Paola Gilsanz, ScD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-3482 (phone)
paola.gilsanz@kp.org

Paola Gilsanz, ScD, is a Research Scientist II at the Division of Research. Dr. Gilsanz received her BA in Community Health from Brown University, her MPH in Epidemiology and Biostatistics from the University of California, Berkeley, and doctorate in Social Epidemiology from Harvard University. Her work focuses on examining risk and protective factors of healthy brain aging across the lifecourse, especially as they related to inequities by sex, race, and ethnicity. She co-leads the Kaiser Healthy Aging and Diverse Life Experience (KHANDLE) study and the LifeAfter90 (LA90) Study both of which look at healthy brain aging in diverse populations. She also works on identifying modifiable risk and protective factors of dementia among individuals with type 1 or type 2 diabetes.

Current Position(s):

Research Scientist II, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Behavioral Health and Aging

Primary Research Interests:

Dementia and cognitive function
Social epidemiology and life course models
Health disparities
Causal inference

Studies

Brain pathologies, reserve, and cognition in aging and dementia

This study is examining racial/ethnic group similarities and differences in brain mechanisms underlying cognitive reserve and functional reserve, and their life course determinants, by conducting secondary data analysis and harmonization of existing data from 4 ongoing longitudinal studies: Alzheimer's Disease Center cohort at UCD, KHANDLE at DOR/UCD, STAR at DOR/UCD, and LA 90 at DOR/UCD. The combined data from these 4 studies will be used to examine MRI derived brain imaging variables associated with cognitive and functional decline; develop measures of functional reserve; examine potentially modifiable factors measured in mid-life that can build cognitive and functional reserve and promote cognitive health and functional independence.
Investigator: Gilsanz, Paola
Funder: National Institute on Aging

Epidemiology of Age-related Dementia, Mild Cognitive Impairment and Brain Pathology in a Multiethnic Cohort of Oldest-Old

This study is following a diverse cohort of approximately 1,000 KPNC members over 90 years old to examine life-course risk and protective factors of healthy brain aging in order to 1) Evaluate differences in dementia incidence and rate of cognitive decline by race/ethnicity; 2) evaluate how early life experience and life-course health are related to dementia incidence and cognitive decline while accounting for selective survival; and 3) examine life-course factors associated with biomarkers from braining imaging and pathology. During this second funding cycle, we will enroll 500 additional KPNC members at least 90 years old.
Investigator: Gilsanz, Paola
Funder: National Institute on Aging

Epidemiology of Age-related Dementia, Mild Cognitive Impairment and Brain Pathology in a Multiethnic Cohort of Oldest-Old

The Life After 90 Study (LA90) is a collaborative study between DOR, UC Davis, and UC Irvine following a diverse cohort of approximately 1,000 KPNC members age 90 and over to examine life course risk factors of cognitive decline and dementia risk. This study is evaluating differences in dementia incidence and rate of cognitive decline by race/ethnicity; evaluating how life course experiences are related to dementia incidence and cognitive decline; and examining life course factors associated with biomarkers from braining imaging and pathology. In 2022, we intend to begin to enroll an additional 500 KPNC members age 90 and over.
Investigator: Gilsanz, Paola
Funder: National Institute on Aging

Lifecourse health, cerebral pathology and ethnic disparities in dementia (KHANDLE Study)

The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study, a collaborative study between DOR and UC Davis, follows a diverse cohort of Kaiser Permanente Northern California members who participated in at least one optional check-up (Multiphasic Health Checkups) during midlife. This study is evaluating differences in dementia incidence and rate of cognitive decline across racial/ethnic group and sexes. It uses over five decades of data to examine how early life experience, life course health, and genetics influence differences in cognitive decline and dementia by race/ethnicity and sex.
Investigator: Gilsanz, Paola
Funder: National Institute on Aging

Glycemic Control and Dementia: The Role of Pharmacotherapy and Vascular Complications

About 25% of people over the age of 65 are living with diabetes, with 90% of them managing type 2 diabetes. Studies have shown that older individuals with type 2 diabetes have a 51-62% higher risk of dementia than those without type 2 diabetes. This study will investigate factors for dementia among Kaiser Permanente Northern California individuals with type 2 diabetes to determine which pattern of glycemic control reduces dementia risk, adjusting for factors such as diabetes treatment and comorbidities.
Investigator: Gilsanz, Paola
Funder:

Contributions of Educational Quality and Occupational Complexity on Racial and Ethnic Inequities in Brain Health and Alzheimer's Disease and Related Dementia

This study utilizes a lifecourse approach to evaluate the roles of education quality and occupational complexity on dementia risk and cognitive decline and to examine if patterns of educational quality and occupational complexity across the lifecourse drive racial and ethnic disparities present in dementia and late-life brain health. This study leverages information from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study, which follows a diverse group of long-term members of Kaiser Permanente Northern California to evaluate the role of lifecourse health on cognitive decline, dementia, and brain imaging markers.
Investigator: Gilsanz, Paola
Funder: National Institute on Aging

Highlighted Publications

The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes

Author(s): Gilsanz P; Karter AJ; Beeri MS; Quesenberry CP; Whitmer RA

Diabetes Care. 2017 Dec 18.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Brain pathologies, reserve, and cognition in aging and dementia

Epidemiology of Age-related Dementia, Mild Cognitive Impairment and Brain Pathology in a Multiethnic Cohort of Oldest-Old

Epidemiology of Age-related Dementia, Mild Cognitive Impairment and Brain Pathology in a Multiethnic Cohort of Oldest-Old

Lifecourse health, cerebral pathology and ethnic disparities in dementia (KHANDLE Study)

Glycemic Control and Dementia: The Role of Pharmacotherapy and Vascular Complications

Contributions of Educational Quality and Occupational Complexity on Racial and Ethnic Inequities in Brain Health and Alzheimer's Disease and Related Dementia

Highlighted Publications

The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes

Female sex, early-onset hypertension, and risk of dementia

Association Between Birth in a High Stroke Mortality State, Race, and Risk of Dementia

Publications

Assessing cognitive impairment in an ethnically diverse cohort of oldest-old: the life after 90 study

Glycemic Control Over Multiple Decades and Dementia Risk in People With Type 2 Diabetes

Association of primary lifetime occupational cognitive complexity and cognitive decline in a diverse cohort: Results from the KHANDLE study

Association of Early Adulthood Hypertension and Blood Pressure Change With Late-Life Neuroimaging Biomarkers

State-Level Indicators of Childhood Educational Quality and Incident Dementia in Older Black and White Adults

Association of Education With Dementia Incidence Stratified by Ethnicity and Nativity in a Cohort of Older Asian American Individuals

The impact of attending historically Black colleges and universities on cognitive decline in Black adults: A longitudinal analysis in the KHANDLE and STAR cohorts

Evaluating interpersonal discrimination and depressive symptoms as partial mediators of the effects of education on cognition: Evidence from the Study of Healthy Aging in African Americans (STAR)

Generation and age of immigration on later life cognitive performance in KHANDLE

Neighborhood disadvantage and dementia incidence in a cohort of Asian American and non-Latino White older adults in Northern California

Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study

Consideration of sex and gender in Alzheimer's disease and related disorders from a global perspective

Association of Social Integration with Cognitive Status in a Multi-Ethnic Cohort: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study

Accounting for lack of representation in dementia research: Generalizing KHANDLE study findings on the prevalence of cognitive impairment to the California older population

The role of nativity in heterogeneous dementia incidence in a large cohort of three Asian American groups and white older adults in California

Prevalence of Instrumental Activities of Daily Living (IADL) Difficulties and Associated Cognitive Predictors Across Racial/Ethnic Groups: Findings from the KHANDLE Study

Comparison of cognitive function in older adults with type 1 diabetes, type 2 diabetes, and no diabetes: results from the Study of Longevity in Diabetes (SOLID)

Comparison of dementia incidence and prevalence between individuals with and without HIV infection in primary care from 2000 to 2016

Measuring cognitive health in ethnically diverse older adults

Perceived Discrimination, Nativity, and Cognitive Performance in a Multi-ethnic Study of Older Adults: Findings from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Marginal structural models for life-course theories and social epidemiology: Definitions, sources of bias, and simulated illustrations

Stroke Belt Birth State and Late-life Cognition in The Study of Healthy Aging in African Americans (STAR)

Association of Timing of School Desegregation in the United States With Late-Life Cognition in the Study of Healthy Aging in African Americans (STAR) Cohort

Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-Life Cognition: Study of Healthy Aging in African Americans

Operationalizing Social Environments in Cognitive Aging and Dementia Research: A Scoping Review

Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California

Association of Type 1 Diabetes and Hypoglycemic and Hyperglycemic Events and Risk of Dementia

Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-life Cognition: Study of Healthy Aging in African Americans (STAR)

Lifecourse socioeconomic changes and late-life cognition in a cohort of U.S.-born and U.S. immigrants: findings from the KHANDLE study

Temporal Trends in Stroke-Related Memory Change: Results From a US National Cohort 1998-2016

Do the Benefits of Educational Attainment for Late-life Cognition Differ by Racial/Ethnic Group?: Evidence for Heterogenous Treatment Effects in the Kaiser Healthy Aging and Diverse Life Experience (KHANDLE) Study

Racial/Ethnic Disparities in Young Adulthood and Midlife Cardiovascular Risk Factors and Late-life Cognitive Domains: The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Comparison of dementia risk after age 50 between individuals with and without HIV infection

Are adverse childhood experiences associated with late-life cognitive performance across racial/ethnic groups: results from the Kaiser Healthy Aging and Diverse Life Experiences study baseline

Physical Performance and Cognition in a Diverse Cohort: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Fitting a shared frailty illness-death model to left-truncated semi-competing risks data to examine the impact of education level on incident dementia

Sex, diabetes status and cognition: findings from the study of longevity in diabetes

Physical Performance and Cognition in a Diverse Cohort: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Cognitive impairment in racially/ethnically diverse older adults: Accounting for sources of diagnostic bias

Elevated Depressive Symptoms and the Risk of Stroke among the Mexican Older Population

Recurrent diabetic ketoacidosis and cognitive function among older adults with type 1 diabetes: findings from the Study of Longevity in Diabetes

Severe Hypoglycemia and Cognitive Function in Older Adults With Type 1 Diabetes: The Study of Longevity in Diabetes (SOLID)

Sleep Quality and Cognitive Function in Type 1 Diabetes: Findings From the Study of Longevity in Diabetes (SOLID)

Differences in association of leisure time activities and cognition in a racially/ethnically diverse cohort of older adults: Findings from the KHANDLE study

Racial/Ethnic Differences in Sleep Quality among Older Adults: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Locus of Control and Cognition in Older Adults With Type I Diabetes: Evidence For Sex Differences From the Study of Longevity in Diabetes (SOLID)

Is it possible to overcome the 'long arm' of childhood socioeconomic disadvantage through upward socioeconomic mobility?

Stressors in Midlife and Risk of Dementia: The Role of Race and Education

Initiation of antidepressant medication and risk of incident stroke: using the Adult Changes in Thought cohort to address time-varying confounding

Reproductive period and risk of dementia in a diverse cohort of health care members

Incidence of dementia after age 90 in a multiracial cohort

Birth in High Infant Mortality States and Dementia Risk in a Cohort of Elderly African American and White Health Care Members

Posttraumatic stress disorder symptoms and television viewing patterns in the Nurses' Health Study II: A longitudinal analysis

Early Midlife Pulmonary Function and Dementia Risk

Traumatic brain injury associated with dementia risk among people with type 1 diabetes

Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes

Depression in type 1 diabetes and risk of dementia

Diabetic Retinopathy and Dementia in Type 1 Diabetes

Post-traumatic stress disorder and risk of dementia among members of a health care delivery system

The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes

Posttraumatic stress disorder onset and inflammatory and endothelial function biomarkers in women

Female sex, early-onset hypertension, and risk of dementia

Association Between Birth in a High Stroke Mortality State, Race, and Risk of Dementia

Alzheimer's disease genetic risk variants beyondAPOEε4 predict mortality

Cross-Sectional and Longitudinal Associations of Chronic Posttraumatic Stress Disorder With Inflammatory and Endothelial Function Markers in Women

Dysregulated Blood Pressure: Can Regulating Emotions Help?

Early life predictors of atrial fibrillation-related mortality: evidence from the health and retirement study