March 30, 2022

College ranks #13 overall, #8 among public institutions 

COLUMBUS, Ohio – The Ohio State University College of Nursing continues to rank among the top 10 public colleges/schools of nursing throughout the country for research funding support from the National Institutes of Health (NIH), ranking #13 overall and #8 among public institutions. According to the Blue Ridge Institute for Medical Research, the College of Nursing earned more than $5.7 million in primary NIH research funding in 2021. 

“Our standing as a prominent destination for cutting-edge nursing research starts with our awesome, innovative research faculty,” said Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, EBP-C, vice president for health promotion, chief wellness officer and dean of the College of Nursing. “They dream big and achieve the impossible to transform health and improve lives, especially in vulnerable populations. We are so very proud and grateful for their terrific work and the impact it has to improve health outcomes and peoples’ well-being.” 

College of Nursing research newly funded by the NIH this year includes: 
Parent training program for prematurely born toddlers
January 12, 2022

by Todd B. Monroe and Karen O. Moss

Advanced age is associated with both an increased risk of dementia and pain. The prevalence of cognitively impaired individuals suffering from painful conditions will likely increase in the coming decades. Because there is no successful cure for dementia, people living with dementia are at great risk of suffering from pain and discomfort, especially in the later stages of the disease and life when the ability to communicate and verbally report pain is lost.1

Unfortunately, pain is often misinterpreted as a dementia-related behavioral disturbance, leading to overuse of psychotropic drugs to blunt the behavior, which can lead to poorly managed pain.2 The United States is in the midst of an Alzheimer’s disease (AD) crisis: More than six million people are living with AD, the most common type of dementia compromising about 65% of cases.3 By the year 2050, the number of people age 65 or older living with AD is projected to reach 12.7 million.3 African Americans/Blacks in the United States are two times more likely to develop AD.3,4

With that perspective as a backdrop, our team is leading several active studies examining sex-differences in pain in people living with AD. One study funded by a National Institutes of Health National Institute on Aging (NIH/NIA) R01 grant uses an FDA-approved device to deliver experimental thermal heat with an MRI-safe probe placed on the palm of the hand. At various points in time, the older adult then verbally rates the level of intensity and unpleasantness experienced on a standard pain scale. Next, we deliver the heat stimulus while the older adult receives an MRI that allows researchers to examine the integrity of the pain pathways in the brain, allowing for comparisons in brain activation between cognitively healthy adults and those with AD.

Racial disparities in pain assessment and management exist.5 With the support from a Diversity Supplement awarded to the parent R01, we are examining differences in pain responses and brain activation between Black and White older adults living with AD. Pilot data analysis from two NIH/NIA grants in partnership with Dr. Ronald Cowan at The University of Tennessee Health Science Center revealed that Black females reported experimental thermal pain at lower temperatures (were more sensitive) than White females.6

Family caregivers are integral to the care of people living with AD, and more than 11 million currently care for a loved one living with AD or another type of dementia.3 Our team is examining pain and stress in older adults living with AD and their family caregivers using questionnaires and hair cortisol levels as a biomarker measure of stress. This research is funded by The Ohio State University College of Nursing Research Development Funds.

During the ongoing coronavirus pandemic (COVID-19), dementia-related deaths have risen by 16%.3 As our team’s research remains focused on improving pain management in older adults living with AD, we remain mindful that AD is currently a diagnosis that contributes to eventual death with an increased risk of end-of-life pain. Since many older adults and those living with AD have numerous health conditions, we have carefully modified all current studies to account for the ongoing COVID-19 pandemic. This includes procedures to conduct study consent and questionnaires over the telephone or by video (Zoom) in certain situations.

Our team is committed to improving overall quality of life for persons living with AD and their family caregivers through better pain assessment and management. While much of our research is focused on how AD impacts the neurobiology of pain and is foundational in nature, we look forward to the long-term impacts of these important early contributions to improving quality of life. Until there is a cure for AD, we urge everyone to carefully monitor their older adult loved ones who are at risk for AD, seek help from a healthcare provider and also offer needed support to those who are caregiving for them. Suffering is not acceptable at any stage of AD, and there is a critical need to improve pain management in people living with dementia and to assist family caregivers providing support.

Todd B. Monroe, PhD, RN-BC, FNAP, FGSA, FAAN is a research associate professor at The Ohio State University College of Nursing and principal investigator of the Pain and Aging Lab. He is the previous recipient of an NIH/NIA K23 and two NIH/NIA R21 awards, as well as two current NIH/NIA R01 awards. Karen O. Moss, PhD, RN, CNL is an assistant professor at The Ohio State University Colleges of Nursing and Medicine, principal investigator in the Family Caregiver Community Research Lab and member of the Pain and Aging Lab.


References
  1. Monroe TB, Mion LC. Patients with Advanced Dementia: How Do We Know If They are in Pain? Geriatr Nurs (Minneap). 2012;33(3):226-228. doi:10.1016/j.gerinurse.2012.03.008
  2. Achterberg WP, Pieper MJ, van Dalen-Kok AH, et al. Pain management in patients with dementia. Clin Interv Aging. 2013;8:1471-1482. doi:10.2147/CIA.S36739
  3. Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures.; 2021. https://www.alz.org/alzheimers-dementia/facts-figures
  4. Alzheimer’s Association. Special Report: Race, Ethnicity and Alzheimer’s Disease.; 2021. https://www.alz.org/alzheimers-dementia/facts-figures
  5. Green CR, Anderson KO, Baker TA, et al. The unequal burden of pain: Confronting racial and ethnic disparities in pain. Pain Med. 2003;4(3):277-294. doi:10.1046/j.1526-4637.2003.03034.x
  6. Moss KO, Wright KD, Tan A, et al. Race-Related Differences Between and Within Sex to Experimental Thermal Pain in Middle and Older Adulthood: An Exploratory Pilot Analysis. Front Pain Res. 2021;2(November):1-4. doi:10.3389/fpain.2021.780338
February 24, 2021

Memphis, TN – Early diagnosis of Alzheimer’s disease has been shown to reduce cost and improve patient outcomes, but current diagnostic approaches can be invasive and costly. A recent study, published in the Journal of Alzheimer’s Disease, has found a novel way to identify a high potential for developing Alzheimer’s disease before symptoms occur. Ray Romano, PhD, RN, completed the research as part of his PhD in the Nursing Science Program at the University of Tennessee Health Science Center (UTHSC) College of Graduate Health Sciences. Dr. Romano conducted the research through the joint laboratory of Associate Professor Todd Monroe, PhD, RN, at The Ohio State University, who is also a graduate of the UTHSC Nursing Science PhD Program and Dr. Ronald Cowan, MD, PhD, who is the Chair of Psychiatry at UTHSC.

September 10, 2019
New five-year, $5 million grant project to advance study on sensitivity to pain

COLUMBUS, Ohio – Todd Monroe, PhD, RN-BC, FNAP, FGSA, FAAN, associate professor at The Ohio State University College of Nursing, will help lead a multi-site five-year, $5 million grant project awarded by the National Institutes of Health (NIH) and National Institute on Aging (NIA) to advance research focused on patients with Alzheimer’s disease and cancer and their sensitivity to pain.

“This grant will study the response to experimentally-evoked thermal and pressure pain to determine if people with chronic cancer pain and Alzheimer’s disease may be at greater risk of suffering from poorly-treated pain at the end of life,” Monroe said. “This is especially important for patients with Alzheimer’s disease who also have cancers, such as prostate and breast cancer, that generally lead to very painful bone metastasis.”

The multi-site, multiple PI R01, Pain Sensitivity and Unpleasantness in People with Alzheimer’s Disease and Cancer, will be performed in close partnership with Ronald Cowan, MD, PhD, Professor of Psychiatry and Behavioral Health from Vanderbilt University. The research builds on numerous studies that Monroe and his colleagues have conducted over the last decade, including research that concluded that patients living with more severe dementia and cancer were at greater risk for not receiving hospice services and for receiving little or no pain medication during the end of life. Last year, Monroe and his team earned a five-year, $3.3 million NIH/NIA grant to examine gender and Alzheimer’s-related differences in verbal pain reporting patterns and how they are displayed in regional and network brain function, with an aim to lead to a better understanding of how Alzheimer’s and gender impact central pain mechanisms.

Monroe, Cowan and their team hope to use the information from this research to further explore the neurobiology of pain in older adults with dementia and chronic pain, which can in turn help lead to the development and testing of interventions to better manage pain in this growing population.

September 17, 2018

The National Institutes of Health/National Institute on Aging (NIH/NIA) has awarded a five-year, $3.3 million R01 grant to fund the study titled, “Sex Differences in Pain Reports and Brain Activation in Older Adults with Alzheimer’s Disease.” The grant was awarded to Todd Monroe, PhD, RN-BC, FNAP, FGSA, FAAN, (PI) associate professor in The Ohio State University College of Nursing.

Monroe’s interdisciplinary team will include faculty from the College of Nursing, the Departments of Neurology and Geriatrics, and the Wright Center of Innovation in Biomedical Imaging at Ohio State, as well as collaborators from Vanderbilt University.

“Older adults with Alzheimer’s disease (AD) are at risk of having their pain undertreated. We do know that healthy males and females experience pain differently. It is not known if these sex-differences extend into the AD population. This study will provide research focused on better management of pain in people with AD,” Monroe stated in the proposal. “Poorly treated pain in older adults with Alzheimer’s disease (AD) is a critical public health problem and understanding sex and AD-related differences in pain function is an NIA priority area.”

The proposal stated that when compared to healthy adults, and in the presence of similarly known painful conditions, older adults with AD receive less pain medication. Reasons for this discrepancy are poorly understood. Meanwhile, inadequately treated pain negatively impacts quality of life and increases health care costs.

The research will examine how verbal pain reporting patterns in responses to acute experimental thermal pain differs between older males and females with and without AD and how these sex-differences map onto regional and network brain functional changes. The study aims to determine whether sensory (stimulus intensity) and affective (stimulus unpleasantness) responses differ by sex in people with and without AD during cutaneous thermal stimulation. Examining baseline differences in experimental thermal pain between males and females with and without AD will provide a foundation for understanding factors that may contribute to untreated pain risk, as well as for developing sex-specific novel assessment, prevention, and treatment strategies in the older population with AD.