Personnel iCAN Program Resources MKN iCAN Program Resources Med

Healthy Aging

The Integrative Science for Healthy Aging Program, led by Dr. Julia Sheffler, broadly involves the development and assessment of behavioral interventions for physical, mental, and neurocognitive health in older adults. We are especially interested in the interaction of biological, psychological, and social lifespan processes that influence functioning in older age. Through understanding these processes, this program aims to develop psychological and behavioral approaches to improve adherence and the long-term success of health behavior interventions for older adults.

Current projects in our program span the translational spectrum, from basic social science approaches led by undergraduate researchers examining how childhood adversity influences health and emotion regulation across the lifespan, to clinical trials examining a nutrition adherence intervention for older adults at-risk for Alzheimer’s disease. 

If you would like to get involved in research as a participant or if you are interested in joining our program as a student or volunteer, please contact Dr. Julia Sheffler at Julia.Sheffler@med.fsu.edu or call 850.644.4209.

Current Research Projects

A Scalable Mediterranean-Ketogenic Nutrition Intervention to Improve Gut and Brain Health in Underserved Rural Older Adults

Florida Department of Health (FDOH), Ed and Ethel Moore Alzheimer's Disease Research Program  
Julia Sheffler, PhD: Principal Investigator
2023 - 2027

Aims: First, we are looking for ways to increase access to a nutrition program to help people make changes to their diet that support brain health. Secondly, we are testing the health effects of eating using Mediterranean or Mediterranean ketogenic nutrition (MKN). We will look to see if these have benefits on gut and brain health related to risk for dementia. We are recruiting people who have mild problems with their thinking and memory, as well as people with normal thinking and memory. There are important relationships between gut health and brain health that may affect risk for dementia, and our study will examine whether this type of nutrition may be helpful.

Using a Novel, Digital, and Multimodal Platform to Optimize Waist Circumference, Body Composition, and Cardiovascular Health in Endometrial Cancer Survivors 

Lev-Max Health Program, Alberta Innovates 
Julia Sheffler, PhD: Co-Investigator 
2023 - 2026

Randomized Clinical Trial of a Brief, Anxiety Intervention for Mild Cognitive Impairment/Mild Alzheimer's Disease and their Care Providers

NIH, R01 
Julia Sheffler, PhD: Co-Investigator 
2023 - 2027

Aims: This study aims to test a brief, CBT-based intervention called Cognitive Anxiety Sensitivity Treatment (CAST) for individuals with mild cognitive impairment (MCI) or mild Alzheimer’s disease (AD) and their care partners. Anxiety is common in this population, but existing treatments are often lengthy and rely on strong memory and cognitive abilities, leading to high dropout rates. CAST, focused on reducing anxiety sensitivity (AS), utilizes psychoeducation and interoceptive exposure (IE) exercises. This randomized clinical trial (RCT) will assess the effectiveness of CAST compared to a Health Education Control (HEC) condition in reducing anxiety, improving cognitive function, and enhancing quality of life.

Completed Research Projects

Pilot Randomized Trial of an MI-CBT Adherence Program for Lifestyle Interventions in Older Adults with Mild Cognitive Impairment (MCI)

University of Florida, KL2 
Principal Investigator: Julia Sheffler, PhD 
Co-Investigators: Sylvie Naar, Ph.D., Zhe He, Ph.D., Dimitris Kiosses, Ph.D., & Paul Katz, M.D. 

Summary of Findings: This pilot trial demonstrated that the Mediterranean ketogenic nutrition (MKN) program incorporating MI and BCT strategies may better engage and retain participants than a nutrition education program alone, although participants in both groups reported high satisfaction.  Clinical benefits, such as improved memory, BMI, and blood pressure, as well as reduced pain were identified from the intervention.

Publication available here: https://pubmed.ncbi.nlm.nih.gov/37242211/

Feasibility and Acceptability of an MI-CBT Ketogenic Adherence Program for Pain in Older Adults with Mild Cognitive Impairment 

University of Florida Sub-award (NCATS)
Principal Investigator: Julia Sheffler, PhD
Co-investigators: Sylvie Naar, PhD, Bahram Arjmandi, PhD, Jamie Quinn, PhD, Greg Hajcak, PhD, Cynthia Vied, PhD, and Neda Akhavan, PhD.

Summary of Findings: Based on these findings, adherence to Mediterranean ketogenic nutrition (MKN) may promote improvements in self-reported pain in older adults with possible mild cognitive impairment and findings support the need for future full-scale randomized clinical trials evaluating MKN programs on pain.

Publication available here: https://pubmed.ncbi.nlm.nih.gov/38803693/ 

Proof-of-Concept: Examining the Effects of a Nutrition Adherence Program on Risks for Alzheimer's Disease 

Florida State University Team Science for Translational Research Seed Grant
Florida State University Institute for Successful Longevity Planning Grant
Investigators: Julia Sheffler, Ph.D., Sylvie Naar, Ph.D., Bahram Arjmandi, Ph.D., Cynthia Vied, Ph.D., Greg Hajcak, Ph.D., Jamie Quinn, Ph.D., & Neda Akhavan, Ph.D.

Project Overview: The project provided the proof-of-concept phase for developing a ketogenic nutrition adherence program that incorporates motivational interviewing and cognitive behavioral therapy strategies to promote long-term change. We assessed the feasibility, acceptability, and preliminary effects of implementing this program for older adults at risk for developing Alzheimer's disease, based on self-report and neuropsychological testing. We used a team science approach to develop and refine the intervention for future clinical trials. We also incorporated comprehensive assessment techniques, including neuropsychological testing, EEG, genetic data, and physical health assessments to measure the effects of ketogenic nutrition on all aspects of functioning.

Summary of Findings: 100% of participants who began the trial completed the 6-week ketogenic nutrition adherence program, including completion of the pre- and post-assessments. Eight participants achieved measurable levels of ketones during the program. The average self-rated adherence across the program was 8.7 out of 10. Participants demonstrated significant improvement in cognitive performance from baseline to follow up. Results supported the feasibility for moving to the next phase and demonstrated proof-of-concept for the intervention. The next step is a randomized pilot trial.

Publication available here: https://pubmed.ncbi.nlm.nih.gov/35065656/

Resilience through Adversity: Examining the Long-Term Impacts of Adverse Childhood Experiences (ACEs) and Adult Stress on Health and Well-being across the Lifespan  

Julia Sheffler, PhD: Principal Investigator

Specific Aims: Our program involves multiple ongoing projects that examine the long-term adverse impacts of ACEs on health and psychological functioning across the life course. For example, Celina Meyer, a research assistant in the lab was recently awarded the IDEA Grant for her project examining the interactions between early household chaos and ACEs on later emotional and cognitive regulation strategies. We are interested in understanding ACEs as a form of significant early stress, which disrupts key areas of neuro-immune and emotional development leading to lasting changes in psychosocial functioning. Our goal is to identify resiliency factors that may be useful for interventions in adults and older adults exposed to ACEs.

Key Publications 

CTBScience faculty & staff in bold. 

  1. Klejc, K., Cruz-Almeida, Y., & Sheffler, J. (2024). Feasibility of Addressing Pain using a Mediterranean Ketogenic Nutrition Program in Older Adults with Mild Cognitive Impairment. Journal of Pain Research, 17,1867-1880.

  2. Park, G., Kadyan, S., Hochuli, N., Pollak, J., Wang, B., Salazar, G., Chakrabarty, P., Efron, P., Sheffler, J., & Nagpal, R. (2024). A modified Mediterranean-style diet enhances brain function via specific gut-microbiome-brain mechanisms. Gut Microbes, 16(1), 2323752.

  3. Sheffler, J. L., Meng, Z. Sachs-Ericsson, N., Gutierrez Caimary, V., Patel, J., & Pickett, S. (2024). Sleep quality as a critical pathway between adverse childhood experiences and multimorbidity and the impact of lifestyle. Journal of Aging and Health. DOI: 10.1177/0898264324123783

  4. Sheffler, J. L., Kiosses, D. N., He, Z., Arjmandi, B. H., Akhavan, N. S., Klejc, K., & Naar, S. (2023). Improving Adherence to a Mediterranean Ketogenic Nutrition Program for High-Risk Older Adults: A Pilot Randomized Trial. Nutrients, 15(10), 2329.

  5. Sheffler, J.L., Burchard, V., Pickett, S.M. (2023). Adverse childhood experiences and poor sleep quality in older adults: The influence of emotion regulation. Journal of Gerontology: Medical Sciences.

  6. Sheffler, J.L., Saliga, H., Pickett, S.M. (2022). The role of physical activity on the relationships between pain, anxiety, and sleep quality in older age. Journal of Gerontology: Medical Sciences. DOI: 10.1093/gerona/glac205

  7. Schmidt, N. B., Schubert, F. T., & Sheffler, J.L. (2022). Brief, Interoceptive Exposure Focused Treatment for Anxiety in Mild Cognitive Impairment. Age and Ageing, 51(6), afac133. DOI: 10.1093/ageing/afac133

  8. Brush, C. J., Kallen, A. M., Meynadasy, M. A., King, T., Hajcak, G., & Sheffler, J. L. (2022). The P300, loneliness, and depression in older adults. Biological Psychology, 171, 108339. DOI: 10.1016/j.biopsycho.2022.108339

  9. Moliner, S., Quinn, J., & Sheffler., J. (2022). The Mediating Role of Cardiometabolic Dysregulation on the Relation between Adverse Childhood Experiences and Adult Cognition. Psychosomatic Medicine. DOI: 10.1097/PSY.0000000000001093

  10. Sheffler, J., Arjmandi, B., Hajcak, G., Quinn, J., Vied, C., Akhavan, N., & Naar, S. (2022). Feasibility of an MI-CBT Ketogenic Adherence Program for Older adults with Mild Cognitive Impairment. Pilot and Feasibility Studies, 8(16). DOI: http://dx.doi.org/10.1186/s40814-022-00970-z

  11. Sheffler, J., Meynadasy, M., Taylor, D., Kiosses, D., & Hajcak, G. (2021). Subjective, Neuropsychological, and Neural Markers of Memory in Older Adults. International Psychogeriatrics, 1-9. DOI: 10.1017/S1041610221002623
  12. Sheffler, J., Meyer, C., & Puga, F. (2021). Multi-sample assessment of stress reactivity as a mediator between childhood adversity and mid-to late-life Outcomes. Aging & Mental Health. DOI: 10.1080/13607863.2021.1910787

  13. Sheffler, J., Bekelman, D, Schmiege, S., & Sussman, J. (2020). A longitudinal analysis of the relationships between depression, fatigue, and pain in patients with heart failure. Aging & Mental Health, 1-7. DOI: 10.1080/13607863.2020.1855626

  14. Sheffler, J., Joiner, T., & Sachs-Ericsson, N. (2020). The Interpersonal and Psychological Impacts of COVID-19 on Risk for Late-Life Suicide. The Gerontologist. DOI: 10.1093/geront/gnaa103

  15. Sheffler, J. L., Piazza, J. R., Quinn, J. M., Sachs-Ericsson, N. J., & Stanley, I. H. (2019). Adverse childhood experiences and coping strategies: identifying pathways to resiliency in adulthood. Anxiety, Stress, & Coping, 1-16. DOI: 10.1080/10615806.2019.1638699

  16. Piazza, J. R., Stawski, R. S., & Sheffler, J. L. (2019). Age, daily stress processes, and allostatic load: A longitudinal study. Journal of Aging and Health, 31(9), 1671-1691.

  17. Sheffler, J. & Sachs-Ericsson, N. (2016). Racial differences in the effect of stress on health and the moderating role of perceived Social support. Journal of Aging and Health, 28(8), 1362-1381.

  18. Sheffler, J., Rushing, N. C., Stanley, I. H., & Sachs-Ericsson, N. J. (2016). The long-term impact of combat exposure on health, interpersonal, and economic domains of functioning. Aging & Mental Health, 20(11), 1202-1212.

  19. Sachs-Ericsson, N. J., Rushing, N. C., Stanley, I. H., & Sheffler, J. (2016). In my end is my beginning: Developmental trajectories of adverse childhood experiences to late-life suicide. Aging & Mental Health, 20(2), 139-165.  

  20. Sachs-Ericsson, N., Joiner, T., Cougle, J., & Sheffler, J. (2015). Combat Exposure in Early Adulthood Interacts with Recent Stressors to Predict PTSD in Aging Male Veterans. The Gerontologist, 56(1), 82-91

  21. Sheffler, J., Moxely, J., & Sachs-Ericsson, N. (2014). Stress, race, and APOE: Understanding the interplay of risk factors for changes in cognitive functioning. Aging & Mental Health, 18(6), 784-791.