About

Avron Spiro is an Associate Professor of Health Policy and Health Services Research at the Henry M. Goldman School of Dental Medicine. He holds a PhD in Human Development and Family Studies from Pennsylvania State University, obtained in 1982. His academic and professional focus is on health policy and health services research, contributing to the educational and research missions of the dental school. Further details about his specific research interests or key contributions are not provided in the available page text.

Research topics

• Psychology
• Social psychology
• Clinical psychology
• Medicine
• Developmental psychology
• Sociology
• Political Science
• Gerontology
• Demography
• Internal medicine

Selected publications

• APA handbook of adult development and aging.

  American Psychological Association eBooks · 2026-01-01

  book
  PublisherDOI

• Studying adult development and aging the long way: 100 years of U.S. Longitudinal studies of aging.

  American Psychological Association eBooks · 2026-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• Posttraumatic Stress Disorder and Hypertension in Vietnam Veteran Men and Women

  Innovation in Aging · 2025-12-01

  articleOpen access1st authorCorresponding

  Abstract Hypertension is a risk factor for cardiovascular disease, a leading cause of death for older adults. Posttraumatic stress disorder (PTSD) may increase the likelihood of developing hypertension. However, this association has seldom been studied in older adults and infrequently among veterans. The present study used data from two cohorts of older adult Vietnam era veterans: over 4104 women (Mage= 67 years) and 5767 men Mage= 62 years). Respondents completed by telephone a structured clinical interview assessing lifetime PTSD. Information on self-reported hypertension diagnosis, age of onset, and past-year treatment, as well as on covariates was obtained by mail survey. Weighted logistic regression analyses adjusted for relevant covariates revealed an association between PTSD and higher likelihood of hypertension in male veterans (OR = 1.57; 95% CI [1.30, 1.91]). There was no association between lifetime PTSD and hypertension in female veterans (OR = 0.93; 95% CI [0.78, 1.11]). Exploratory secondary analyses suggested an association between PTSD and hypertension onset in early and middle adulthood only in men. PTSD was not associated with past-year hypertension treatment for women or men. Overall, these findings suggest that PTSD may contribute to hypertension risk in older male veterans, but no contribution was found for female veterans. Prospective research is needed to confirm these findings and further clarify the relationship between PTSD and hypertension to inform veteran clinical care.

  PublisherOA PDFDOI

• Leveraging Administrative Data Linkages to Study Waterborne Lead Exposure in Longitudinal Aging Cohort Studies

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Lead (Pb) is a neurotoxin with lasting cognitive, behavioral, and physiological effects, particularly when exposure occurs in early childhood. Nearly half of the U.S. population today experienced Pb exposure during this critical developmental period, yet few studies have examined its long-term health consequences using a life course perspective. We aim to demonstrate the feasibility of aging cohort studies to construct a phenotype of early childhood Pb exposure via administrative data linkages. The Boston Early Adversity and Mortality Study integrated municipal, state, and federal records with data from three Boston-based, socioeconomically diverse longitudinal cohorts (the Normative Aging Study [NAS] and the Grant and Glueck [GG] cohorts of the Harvard Study of Adult Development) and added siblings (NBEAMS=13,151; nNAS=9,972, nGG=3,179). Pb exposure was operationalized using linkage-derived information on water service line materials (non-Pb, Pb, mixed Pb and non-Pb) and municipal water pH (continuous) anchored to participants’ residential home address at birth. We examined Pb exposure patterns by childhood SES status. We identified birth locations for 99% of the 12,559 U.S.-born BEAMS participants, spanning 688 unique city-state combinations. Pb exposure could be estimated for 52% of 688 birth locations, covering 93% (n = 11,654) of U.S.-born BEAMS participants. Pb exposure followed a socioeconomic gradient, χ2(4)=1,035.9, p<.0001, such that 90%, 66%, and 37% of the lowest- (Glueck), middle- (NAS), and highest- (Grant) SES cohorts, respectively, had the highest Pb exposure levels. We discuss the value of administrative data linkages in reconstructing environmental exposures and advancing life course research.

  PublisherOA PDFDOI

• The VA Normative Aging Study: The Aging of a Longitudinal Study of Aging

  Innovation in Aging · 2025-12-01

  articleOpen access1st authorCorresponding

  Abstract In 1963, the Normative Aging Study (NAS) was initiated at the Boston VA Outpatient Clinic. Over the next several years, 2280 men, mostly veterans, were enrolled into a life-long study of aging. To better understand the distinction between aging per se vs. the progression of disease, these men were selected for good health, regardless of age. The intention was to examine, over their lifespan, the interplay between aging and the development and progression of disease. Men returned to the clinic every few years for examinations and completed periodic surveys that assessed their health, disease, anthropometry, and health behaviors. In this talk, we will discuss the origins of the NAS and its place in the first wave of longitudinal studies of aging (e.g., Framingham, Baltimore, Duke). We will then focus on the growth of the psychosocial research program at NAS, which was nascent in the initial decades but expanded rapidly during the 1980’s. This program examined social support, stress and coping, mental health, personality and cognition. We will also mention recent work in this deeply phenotyped study that focuses on epigenetics and its role in psychosocial aging and health. In concluding, we offer some observations on the complexities of establishing and maintaining longitudinal studies and their contributions to the study of aging and development.

  PublisherDOI

• Epigenome-wide association study meta-analysis of wellbeing

  bioRxiv (Cold Spring Harbor Laboratory) · 2025-09-12 · 1 citations

  preprintOpen access

  Abstract Wellbeing is associated with both behavioral phenotypes as well as several key life outcomes, such as health, employment, and coping with stressful events. These phenotypes associated with wellbeing could be potential indicators of differential epigenetic patterns between individuals that differ in their levels of wellbeing. We performed the largest epigenome-wide (EWAS) meta-analysis of wellbeing to date by combining whole blood DNA methylation data (Illumina 450k array) from 13 cohorts from Europe, Australia, and the USA ( N = 10,757 participants). After correcting for smoking and BMI, no epigenome-wide significant methylation sites were identified. We tested whether a weighted methylation score (MS) based on leave-one-cohort-out EWAS meta-analysis summary statistics predicted wellbeing in an independent cohort, and whether prediction was significant over and above the polygenic score (PGS) for wellbeing. The MS was associated with wellbeing (variance explained=0.22%, p =0.03) and was no longer significant after adding the polygenic score (PGS; variance explained=0.43%, p =0.0046, MS; variance explained=0.07%, p =0.2842). We further compared DNA methylation levels in 16 pairs of monozygotic twins discordant for wellbeing. These analyses revealed no significant within-pair DNA methylation differences at the top-sites from the meta-analysis or in MS. Our results suggest that larger EWAS meta-analyses with uniform phenotype assessment are required to identify methylation sites associated with wellbeing.

  PublisherOA PDFDOI

• Persistence and Patterns of Combat-Related Posttraumatic Stress Disorder (PTSD), Medical, and Social Dysfunction in Male Military Veterans 50 Years After Deployment to Vietnam

  Journal of Occupational and Environmental Medicine · 2025-01-27 · 4 citations

  articleOpen access

  OBJECTIVES: We examined long-term patterns of posttraumatic stress disorder (PTSD) and behavioral outcomes in Vietnam veterans. METHODS: A random sample of 12,400 veterans was surveyed in 1984, 1998, and a deployed subset (n = 729) in 2020. Outcomes included PTSD, psychological well-being, health functioning, and disability. RESULTS: Four PTSD patterns emerged over 35 years: current PTSD (9.1%, rising to 15.5% in heavy combat), prior PTSD (9.7%), subthreshold PTSD (25.2%), and never PTSD (56.0%). A strong combat-PTSD dose-response relationship persisted across time points. Veterans with current PTSD showed the worst outcomes; those with subthreshold or prior PTSD had intermediate outcomes, while never-PTSD veterans fared best. Community support mitigated adverse effects. CONCLUSIONS: Findings highlight the enduring impact of combat, with PTSD and related dysfunction affecting veterans even below clinical thresholds, leaving many ineligible for Department of Veterans Affairs (DVA) programs.

  PublisherOA PDFDOI

• Functioning and disability consequences of comorbid posttraumatic stress disorder and diabetes in Vietnam era men and women veterans.

  Health Psychology · 2025-06-12

  articleOpen access

  OBJECTIVE: Diabetes mellitus (DM) negatively impacts functioning and disability, particularly when comorbid with mental health diagnoses. Posttraumatic stress disorder (PTSD) increases the risk of developing DM and may have a particularly deleterious impact on DM-related outcomes. This study aimed to determine the extent to which PTSD and DM comorbidity was associated with poorer functioning and greater disability relative to neither or single diagnoses in older adult veteran men and women. METHOD: = 4,102). Participants completed self-report measures of diagnosed physical health conditions, functioning, and disability. PTSD and other mental health conditions were assessed via a telephone-administered diagnostic interview, and military characteristics were gathered from service records. RESULTS: In sex-specific weighted linear regression analyses adjusted for relevant covariates, veterans with PTSD only, DM only, and PTSD + DM reported significantly worse mental and physical health functioning and greater disability compared with veterans with neither condition. PTSD + DM comorbidity was associated with worse outcomes than DM only and worse physical health functioning than PTSD only. The pattern of results was similar for men and women. CONCLUSIONS: Older adult veterans with both PTSD and DM may experience worse health functioning and greater disability relative to veterans with neither or single diagnoses only. Although effects were small to medium, potential clinical implications include assessment of PTSD among veterans with DM and intervention efforts that address the effects of both conditions on health and well-being. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

  PublisherDOI

• Posttraumatic stress disorder and hypertension in older adult Vietnam Era male and female veterans

  Journal of Traumatic Stress · 2025-05-12 · 2 citations

  articleOpen access

  Abstract Hypertension is a known risk factor for cardiovascular disease, a leading cause of death for older adults. Posttraumatic stress disorder (PTSD) may increase the likelihood of developing hypertension; however, little is known about this association in older adult male and female veterans. To better understand the ways in which aging and biological sex impact the link between PTSD and hypertension, the present study used data from two cohorts of older adult Vietnam Era veterans (women: N = 4,104, M age = 67.4 years; men: N = 5,767, M age = 61.9 years). Veterans completed a telephone structured clinical interview assessing lifetime PTSD and self‐reported hypertension diagnosis, age of onset, and past‐year treatment. Weighted logistic regression analyses adjusted for relevant covariates revealed an association between PTSD and a higher likelihood of hypertension in male veterans, OR = 1.57, 95% CI [1.30, 1.91]. There was no association between lifetime PTSD and hypertension in female veterans, OR = 0.93; 95% CI [0.77, 1.11]. Exploratory secondary analyses suggested an association between PTSD and hypertension onset in early and middle adulthood in men. PTSD was not associated with past‐year hypertension treatment. Overall, these findings suggest that PTSD may contribute to hypertension risk in older adult male veterans, which has important implications for their long‐term cardiovascular health. The association between PTSD and hypertension may differ across the lifespan and for male and female veterans. Additional prospective research is needed to confirm these findings and further clarify the association between PTSD and hypertension to inform veteran clinical care.

  PublisherOA PDFDOI

• Optimism and cognitive functioning trajectories in a cohort of aging men

  The Journals of Gerontology Series B · 2025-07-25 · 1 citations

  articleOpen access

  OBJECTIVES: Robust evidence supports optimism as an asset for good physical and emotional health in aging populations, but its role in cognitive aging remains understudied. This study evaluated whether higher optimism levels would be prospectively associated with higher initial levels and slower decline in cognitive functioning over 26 years in a community-dwelling cohort of aging men. METHODS: Participants included 847 men from the Veterans Affairs Normative Aging Study who completed the Revised Optimism-Pessimism scale of the Minnesota Multiphasic Personality Inventory-2 in 1986 and ≥1 cognitive assessment repeated triennially in 1993-2019. At each assessment, scores from seven cognitive tests were combined into a global composite and three domain-specific composites: verbal memory, executive functioning, and visuospatial ability. Mixed-effects regression models evaluated the associations between optimism and cognitive trajectories. RESULTS: Higher optimism levels were associated with higher initial levels but not less decline in global cognitive functioning over time (B = 0.04, 95% CI: 0.001-00.07), , adjusted for demographics, practice effects, and lag between optimism assessment and the first cognitive assessment. In domain-specific analyses, optimism was associated with higher initial levels but not magnitude of decline in verbal memory (B = 0.06, 95% CI: 0.01-0.12), and unrelated to executive functioning or visuospatial ability trajectories. DISCUSSION: This study adds specificity to a nascent literature linking optimism to cognitive aging, indicating an association with initial levels, but not decline-particularly in verbal memory-in older men. Examining these relationships earlier in life may further clarify the etiologic role of optimism in cognitive health across the developmental span.

  PublisherOA PDFDOI

Recent grants

• NIH Grant U54DE014264

  NIH · $20.1M · 2010

• NIH Grant R24AG039343

  NIH · $845k · 2017

Frequent coauthors

• Lewis E. Kazis

  Spaulding Rehabilitation Hospital

  307 shared

• Donald R. Miller

  North Dakota State University

  261 shared

• Carolyn M. Aldwin

  Oregon State University

  211 shared

• David Sparrow

  VA Boston Healthcare System

  192 shared

• B. Graeme Fincke

  VA New England Healthcare System

  189 shared

• William H. Rogers

  University of Massachusetts Chan Medical School

  185 shared

• Katherine M. Skinner

  University of Michigan–Ann Arbor

  182 shared

• Pantel Vokonas

  Boston University

  178 shared

Education

• Ph.D., Human Development and Family Studies

  Pennsylvania State University

  1982