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We are committed to advancing innovative, high-quality geriatrics interprofessional education, research in geriatric medicine, and geriatric clinical care. In collaboration with the Center for Aging and Health<\/a>, our overarching goal is to improve the health and well-being of the aging population across North Carolina and the nation.<\/p>\n Research in the Division of Geriatric Medicine occurs in partnership with multiple Centers, Institutes, Divisions, Departments, and Schools at 黑料网. Furthermore, our faculty are Principal Investigators on research grants aimed at bringing critical evidence-based findings into healthcare practice to improve the care of older adults.<\/p>\n <\/p>\n <\/p>\n The NIH-funded Duke University and the University of North Carolina Alzheimer\u2019s Disease Research Center (Duke\/黑料网 ADRC<\/a>) brings together leading researchers in Alzheimer\u2019s disease and related dementias across two major research institutions. Specifically, we aim to catalyze and support research, innovations in clinical care and academic work force development (with North Carolina Central University, East Carolina University and 黑料网 Pembroke as partner institutions) in this field.<\/p>\n Ultimately, our purpose is to reduce the burden of Alzheimer\u2019s disease and related dementias regionally and nationally. The outstanding scientific environment at both institutions enables novel research to identify effective methods of prevention and\/or early intervention, and to reduce racial and urban\/rural disparities associated with dementia.<\/p>\n<\/div>\nDementia Friendly Hospital Initiative<\/span> Through a 2018 grant from the Duke Endowment, the Division launched a ground-breaking program to transform hospitals into dementia-friendly centers of care. The Duke Endowment-funded Dementia Friendly Hospital Initiative<\/a> program brings comprehensive dementia-friendly training to four 黑料网 Healthcare Hospitals. In addition, it serves as a blueprint for program expansion both regionally and nationally. 黑料网 Hospitals Hillsborough Campus is the pilot site for hospital-wide training of all staff and clinicians who interact with patients with dementia. The Carolina Geriatric Workforce Enhancement Program (GWEP)<\/a> funded by HRSA, is led by Project Director, Jan Busby-Whitehead, MD. The CGWEP integrates geriatric principles and interprofessional teamwork to address the 4Ms of age-friendly health systems (What Matters to older adults, Medication, Mentation, and Mobility) and to address dementia-friendly care. Academic partners and NC AHECs are providing both in person and virtual training and consultation to tribal organizations, rural and underserved primary care sites to better integrate age-friendly and dementia-friendly content into practices and health care systems.<\/p>\n<\/div>\n Dr. Adrian Austin (MD, MCSR)<\/a> is a delirium researcher who is dually board certified in Geriatric Medicine and Critical Care \/ Pulmonary Medicine. Additionally, he has two pilot projects on delirium: a tablet-based delirium assessment tool for home use and a pharmacogenomic study of dose and response variability among mechanically ventilated ICU patients. Dr. Ferreri also led a 2016 CDC-funded grant on implementing an integrative falls prevention program for which Dr. Busby-Whitehead is a Co-Investigator. This work led to the development of STEADI-Rx<\/a>. This guide helps improve collaboration between prescribers and pharmacists to screen patients and intervene to reduce falls risk. Joshua Niznik, PharmD, PhD<\/a>, Assistant Professor of Medicine, leads a program of research in geriatric medicine aimed at medication optimization for nursing home residents with dementia. He leverages large healthcare databases including electronic health records, Medicare claims, and VA Healthcare System data to conduct pharmacoepidemiologic analyses examining patterns of medication use and health-related outcomes.<\/p>\n In 2020-2021, Dr. Niznik was a member of the US Deprescribing Network Junior Investigator Initiative. Also, he was awarded a USDN pilot grant to evaluate deprescribing of bisphosphonates. This led to his five-year K08 Mentored Clinical Scientist Development Award from the National Institutes on Aging. Dr. Niznik also collaborates with Eshelman School of Pharmacy faculty member Carolyn Thorpe, PhD, MPH, to evaluate medication de-intensification in older Veteran nursing home residents near end of life. This project addresses the gap in dementia-specific advance care planning and medical treatment decisions for clinicians who provide primary care. Specifically, the training uses 4 video-based advance care planning scenarios and an accompanying training toolkit. Furthermore, trained clinicians are assessed for actual application of these skills in their clinical encounters. In addition, the training modules are disseminated through collaboration with Vital Talk. Dr. Hyman Muss<\/a>, Vice Chair of Hematology\/Oncology and Dr. Jan Busby-Whitehead, Geriatric Medicine Division Chief, are Co-Principal Investigators and lead the Geriatric Oncology Program<\/a>. This program trains fellows in Medical Oncology and Geriatric Medicine through several pathways. 黑料网\u2019s Division of Geriatric Medicine is one of seven national Medical Students Training in Aging Research (MSTAR)<\/a> training centers. It has been funded since 2010. The National Institute on Aging (NIA) sponsors this program to connect medical students with mentored research opportunities and academic experiences. Mentorship helps to advance students’ knowledge of aging. It also exposes them to broad possibilities for basic science, clinical, and health services research.
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Focus Areas<\/h2>\n
Alzheimer\u2019s Disease and Related Dementias<\/h3>\nDuke-黑料网 Alzheimer\u2019s Disease Research Center<\/span>
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\n<\/div>\nWorkforce Education on Aging<\/h3>\nCarolina Geriatric Workforce Enhancement Program<\/span>
\nDelirium Research<\/h3>\nDelirium Research<\/span>
\n![\"NIDUS](\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2022\/02\/NIDUS-horizontal_website-banner-300x112.png\")
Division Chief Dr. Jan Busby-Whitehead is Co-Investigator and Dissemination Task Force Co-Leader for the NIA\u2019s Network for the Investigation of Delirium: Unifying Scientists (NIDUS)<\/a>. NIDUS gathers data on all delirium research, grants, and studies worldwide, and advocates to advance delirium research and understanding. NIDUS has five Cores:<\/p>\n\n
\n<\/div>\nDeprescribing<\/h3>\nDeprescribing<\/span>
\nAs adults age, it is important to reconsider the risks and benefits of medications. Many medications that were once appropriate no longer hold the same benefit as the risk for side effects increases. Deprescribing is the gradual reduction of medications when the benefits no longer outweigh the potential harms. Undoubtedly, it is a cornerstone of geriatrics clinical practice to optimize care for older adults. Deprescribing is a rapidly growing area of research in geriatric medicine. As such, the Division of Geriatrics, and the Center for Aging and Health is quickly becoming a hub these projects.
\n<\/div>\nOpioids and Falls Risk | Falls Prevention<\/span>\nStefanie Ferreri, PharmD<\/a>, Vice Chair of the Division of Practice Advancement and Clinical Education at the 黑料网 Eshelman School of Pharmacy and Geriatric Medicine Division Chief Jan Busby-Whitehead, MD, are co-Principal Investigators of a CDC-funded grant on screening older adults who use prescription opioids and are at risk for falls. The study will engage patients 65 years and older within the 黑料网 Health Care system. Specifically, these are patients who are taking either an opioid or benzodiazepine. Accordingly, a centralized team of clinical pharmacists will screen patients. In the end, the team will provide recommendations on deprescribing these medications with the goal of reducing the risk for future falls.<\/p>\n
\n<\/div>\nDeprescribing in Nursing Home Residents with Dementia<\/span>\n![\"Josh](\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2020\/02\/Niznik_Josh-284x300.jpg\")
\n<\/div>\nPhysical Function and Obesity in Older Adults<\/h3>\nDr. John Batsis Research<\/span>
\nLearn more about Dr. John Batsis<\/a>, his team, and their research on Physical Function, Obesity, and other topics.
\n<\/div>\nPalliative Care<\/h3>\nPalliative Care for Stage IV Cancer<\/span>
\nWith funding from a Tier 2 Clinical \/ Translational Award from the 黑料网 Lineberger Comprehensive Cancer Center, Laura Hanson, MD, MPH<\/a>, and other Geriatrics, Palliative Care and Oncology faculty have developed and begun testing a collaborative palliative care model for patients with Stage IV cancer. Specifically, the research<\/a> tests an innovative approach to support continuity of care between inpatient and outpatient providers. It also facilitates efficient and targeted use of specialty Palliative Care.
\n<\/div>\nPrimary Care Clinicians\u2019 Communication Skills in Dementia Palliative Care<\/span>\nWith funding from the Gordon and Betty Moore Foundation, Chrissy Kistler, MD<\/a>, and Laura C. Hanson, MD, are Co-Principal Investigators for a 2-year project on Improving Primary Care Clinicians\u2019 Communication Skills in Dementia Palliative Care. Advance care planning decisions are particularly challenging in the context of Alzheimer\u2019s disease and related neurodegenerative dementias. These diseases last for years yet affect cognitive and communication abilities early in the disease course.<\/p>\n
\n<\/div>\nAging Research Training Programs<\/h3>\nT-32 | Cancer and Older Adults<\/span>
\nThe 黑料网 Geriatric Oncology Training Program (黑料网-GO)<\/a> is a T32 training application specifically focused on training physicians (MDs, DOs). The focus is clinical\/translational and\/or health services research at the interface of Geriatrics and Oncology. The central component of 黑料网-GO training is the mentored research experience. Trainees choose between two research tracks that represent the best research areas that 黑料网 has to offer. Furthermore, these two tracks are clinical\/translational research and health services research. Additionally, under the guidance of the mentoring team, trainees design and conduct one or more independent projects.<\/p>\n
\n<\/div>\nT-35 | MSTAR<\/span>\n![\"Dr.](\"https:\/\/www.med.unc.edu\/medicine\/wp-content\/uploads\/sites\/945\/2019\/04\/DOM_Geriatrics_chamaraRoberts_MSTAR-300x166.jpg\")
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