Focus on Geriatric Medicine and Aging

Host: Matt Birnholz, MD Guest: Slavica Janeva, MD Despite the increasing number of elderly patients diagnosed with breast cancer, few clinical trials focus on this age group. That’s why Dr. Slavica Janeva's team focused on the impacts of adjuvant chemotherapy on survival rates in this patient population, the results of which may change clinical practice paradigms moving forward, as he discusses with Dr. Matt Birnholz.

Host: Brian P. McDonough, MD, FAAFP Several studies have shown that therapy dogs help to reduce people’s pain levels and anxiety. Therapy dogs have also been found to increase patients’ physical, mental, emotional and social states and improve their quality of life. Host Dr. Brian McDonough talks with David Frei, co-creator of Angel on a Leash, a charity supporting therapy dog programs that serve health care facilities, about how therapy dogs bring comfort, affection and happiness to people in confined living situations. Frei is the former host of The Westminster Kennel Club Dog Show and expert analyst for The National Dog Show on NBC Thanksgiving Day.

Host: Brian P. McDonough, MD, FAAFP Out of the approximately 340,000 hip fractures that occur in the US each year, 9 out of 10 of them happen to people older than 65. Hip fractures in an older population can result in significant complications including pneumonia and blood clots, among others. Host Dr. Brian McDonough sits down with Dr. Derek Donegan, Assistant Professor of Orthopedic Surgery in the Division of Orthopedic Trauma at the Hospital of the University of Pennsylvania to talk about some of the challenges physicians face when treating hip fractures in elderly patients.

Host: Jennifer Caudle, DO The burden of deciding end-of-life care often falls on family and friends when patients are no longer able to make decisions regarding their own care. What do physicians need to know when guiding families through these tough situations? Host Dr. Jennifer Caudle is joined by Dr. Marianne Holler, Medical Director of Hospice and Palliative Programs for the VNA Health Group of New Jersey. They talk about what physicians can do to aid families when faced with end-of-life decisions.

Host: Maurice Pickard, MD Dr. Maurice Pickards talks with Dr. Edward Shaw about his book Keeping Love Alive as Memories Fade: The 5 Love Languages and the Alzheimer's Journey. Dr. Shaw shares how love can lift a corner of dementia’s dark curtain to cultivate an emotional connection amid memory loss. The book provides focused help for those feeling overwhelmed by the relational toll of Alzheimer’s.

Host: Kathy King, RDN Can good nutrition improve cognition in the aging brain, as well as expand life spans in older adults? Host Kathy King speaks with dietitian and nutrition consultant Matthew Ruscigno about the latest research and subsequent dietetic recommendations aimed at seniors. They discuss which foods and dietary practices are now associated with helping seniors preserve cognition and live longer.

A protein homeostasis signature in healthy brains recapitulates tissue vulnerability to Alzheimer’s disease Rosie Freer, Pietro Sormanni, Giulia Vecchi, Prajwal Ciryam, Christopher M. Dobson, and Michele Vendruscolo Science Advances 10 Aug 2016: Vol. 2, no. 8, e1600947 DOI: 10.1126/sciadv.1600947 Abstract: In Alzheimer’s disease, aggregates of Aβ and tau in amyloid plaques and neurofibrillary tangles spread progressively across brain tissues following a characteristic pattern, implying a tissue-specific vulnerability to the disease. We report a transcriptional analysis of healthy brains and identify an expression signature that predicts—at ages well before the typical onset—the tissue-specific progression of the disease. We obtain this result by finding a quantitative correlation between the histopathological staging of the disease and the expression patterns of the proteins that coaggregate in amyloid plaques and neurofibrillary tangles, together with those of the protein homeostasis components that regulate Aβ and tau. Because this expression signature is evident in healthy brains, our analysis provides an explanatory link between a tissue-specific environmental risk of protein aggregation and a corresponding vulnerability to Alzheimer’s disease.

Host: John J. Russell, MD Guest: Howard Fillit, MD Quality care for patients with Alzheimer's disease starts with early recognition, which enables a timely diagnosis and subsequent intervention with the best available treatment and support options. As such, understanding the broad spectrum of signs and symptoms at the earliest stages of disease is absolutely critical. Joining host Dr. John Russell to discuss the keys to early recognition for Alzheimer's Disease is Dr. Howard Fillit, founding Executive Director and Chief Science Officer for the Alzheimer's Drug Discovery Foundation. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Carol Lippa, MD Understandings of the origins and mechanisms of Alzheimer's disease are evolving constantly, opening doors to improved targets for therapeutic research. But at a time when disease-modifying therapies for advanced Alzheimer's aren't yet available, the need for early detection becomes critically important to help protect quality of life for patients. Host Dr. Matt Birnholz welcomes Dr. Carol Lippa, Professor of Neurology & Director of the Memory Disorders Program at Drexel University College of Medicine. Dr. Lippa is a member of the Board of Directors for the Alzheimer's Association and Chair of the Delaware Valley Chapter's Medical & Scientific Committee. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Jennifer Caudle, DO Guest: Douglas Scharre, MD, CMD Cognitive assessment tools and detection tests for Alzheimer's disease are mutually designed to identify signs of cognitive impairment that are sometimes too subtle to catch by astute clinicians or even patients themselves. But what methods are available to help detect Alzheimer's as early as possible, and how do they impact quality of life for patients throughout the disease progression? Host Dr. Jennifer Caudle welcomes Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Marwan Noel Sabbagh, MD, FAAN, CCRI In efforts to detect and diagnose Alzheimer's Disease, time is of the essence. But there are numerous barriers that clinicians face in practice to establishing a diagnosis quickly and accurately, which affects quality of care for patients. Joining host Dr. Matt Birnholz to address and consider solutions for these barriers is Dr. Marwan Sabbagh, Professor of Neurology and Chief of the Memory Disorders Division at the Barrow Neurological Institute. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: David Weisman, MD Dr. David Weisman, neurologist with Abington Neurological Associates and Director of Abington Neurologic Association's Trial Center, talks about expert approaches to recognizing the signs and symptoms for Alzheimer's disease. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center, explains the importance of early detection for Alzheimer's disease on patient quality of life, as well as broader impacts on American healthcare systems. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center, describes updated perspectives and understandings on the pathophysiology for Alzheimer's disease. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Carol Lippa, MD Dr. Carol Lippa, Professor of Neurology & Director of the Memory Disorders Program at Drexel University College of Medicine, member of the Board of Directors for the Alzheimer's Association, and Chair of the Delaware Valley Chapter's Medical & Scientific Committee, reveals the biological, social, and stigma-based ways in which Alzheimer's remains the most prominently "hidden" disease in America. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD More than half of those seeking a diagnosis for dementia have delayed going to their doctor by at least a year, according to a survey carried out by the Alzheimer's Society of Great Britain. Dr. Matt Birnholz reports. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry with the Center for Cognitive and Memory Disorder at The Ohio State University Wexner Medical Center, speaks to the methods used for early detection of Alzheimer's Disease, and their respective advantages vs costs in clinical practice. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Marwan Noel Sabbagh, MD, FAAN, CCRI Dr. Marwan Sabbagh, Professor of Neurology and Chief of the Memory Disorders Division at Barrow Neurological Institute, describes some of his key priorities for the current and future state of Alzheimer's care. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: John J. Russell, MD Guest: Howard Fillit, MD Quality care for patients with Alzheimer's disease starts with early recognition, which enables a timely diagnosis and subsequent intervention with the best available treatment and support options. As such, understanding the broad spectrum of signs and symptoms at the earliest stages of disease is absolutely critical. Joining host Dr. John Russell to discuss the keys to early recognition for Alzheimer's Disease is Dr. Howard Fillit, founding Executive Director and Chief Science Officer for the Alzheimer's Drug Discovery Foundation. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Carol Lippa, MD Understandings of the origins and mechanisms of Alzheimer's disease are evolving constantly, opening doors to improved targets for therapeutic research. But at a time when disease-modifying therapies for advanced Alzheimer's aren't yet available, the need for early detection becomes critically important to help protect quality of life for patients. Host Dr. Matt Birnholz welcomes Dr. Carol Lippa, Professor of Neurology & Director of the Memory Disorders Program at Drexel University College of Medicine. Dr. Lippa is a member of the Board of Directors for the Alzheimer's Association and Chair of the Delaware Valley Chapter’s Medical & Scientific Committee. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Jennifer Caudle, DO Guest: Douglas Scharre, MD, CMD Cognitive assessment tools and detection tests for Alzheimer's disease are mutually designed to identify signs of cognitive impairment that are sometimes too subtle to catch by astute clinicians or even patients themselves. But what methods are available to help detect Alzheimer's as early as possible, and how do they impact quality of life for patients throughout the disease progression? Host Dr. Jennifer Caudle welcomes Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Marwan Sabbagh, MD In efforts to detect and diagnose Alzheimer's Disease, time is of the essence. But there are numerous barriers that clinicians face in practice to establishing a diagnosis quickly and accurately, which affects quality of care for patients. Joining host Dr. Matt Birnholz to address and consider solutions for these barriers is Dr. Marwan Sabbagh, Professor of Neurology and Chief of the Memory Disorders Division at the Barrow Neurological Institute. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: David Weisman, MD Dr. David Weisman, neurologist with Abington Neurological Associates and Director of Abington Neurologic Association's Trial Center, talks about expert approaches to recognizing the signs and symptoms for Alzheimer's disease. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center, explains the importance of early detection for Alzheimer's disease on patient quality of life, as well as broader impacts on American healthcare systems. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry and Director of the Center for Cognitive and Memory Disorders at The Ohio State University Wexner Medical Center, describes updated perspectives and understandings on the pathophysiology for Alzheimer's disease. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Carol Lippa, MD Dr. Carol Lippa, Professor of Neurology & Director of the Memory Disorders Program at Drexel University College of Medicine, member of the Board of Directors for the Alzheimer's Association, and Chair of the Delaware Valley Chapter’s Medical & Scientific Committee, reveals the biological, social, and stigma-based ways in which Alzheimer's remains the most prominently "hidden" disease in America. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD More than half of those seeking a diagnosis for dementia have delayed going to their doctor by at least a year, according to a survey carried out by the Alzheimer’s Society of Great Britain. Dr. Matt Birnholz reports. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Douglas Scharre, MD, CMD Dr. Douglas Scharre, Professor of Clinical Neurology and Psychiatry with the Center for Cognitive and Memory Disorder at The Ohio State University Wexner Medical Center, speaks to the methods used for early detection of Alzheimer’s Disease, and their respective advantages vs costs in clinical practice. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Matt Birnholz, MD Guest: Marwan Sabbagh, MD Dr. Marwan Sabbagh, Professor of Neurology and Chief of the Memory Disorders Division at Barrow Neurological Institute, describes some of his key priorities for the current and future state of Alzheimer’s care. Uncover the truth about Alzheimer's in the non-certified educational series, Alzheimer's Disease: Towards Earlier Detection

Host: Brian P. McDonough, MD, FAAFP Alzheimer’s Disease is the most common cause of dementia among people aged 65 and older. With the population of older Americans growing, research for new therapies becomes ever more critical. Yet one of the most important factors in advancing research, fundraising, has been hampered by numerous challenges. Host Dr. Brian McDonough talks with Charles Fushcillo Jr., President and Chief Executive Officer of the Alzheimer’s Foundation of America about the challenges in securing additional funding for Alzheimer’s Research.

Host: Alan S. Brown, MD, FNLA Guest: Joyce Ross, MSN, CRNP, CS, CLS, FNLA, FPCNA Host Dr. Alan Brown welcomes Joyce Ross, MSN, CRNP, FNLA, President-Elect of the National Lipid Association. Joyce serves as a consultative education specialist in cardiovascular risk intervention with the University of Pennsylvania Health System. Their discussion focuses on lipid management to reduce atherosclerotic cardiovascular disease (ASCVD) risk in elderly patient populations. Thhis interview was recorded live at the National Lipid Association in San Diego, California for the 2016 Spring Clinical Lipid Update.

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 occur, it tended to be less severe. Researchers also found that not only is the combined drug effective, but safe. [Watch more videos of The JAMA Report] JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

[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 pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

[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 more videos of The JAMA Report] JAMA Report videos provided pursuant to license. ©2015 American Medical Association, publisher of JAMA® and The JAMA Network® journals.

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.