 1 million millennials who will have elder care obligations. Johnson works with leaders in many industries to help them understand and strategize how to embrace the changes and the opportunities that come with them.

Assistive technologies

One potential area of viable research translation will be technologies that afford individuals autonomy as the population continues to age. Led by Ron Alterovitz, the Computational Robotics Research Group investigates new robot designs to enable physicians to provide better medical care and to assist people in their homes.

Their research is examining new algorithms for minimally invasive medical devices such as steerable needles and tentacle-like robots that can provide physicians with access to targets that previously were unreachable without open surgery. The group is also applying those algorithms to personal robots that can assist people with a variety of daily routine tasks at home and in the workplace. Robots capable of learning and performing assistive tasks have the potential to help people who are elderly or disabled to live independently with a higher quality of life.

Similarly, John Batsis in the Division of Geriatric Medicine uses novel technologies, telemedicine and remote monitoring to reduce transportation and geographic barriers to health care services for older adults, particularly in rural parts of the country.

Carolina’s collaborative research brings significant strengths to contribute to a broad spectrum of aging research, including cellular senescence, epigenetic changes, neurocognitive disorders, disability and physical and social environments. Carolina researchers are making major inroads to ensure healthy aging for all.

To read more from the interim vice chancellor for research, visit the Carolina Discoveries blog.