Focus On Geriatric Medicine And Aging

Host: Brian P. McDonough, MD, FAAFP According to a recent study, the percentage of elderly people in American nursing homes who are moderately to severely overweight has climbed to 25%, a dramatic increase from 14% back in 2000. How does this alarming trend affect both health outcomes and care delivery in caregiving settings? Joining Dr. Brian McDonough to discuss this underrecognized issue of obesity in senior populations is Dr. Caroline Cederquist, bariatrics expert and founder of Cederquist Medical Wellness Center in Naples FL. Dr. Cederquist is also co-founder of bistroMD, a company premised on delivering physician-designed gourmet meals to patients for purposes of weight loss and health maintenance.

Host: Jennifer Caudle, DO Host Jennifer Caudle, DO welcomes Robert Nagele, PhD, a Rowan University researcher and Professor at the Rowan University School of Osteopathic Medicine. Dr. Nagele and his team are closing in on a new blood test to detect Alzheimer’s, Parkinson’s, MS, cancers and other diseases by searching for the autoantibodies created by the disease processes. The test has initially shown to be remarkably accurate in research trials with a capability to accurately assess the stage of disease. More important, it appears to detect pre-clinical disease, giving physicians an opportunity to intervene with lifestyle changes that delay or defer the onset of symptoms. This program was recorded live at the American Osteopathic Association's annual medical education conference, OMED2015 in Orlando, FL,

Host: Jennifer Caudle, DO Guest: Michael Lewiecki, MD, FACP, FACE With an incidence rate of more than 750,000 per year, vertebral fractures contribute significantly to morbidity and mortality rates in osteoporosis patients, particularly those who have sustained a VCF in the past. In this new segment, we will hear from Dr. Michael Lewiecki, as he examines this debilitating issue. Dr. Lewiecki is the Director of the New Mexico Clinical Research and Osteoporosis Center; and, Clinical Assistant Professor of Medicine at UNM School of Medicine in Albuquerque, New Mexico.

[Read the Article] Agitation is common in patients with dementia and can contribute to distress for patients and caregivers and an increased risk of institutionalization. Nonpharmacological interventions are recommended as first-line therapy, but many patients fail to respond, and medications are often needed. Currently available medications don't work very well and can have serious side effects. A new study tested a combination of two existing medications, dextromethorphan hydrobromide and quinidine sulfate, to see if this would help control agitation in patients with Alzheimer's dementia. Researchers from the Cleveland Clinic recruited 220 patients with Alzheimer's dementia and agitation. During a preliminary 10 week trial, participants were randomly assigned to receive either the dextromethorphan- quinidine combination or a placebo. Results showed that patients receiving the combination medication demonstrated fewer episodes of agitation compared to patients who received the placebo. When agitation did oc

[Read the Article] Some evidence suggests that physical activity can help slow cognitive decline. A new study evaluated whether a program of moderate physical activity would result in better cognitive function, lower risk of dementia, or both, for older adults compared with a health education program.Researchers from Wake Forest School of Medicine, Winston-Salem, North Carolina evaluated more than 1,600 sedentary adults, between the ages of 70 and 89, and randomly assigned them to either physical activity or a health education program. The participants were monitored for 24 months, during which their cognitive function was measured using a variety of clinical tests.Results found that both groups preserved their cognitive function over the two year study period. Although there was no difference between the groups, the outcomes still prove notable, since steady decline in cognitive function would generally be expected within this age group. [Watch more videos of The JAMA Report] JAMA Report videos provided pur

[Read the Article] America's landmark health care programs, Medicare and Medicaid, celebrate their 50th anniversaries on July 30th. Over the past five decades, the United States healthcare system has experienced dynamic changes, most notably in recent years with improvements in technology, care delivery and health related behaviors. A new study examined key outcomes among the Medicare population over a 15 year period.Researchers from Yale University School of Medicine reviewed the records of nearly 70 million Medicare beneficiaries enrolled in fee-for-service and Medicare Advantage plans from 1999 to 2013, to better understand long-term trends in mortality, hospitalizations, and healthcare costs.Results found that among Medicare beneficiaries, death rates have dropped an estimated twenty percent, there have been ten percent fewer hospitalizations, and overall expenditures have decreased from 1999 to 2013. In the last six months of life, total hospitalizations and inpatient costs have also decreased. [Watch mo

Host: Matt Birnholz, MD Studies in the field of anthropology have shown that having a healthy grandmother plays a critically positive role in family cohesion. But the wholistic, personalized health needs of women in their elder years are not always recognized. This care disparity is all the more prominent in general OB/GYN practice, but thanks to the work of a select few, the trends may be about to change. Dr. Matt Birnholz speaks with Dr. Sarah Berga, Professor and Chair of OB/GYN at Wake Forest School of Medicine at ACOG’s annual meeting in San Francisco. They discuss maintaining grandmothers' health across both physiological and psychological spectra, and how this attention in care fundamentally changes larger family units for the better.

Guest: Steven N. Austad, PhD Host: Mary Leuchars, MD The bowhead whale is the longest-living mammal on Earth. Its lifespan can exceed 200 years. What can we learn about fostering human longevity from the extraordinarily long-living animals in what author Dr. Steven Austad calls "Methuselah’s Zoo" (so named for Methuselah, the oldest figure in the Bible, said to have lived for 969 years)? Dr. Austad, professor of cellular and structural biology at the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center, talks to host Dr. Mary Leuchars.

Guest: Steven N. Austad, PhD Host: Mary Leuchars, MD We assume that we know the answer to the question, Why does the body age? In short, we age, and eventually die, because we live. But what can we learn from studying aging on a cellular level? Host Dr. Mary Leuchars talks with Dr. Steven Austad, professor of cellular and structural biology at the Barshop Institute for Longevity and Aging Studies at the University of Texas Health Science Center at San Antonio and research chair of the American Federation for Aging Research, about why humans age, why we age, how to extend longevity, and the ramifications of extending our lives.

Guest: Wayne McCormick, MD, MPH Host: Lee Freedman, MD House calls have become a rarity in the US, but were the cornerstone of medical care for most of modern medical history. Dr. Wayne McCormick, professor of medicine at the University of Washington's division of gerontology and geriatric medicine, talks about how physicians are once again incorporating house calls into their practice. How do insurance companies and Medicare reimburse house call visits, and are house calls a viable option for your practice? Hosted by Dr. Lee Freedman.

Guest: Richard deShazo, MD Host: Lee Freedman, MD When older patients present with shortness of breath or fatigue, physicians may test for heart failure. Asthma is another diagnosis to consider, since a growing number of seniors have the condition. Dr. Richard deShazo, the Billy S. Guyton Distinguished Professor and professor of medicine and pediatrics at the University of Mississippi Medical Center, explains how older patients often experience asthma symptoms differently than younger patients. In a patient population that may have other comorbid conditions, what's the best way to treat asthma in seniors? Dr. Lee Freedman hosts.

Guest: William Thomas, MD Host: Lee Freedman, MD Why are conventional emergency departments less than ideal environments for older patients, and how can EDs be acclimated for seniors? Dr. William Thomas, geriatrician and professor of aging studies at the Erickson School at the University of Maryland, describes to host Dr. Lee Freedman the philosophy behind the nation's first ED designed specifically for older patients, at Holy Cross Hospital in Silver Springs, Maryland. How do staffing and design changes, as well as new screening methods, help physicians better care for older patients? Is this model cost-effective and efficient enough for other hospitals to emulate?

Guest: Karen B. Hirschman, PhD, MSW Host: Susan Dolan, RN, JD Is there a best-practice approach to working with families of patients with dementia? Dr. Karen Hirschman, research assistant professor in the department of nursing and a fellow at the Institute on Aging in the Department of Medicine at the University of Pennsylvania joins host Susan Dolan, RN to discuss many aspects of caring for patients with dementia in the hospital and at home. She also shares the progress of the Enhancing Care Coordination Study examining the benefits of home nursing care following a hospital stay for dementia patients.

Host: Eric Tangalos, MD Guest: Charles Crecelius, MD, PhD There are many different types of long term care facilities, including nursing homes, skilled nursing facilities and assisted living facilities. Dr. Charles Crecelius, clinical instructor of internal medicine and geriatrics at Washington University School of Medicine in St. Louis, explains the services these different facilities provide, and offers some suggestions to physicians about ways to assess long-term care facilities. Dr. Eric Tangalos hosts. You can visit Medicare's Nursing Home Compare website here. Additionally, senior resources for chronic pain, substance abuse, and addiction include the following: the Substance Abuse and Mental Health Services Administration, or SAMHSA, offers a search engine of more than 20,000 drug and alcohol treatment providers offering different methods and levels of care across the country. the Forterus Senior Addiction Treatment Center page provides one of the most comprehensive resource for seniors with sub

Guest: Nir Barzilai, MD Host: Maurice Pickard, MD What is the role of insulin growth factor in longevity? Dr. Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine and chaired professor of medicine and molecular genetics, speaks about changes in insulin-like growth factor pathways in relation to longevity. The genotype of exceptional age is also associated with improved cognitive function.

Guest: Nir Barzilai, MD Host: Maurice Pickard, MD What does the latest research tell us about longevity? Dr. Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine and chaired professor of medicine and molecular genetics, discusses the development of a study in a homogenous founder population in order to identify the biological and genetic underpinnings of exceptional longevity. The genotype and associated phenotype may modulate aging processes and disease susceptibility. Hosted by Dr. Maurice Pickard.

Guest: William Hall, MD Host: Maurice Pickard, MD Dr. William Hall, director of the Center for Healthy Aging at Highland Hospital in Rochester, New York, discusses with host Dr. Maurice Pickard the unprecedented increase in members of our population age 85 and older, and the role this may play in exceptional longevity. We know more today than we ever have before about disease factors that cause disability and frailty, such as depression, neuromuscular stability, cognitive status and urinary incontinence. How will these factors help to support older patients?

Guest: Lisa Gibbs Host: Susan Dolan, RN, JD How is self-neglect defined and how prevalent is it in the elderly population? Dr. Lisa Gibbs, professor in the department of family medicine at the University of California, Irvine School of Medicine, defines self-neglect and explains why it is a geriatric syndrome. She describes how to conduct a comprehensive assessment for self neglect, and discusses the relevant research. Hosted by Susan Dolan.

Guest: Lisa Gibbs Host: Susan Dolan, RN, JD Dr. Lisa Gibbs, associate professor in the department of family medicine at the University of California, Irvine School of Medicine, describes the different types of elder abuse and who is most vulnerable. She explains how physicians evaluate mental capacity and the difference between capacity and competency. She also discusses the latest research in elder abuse. Hosted by Susan Dolan.

Guest: Stacy Tessler Lindau, MD Host: Lee Freedman, MD Dr. Stacy Tessler Lindau, assistant professor in the departments of OB/GYN and geriatrics and the University of Chicago Cancer Research Center, discusses the findings of her landmark study on the sexual practices of older Americans. Older adults are indeed sexually active and healthcare providers need to discuss issues of sexuality with this group of patients. How may one approach this sometimes difficult to address topic and what should be discussed with our older adult patients? Hosted by Dr. Lee Freedman.