My interest in improving health for older adults has resulted in broad clinical experience and a diverse research history. This has exposed me to many clinical subjects in many settings, and to many vexing ethical and regulatory issues. My early research experiences ranged from my own molecular investigations of the etiology of obesity and diabetes to lifestyle activity weight loss interventions in middle-aged, functionally fit individuals. These efforts taught me, amongst other things, that obesity, weight loss, and body composition do impact function but are far more complicated to study well than they may first appear. Recent work in rehabilitation, strength training, and fall prevention in older adults continues to challenge me to examine how best to balance risk vs. benefit on multiple levels — for individual participants, for the specific study, and for research enterprise more broadly.

Often a risk that a patient and I may deem worthwhile for the hope of clinical benefit is simply not appropriate for a research setting. This can be difficult to understand for volunteers who are turned away, and for young investigators struggling to recruit. More difficult for senior research colleagues and regulators is that often the “high-risk subject” will indeed have adverse outcomes while enrolled in research, but that the research itself may have minimally impacted the specific outcome much less the overall risk for the individual (a particularly relevant consideration for exercise interventions and for risk of falls).

My main hope for aging research at the University of Maryland School of Medicine and Baltimore Veterans Affairs Medical Center is that we learn to blend well the compassion that drives our clinical practices and underlies our quest for better treatment options with scientific rigor and due appreciation of the safety and regulatory requirements alluded to above. Learning to do good research and safe, ethical research should always go hand in hand.