THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO (UCSF)
Claude D. Pepper Older Americans Independence Center

Principal Investigator    Kenneth Covinsky M.D., M.P.H.  415-221-4810 x 24363  Ken.Covinsky@ucsf.edu
Program Administrator    Sarah Ngo    Sarah.ngo@ucsf.edu
       
CENTER DESCRIPTION

Established in 2013, the UCSF Claude D. Pepper Older Americans Independence Center focuses on addressing predictors, outcomes, and amelioration of late-life disability in vulnerable populations. Late-life disability, defined as needing help with daily activities, is common, burdensome, and costly to patients, families, and society. Late-life disability is influenced by medical vulnerabilities (including comorbid illnesses, aspects of medical care, medicines, procedures, neuropsychiatric conditions, and behaviors), social vulnerabilities (social supports, financial resources, communication and literacy, and ethnicity), and their interaction. The overriding goal of the UCSF OAIC is to improve the health care and quality of life of vulnerable older adults with or at risk for disability through the following aims:

  1. Catalyze research on disability in vulnerable older persons at UCSF by serving as a hub that brings together scholars and leverages resources
  2. Provide tangible, high-value support to funded projects at UCSF that stimulates new research on disability, and leads to new research opportunities for senior and junior investigators
  3. Support pilot studies that accelerate gerontologic science and lead to research funding in late life disability
  4. Identify the future leaders of geriatrics research and support them with career development funding and exceptional mentoring
  5. Develop a leadership and administrative structure that spurs interdisciplinary collaboration, making the OAIC greater than the sum of its parts

Our Center supports researchers who share our passion for improving the well-being of older persons. We view our resources as venture capital that will catalyze the careers and research paths of investigators who will do cutting edge research that advances the care, health, and wellbeing of older persons, both within the UCSF community and nationally.

CORES
Leadership and Administrative Core (LAC)
Leader 1:    Ken Covinsky, MD, MPH   covinsky@medicine.ucsf.edu
The Leadership Administrative Core (LAC) plays the central role in coordinating the five UCSF OAIC cores, in maintaining communication across programs, and identifying new opportunities, both within and outside the OAIC. The LAC monitors the success of each core based on tangible metrics of productivity: Research leading to publications in the highest impact journals and new NIH grant funding. The LAC monitors, stimulates, evaluates, remediates, and reports progress toward the goals of the OAIC. The LAC also maintains the substantial collaborations with other UCSF research centers, including the UCSF CTSI and RCMAR, and seeks to establish new collaborations which will leverage OAIC resources and develop new and established investigators in aging research. The overall goal of the LAC is to provide the leadership and administration to support the activities of the entire UCSF OAIC.

Research Education Component (REC)
Leader 1:    Louise Walter, MD   Louise.Walter@ucsf.edu
Leader 2:    Kristine Yaffe, MD   kristine.yaffe@ucsf.edu
The Research Education Component (REC) identifies, supports, and nurtures talented junior investigators who will become national leaders in aging research through the REC Scholars Program and Advanced Scholars Program. The REC Scholars Program targets early career faculty and seeks to accelerate their path towards NIA K awards. The Advanced Scholars Program targets current K award recipients and accelerates the path towards their first R01. Both programs provide extensive mentoring and opportunities to participate in an innovative series of seminars designed to develop skills essential to success in aging research, facilitate interdisciplinary communication, build knowledge and relationships that will stimulate translation between basic and clinical research, and accelerate their productivity. The REC leadership also works with leaders of the Resource Cores to provide scholars access to additional support. These mentorship and curricular programs help junior investigators progress along the pathways that lead to high impact publications and grant funding that develops the scholar’s national reputation as a leader in their area. Mentoring services, seminar series, resource core services, and programmatic support are also available to Associate Scholars whose goals are to develop careers in aging research. A particular focus of the Associate Scholars Program is junior faculty who have trained outside of geriatric medicine, but seek to incorporate Geriatric principles into their developing research program. The Research Education Component also sponsors a diversity supplement program to increase the number of faculty members from underrepresented and diverse backgrounds conducting aging research at UCSF.

Pilot and Exploratory Studies Core (PESC)
Leader 1:    Christine Ritchie, MD   Christine.Ritchie@ucsf.edu
The Pilot and Exploratory Studies Core (PESC) facilitates the development and progress of innovative research relating to the Pepper Center focus on the predictors, outcomes and outcomes of late-life disability, especially in vulnerable older populations. We are especially interested in the interaction of serious clinical conditions, disability, and social disadvantage. The goals of the PESC include: 1) Solicit and select innovative proposals from highly qualified applicants; 2) Provide investigators of PESC studies with the support and infrastructure of the OAIC Cores; 3) Integrate PESC studies and investigators with resources from the UCSF Clinical and Translational Science Institute (CTSI) and other relevant resources at UCSF; 4) Monitor the progress of PESC studies; and 5) Provide mentorship and resources to transform PESC funded studies into successful independently-funded projects. The PESC focuses on identifying projects from outstanding investigators who are conducting aging research that is likely to lead to external funding and is aligned with the OAIC theme.

Vulnerable Aging Recruitment and Retention Core (VARC)
Leader 1:    Rebecca Sudore, MD   rebecca.sudore@ucsf.edu
Leader 2:    Brie Williams, MD   brie.williams@ucsf.edu
The Vulnerable Aging Recruitment and Retention Core (VARC) was established in the UCSF Pepper Center grant renewal application. It was developed in response to increased demand both within and outside UCSF to support research focused on improving the knowledge base regarding the needs of medically vulnerable (e.g., complex chronic disease, serious illness, profound cognitive or functional impairment) and/or socially vulnerable (e.g., isolated, impoverished, homeless, incarcerated, with limited literacy or limited English proficiency) older adults. Because these older adults are often particularly difficult to recruit and retain in clinical research, their representation in research is often limited. This impairs our knowledge about how to optimize their care. Therefore, the VARC core focuses on supporting OAIC-affiliated investigators to (1) recruit, enroll, and retain vulnerable older adults in research; (2) use appropriate measures to study their healthcare needs; and (3) engage communities in research about medically and/or socially vulnerable older adults.

Data and Analysis Core (DAC)
Leader 1:    Mike Steinman, MD   Mike.Steinman@ucsf.edu
Leader 2:    John Boscardin, PhD   John.Boscardin@ucsf.edu
The Data and Analysis Core (DAC) provides OAIC investigators access to statistical services at all stages of the research lifecycle. Through the establishment of a central hub of statistical expertise, the DAC ensures smooth delivery of statistical knowledge and rigor across the spectrum of scientific research at the OAIC. This improves the quality of OAIC research studies, helps nurture trainees, facilitates interdisciplinary research groups, and ultimately enhances research on prediction, outcomes, and amelioration of late-life disability, especially in vulnerable populations. The DAC promotes wider use of state of the art statistical practice, lowers barriers of access to basic statistical services to all research groups including trainees, provides access to specialized statistical resources (such as state of the art prognostic model development, complex longitudinal and latent class analysis, and causal inference methods), and develops statistical procedures targeted to solving problems in aging research, and more specifically to challenges that commonly arise in research on disability and function.

CAREER DEVELOPMENT
REC Scholar, Research & Grants Funded During Pepper Supported Time Years Publications
 
Ashwin Kotwal, MD
Assistant Professor, Geriatrics / UCSF
Evaluating Explanations for the Association between Sensory Impairments, Cognitive Decline, and Dementia
  • GEMSSTAR R03 - R03AG064323 Grant Title: Loneliness and Social Isolation among Older Adults in the Last Years of Life Grant Funder: NIA Funding Period: 8/01/2019-5/31/2021
  • NPCRC Award Title: Social Health among Older adults in the Last Years of Life Grant Type: Foundation Grant Grant Funder: National Palliative Care Research Center Funding Period: 7/01/2019-6/31/2021

 2019-2021  2 (2 1st/Sr)
Past Scholars
Lindsey Hampson, MD, UCSF (2019-2020)
Elizabeth (Liz) Whitlock, MD, MS, UCSF (2019-2020)
Lauren Hunt, PhD, RN, FNP, UCSF (2019-2020)
Sachin Shah, MD, MPH, UCSF (2019-2020)
Scott Bauer, MD, MS, UCSF (2019-2020)
Willa Brenowitz, PhD, MPH, UCSF (2019-2020)

PILOT/EXPLORATORY PROJECTS (3 Pilot Projects Listed)
1. Project Title: Functional Impairment and Advance Care Planning among Older Adults Transferred to Long-Term Acute Care Hospitals: An Analysis of the Health and Retirement Study
  Leader: Anil Makam, MD
 

Each year, over 120,000 hospitalized older adults survive an acute or critical illness and are transferred to a long-term acute care hospital (LTAC) to recover. LTACs are distinct from acute care hospitals and skilled nursing facilities (SNFs) in their focus on treating patients who require extended inpatient care, typically for 3-5 weeks following the initial hospitalization. While most commonly understood as the post-acute care setting of choice for chronically critically ill patients, three-quarters of LTAC patients are not mechanically ventilated, but rather, require other medically complex inpatient care, such as antibiotics, complex wound care, and dialysis.

 

The intended goal of LTACs is to help patients recover and regain independence; however, using national Medicare claims data, we found that older adults transferred to an LTAC have poor prognoses. Fewer than 20% of older adults transferred to an LTAC were alive at 5 years. Patients spent on average two-thirds of their remaining time alive after transfer as an inpatient. Over one-third were confined to an inpatient setting and never returned home before dying. One-third received an artificial life-prolonging procedure. Lastly, half experienced a minimal definition of recovery, defined as achieving 60 consecutive days alive without inpatient care. Though half make it back home at some point after their LTAC stay, actual functional recovery is unknown. Maintaining functional independence is an important health care goal for older adults.

Despite this bleak prognosis, there is extremely low use of specialty palliative care and hospice among older adults transferred to LTACs. Using national Medicare data, we found that only 16% of older adults transferred to LTACs in the Medicare program ever enrolled into hospice with a median of 10 days, which is far lower than for the overall Medicare program, where 48% of decedents enrolled in hospice for a median of 24 days, and only 1% were ever seen by a palliative care physician during the initial episode of care. While patients in LTACs may represent a distinct population who desired to pursue life-sustaining and intensive care, we do not know if patients participated in advance care planning—whether goals of care discussions occurred or if patients expressed desire for life-sustaining treatment. Understanding advance care planning actions in this population could uncover a critical gap in LTACs, which are intended to be post-acute care settings that specialize in the care of older adults with serious illness.

 

The objective of this Dr. Makam's study is to develop a novel, robust, and nationally representative cohort of older adults which will include detailed assessments on functioning and advance care planning both before and after LTAC transfer, and will generate compelling preliminary data for a R01 grant application to explore these areas in greater depth. His central hypothesis is that geriatric syndromes and unmet palliative care needs are highly prevalent in this vulnerable population. In subsequent years, Dr. Makam will be using this work to support his future application for a R01 grant.
 
2. Project Title: Understanding the Context of Patient Medication Practices among Diverse Older Adults with Multiple Chronic Conditions
  Leader: Jan Jih, MD
 

By 2050, 42% of the older U.S. adult population will be racial/ethnic minorities. Older minorities bear a substantial burden of multiple chronic conditions (MCC) and polypharmacy and receive poorer quality of chronic disease management. Patient-clinician communication barriers are important contributors to disparities in care and outcomes of MCC including polypharmacy. In particular, clinic visit communication about the context of people’s lives (i.e., contextual factors such as food availability, culture, home safety, etc.) optimally informs MCC management including medication management and is essential to delivering patient-centered healthcare. As the World Health Organization succinctly states: “The context of people’s lives determine their health.” Yet, few patient-clinician communication interventions focused on medication practices have included diverse populations and have centered on patient activation and engagement in clinical communication about medication use. Furthermore, most do not address the interactions of aging, MCC, polypharmacy and contextual factors that enhance or reduce health.

 

Type 2 diabetes is one of the most common conditions among patients with MCC. A common scenario is the minority older adult with diabetes and concurrent comorbid conditions with significant polypharmacy. The burden of self-management tasks related to diabetes (e.g., checking glucose, taking multiple medications, optimizing exercise, adhering to diet) while simultaneously following care plans for other conditions can be overwhelming, particularly when care plans do not account for culture, language and the context of patients’ daily lived experiences. We need clinically feasible, patient-centered interventions, particularly among those with racial/ethnic, cultural or non-English language diversity, to support person-centered communication between patients and clinicians about the complexities of chronic disease care including medication use.

 

The goal of Dr. Jih’s study is to better understand the multi-level contextual factors that influence the medication practices of older minorities with MCC in order to develop a patient-centered technology-enabled, photo-based communication intervention to promote optimal medication management called medPhoto+Care. The premise of a medPhoto+Care is that a picture is worth a thousand words, meaning that photos can promote efficient information exchange and activate patients to communicate their lived experiences to their clinicians, so they can develop patient-centered care plans together.39-41 Using smartphone cameras as a tool, medPhoto+Care will elicit and integrate contextual factors relevant to medication practices into primary care for older minorities with MCC. medPhoto+Care will consist of a patient component, which will comprise: 1) brief training on photo-taking with a smartphone camera; 2) photo-taking guided by standardized structured and open-ended prompts to elicit contextual factors relevant to medication practices; and 3) sharing of photos from the smartphone and their accompanying oral narratives in a clinic visit; and a clinician component, which will include training to 1) respond to the photos and 2) discuss the contextual factors elicited by the photos with patients.

 

Through this pilot, Dr. Jih seeks to prove that medPhoto+Care will improve patient-clinician communication about the contextual factors affecting medication practices within MCC management and lead to realistic care plans that align with patient goals and preferences. She aims to conduct her study with older African American, Latino and Asian patients who speak English, Spanish or Chinese (Cantonese/Mandarin) from the UCSF primary care clinics. Since the start of her study, Dr. Jih has been setting up her study to conduct observations in patients’ homes (n=10) to directly observe medication practices and explore contextual factors related to medication use within the context of MCC in these levels: 1) individual factors, behaviors and preferences (e.g., diet and physical activity practices); 2) clinical factors (e.g., comorbid conditions, geriatric syndromes); and 3) family and community factors (e.g., culture, social support).

 

Currently, Dr Jih and her team have completed 4 home visit interviews to explore patients’ practices, beliefs and preferences on medication use among diverse older adults with multiple chronic conditions. They are in the process of rescheduling 3 home visits through Zoom during the COVID19 pandemic. They have learned a range of patients' medication practices and preferences through these home visits, some of which were easily communicated through photos.
 
3. Project Title: Sleep medication use and cognitive aging in a biracial cohort of community-dwelling elderly
  Leader: Yue Leng, PhD
 

Older adults frequently report sleep disturbances, making sleep medications one of the most commonly used medications in the elderly. Sleep medications can be broadly divided into over-the-counter (OTC) and prescription medication, with different subtypes included in each category. Growing evidence suggested that the use of both OTC and prescription sleep medications in the elderly could lead to a range of adverse events, including high risk of falls and short-term memory loss. However, the effects of sleep medication use on cognitive aging outcomes, including cognitive decline and risk of Alzheimer’s disease and related dementias (ADRD) in the long term are poorly understood. While most previous studies have examined the association between benzodiazepine use and risk of dementia and have found inconsistent results, almost nothing is known about non-benzodiazepine type of sleep medications or if different types of sleep medications influence long-term cognitive trajectory differently. Since different types of sleep medications have different mechanisms of action and different drug detection times, they might also affect cognition differently. Given the high prevalence of both sleep medication use and ADRD in older adults, understanding the link between the two has large public health implications. Characterization of users of different types of sleep medications is a critical first step in understanding their health implications.

 

The overall objective of this study is to characterize older sleep medication users, determine the association between the use of different types of sleep medications and cognitive decline and impairment, and elucidate the role of sleep disturbances, sex and race. Dr. Yue is leveraging the existing data infrastructure of a biracial longitudinal cohort of aging, the Health ABC Study, in order to characterize users of sleep medications, determine the association between sleep medication use and cognitive decline and impairment, and explore the role of sleep disturbances, sex and race in this association. She is developing her analysis to compare baseline characteristics between users and non-users of each sleep medication in univariable analysis. Multivariable logistic regression will be used to identify independent correlates of sleep medication users. Linear regression will be used to estimate the cross-sectional association between sleep medication use and scores of each cognitive test. Mixed effect models will be used to examine the longitudinal effects of sleep medication use on change in cognitive scores over time. She will also use logistic regression to model sleep as a predictor for the development of MCI and dementias. In order to address the independent effects of sleep medication use, we will carefully construct multivariable models to account for potential confounders, determined a-priori. We will also model the interaction to decide if the association between sleep medication use and risk of adverse cognitive outcomes will be modified by sleep disturbances and other factors, such as sex and race.
 
DEVELOPMENT PROJECTS (2 Development Projects Listed)
1. Project Title: Methods with Survey Data
  Leader: Grisell Diaz-Ramirez, MS, Bocheng Jing, MS
  Core(s):
 

Currently there are no clear methods or best practice guidelines regarding analysis of survey data to support all survey topics ranging from surgery prediction to cognition. There are currently no software packages available, thus creating an issue of no standardized methods in calculations to perform analysis. The aims of this development project were to explore survey data issues from three main aspects: survival prediction (cox model, competing risk), propensity score methods, and linear mixed model.

 

Since the start of this project, Ms. Diaz-Ramirez and Mr. Jing have been actively disseminating their findings, of note:

 

1.     The following proceeding paper was accepted to SAS Global: “Mixed-Effects Models and Complex Survey Data with the GLIMMIX Procedure”

 

2.     The following proceeding paper was also accepted to SAS Global: “Propensity Score Matching with Survey Data”

 

3. SAS proceedings papers on mixed model and propensity score were presented at the Virtual SAS Global meeting. They are both now published on the Proceedings of the SAS Global Forum 2020 and also accessible online to reach the a global audience

 

Mixed model download link: https://www.sas.com/content/dam/SAS/support/en/sas-global-forum-proceedings/2020/4937-2020.pdf

 

Propensity score download link: https://www.sas.com/content/dam/SAS/support/en/sas-global-forum-proceedings/2020/4942-2020.pdf
 
2. Project Title: Statistical Harmonization of Two Nationally Representative Data Sets: HRS and NHATS
  Leader: Sun Jeon, PhD
  Core(s):
 

Dr. Sun Jeon seeks to develop a harmonized coding of ADL/IADL and other functional measures using the Health Retirement Study (HRS) and the National Health Aging Trends Study (NHATS).

Through her analysis of the prevalence of disabilities in those two data sets, NHATS showed higher prevalence across ADL/IADL measures than that in HRS. Currently there is a lack of an understanding of whether the NHATS cohort consists of generally sicker people or the discrepancy was derived from the way the questions were asked or the survey is done.

 

From observation of work that UCSF Pepper Center Investigators are engaging in, she has seen great overlap their interests in and demands for this work.

Dr. Jeon will be dedicating her effort to further study in this area to get a deeper understanding of NHATS/HRS cohorts, survey design, and of course as well as some statistical tests.
 
RESEARCH (24 Projects Listed)
1. Project Title: SUICIDAL BEHAVIOR AND SUICIDE IN OLDER VETERANS
  Leader(s): BYERS, AMY LYNN
    VETERANS AFFAIRS MED CTR SAN FRANCISCO
    VA I01CX001119 / (2015-2019)
  Core(s):
  DESCRIPTION (provided by applicant): Little is known about suicide in older Veterans, and suicide-related behaviors (i.e., ideation, plans, and attempts), which are strong risk factors for actual suicide and strong indicators of extreme emotional and mental distress. Recent surveillance data from the Department of Veterans Affairs Suicide Prevention Program suggests that older Vet...
 
2. Project Title: DEVELOPMENT AND VALIDATION OF 10-YEAR LIFE EXPECTANCY CALCULATORS TO INDIVIDUALIZE VETERANS? PREVENTION DECISIONS
  Leader(s): LEE, SEI
    VETERANS AFFAIRS MED CTR SAN FRANCISCO
    VA I01HX002135 / (2017-2021)
  Core(s):
  Ignoring life expectancy can lead to poor clinical decisions. Healthy older adults who could benefit fromscreening have low screening rates. Older adults with dementia or metastatic cancer are screened for slow-growing cancers that are unlikely to cause symptoms but may lead to distress from false-positive results,invasive work-ups and treatments. Life expectancy calculators offer the possibility ...
 
3. Project Title: PALLIATIVE CARE FOR PEOPLE LIVING AT HOME WITH ADVANCING DEMENTIA AND THEIR CAREGIVERS
  Leader(s): HARRISON, KRISTA LYN
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K01AG059831 / (2019-2024)
  Core(s):
  Project Summary/Abstract This is an application for a K01 award for Krista Lyn Harrison, PhD, whose research focuses on improvinglife for older adults with Alzheimer s disease and related dementias (ADRD) and their informal caregivers. Dr.Harrison is a health services and policy researcher and Assistant Professor in the Division of Geriatrics at theUniversity of California, San Francisco (UCSF). D...
 
4. Project Title: EPIDEMIOLOGY AND OUTCOMES OF PREMATURE GERIATRICS SYNDROMES
  Leader(s): BROWN, REBECCA TYLER
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K23AG045290 / (2014-2018)
  Core(s):
  DESCRIPTION (provided by applicant): This is a Resubmission Application for a Mentored Patient-Oriented Research Career Development Award for Dr. Rebecca Brown. Dr. Brown's long-term goal is to become a leader in aging research to improve the health and functional status of socioeconomically disadvantaged older adults, including those with early- onset (premature) geriatric syndromes. This award w...
 
5. Project Title: IMPROVING PALLIATIVE CARE ACCESS THROUGH TECHNOLOGY (IMPACTT): A MULTI-COMPONENT PILOT STUDY
  Leader(s): STEPHENS, CAROLINE
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K76AG054862 / (2017-2021)
  Core(s):
  PROJECT SUMMARY ABSTRACTThis K76 Paul B. Beeson Emerging Leaders Career Development Award in Aging proposes to provide Dr.Caroline Stephens, a newly promoted Associate Professor in the UCSF School of Nursing, with mentorshipand training in translational qualitative research, implementation science, clinical trials, and leadershipdevelopment. The proposed training and support will provide her with ...
 
6. Project Title: IMPROVING AGING IN PLACE FOR OLDER ADULTS LIVING IN SUBSIDIZED HOUSING
  Leader(s): BROWN, REBECCA TYLER
    UNIVERSITY OF PENNSYLVANIA
    NIH K76AG057016 / (2018-2021)
  Core(s):
  PROJECT SUMMARY/ABSTRACT The ability to live comfortably, safely, and independently in one s home and community often called aging in place is a key component of quality of life for older adults. Yet the ability to age in place is severelycompromised among the nearly 3 million older adults living in federally-subsidized housing, whose risk fornursing home admission is seven times that of the ...
 
7. Project Title: IMPROVING OUTCOMES OF OLDER ADULTS WITH PSYCHOSOCIAL VULNERABILITY UNDERGOING MAJOR SURGERY
  Leader(s): TANG, VICTORIA LAI-YEN
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K76AG059931 / (2019-2024)
  Core(s):
  PROJECT SUMMARY / ABSTRACT This application for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76)describes the five-year career development plan of Dr. Victoria Tang, a geriatrician and young physician-scientist in the Division of Geriatrics at the University of California, San Francisco. Dr. Tang s long-term careergoal is to develop a research niche that bridges the fiel...
 
8. Project Title: ADVANCING PATIENT-CENTERED DECISION MAKING IN OLDER ADULTS WITH LUNG CANCER: INCORPORATING RISK OF FUNCTIONAL DECLINE INTO TREATMENT DISCUSSIONS
  Leader(s): WONG, MELISA L
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K76AG064431 / (2019-2024)
  Core(s):
  PROJECT SUMMARY/ABSTRACTThis is a Beeson K76 career development award for Dr. Melisa Wong, a thoracic oncology clinician-investigator dually trained in medical oncology and aging research. Dr. Wong s long-term goal is to become anational leader in geriatric oncology research, improving cancer care for older adults by aligning treatmentswith individualized patient goals. More than 72% of older adul...
 
9. Project Title: TAILORED GERIATRIC ASSESSMENT AND MANAGEMENT FOR HIV CARE SETTINGS
  Leader(s): GREENE, MEREDITH
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH K76AG064545 / (2019-2024)
  Core(s):
  PROJECT SUMMARY/ABSTRACTDue in large part to the successful development of antiretroviral therapy, adults with HIV infection are livinglonger; in the United States, 47% of all people living with HIV are age 50 and older. This aging populationincreasingly experiences multimorbidity, polypharmacy, and significant mental health and psychosocialchallenges. Older HIV-positive adults also experience a h...
 
10. Project Title: OPTIMIZING SURGICAL DECISION-MAKING FOR NURSING HOME RESIDENTS UNDERGOING SURGERY FOR BLADDER AND BOWEL DYSFUNCTION
  Leader(s): SUSKIND, ANNE M.
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R01AG058616 / (2018-2022)
  Core(s):
  PROJECT ABSTRACT:There is a fundamental gap in our understanding of outcomes related to surgery for bladder and boweldysfunction, which are ubiquitous conditions among nursing home residents. Despite these proceduresbeing relatively low risk , they are not without risk, particularly in an already functionally and cognitivelylimited cohort. Currently, the only available information on such outcome...
 
11. Project Title: PREDICTING POST-TRANSPLANT MORTALITY AND GLOBAL FUNCTIONAL HEALTH BASED ON PRE-TRANSPLANT FUNCTIONAL STATUS IN LIVER TRANSPLANTATION
  Leader(s): LAI, JENNIFER C.
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R01AG059183 / (2018-2023)
  Core(s):
  PROJECT SUMMARYThe decision to proceed with liver transplantation in a patient with end-stage liver disease depends not just onthe risk of death without transplant but the risk of adverse outcomes after it. The transplant clinician's assess-ment of a cirrhotic patient's global functional health which we have conceptualized as his or her vulnerabilityto health stressors is a critical factor (of...
 
12. Project Title: TRANSFORMING RESEARCH AND CLINICAL KNOWLEDGE IN GERIATRIC TRAUMATIC BRAIN INJURY (TRACK-GERI)
  Leader(s): GARDNER, RAQUEL C.
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R01NS110944 / (2019-2024)
  Core(s):
  PROJECT SUMMARY / ABSTRACTSome 2.8 million Americans seek medical attention for traumatic brain injury (TBI) annually, resulting inestimated annual costs of over $75 billion. Older adults have the highest and fastest rising rate of TBI of anyother age-group, with 1 in 50 adults age =75y seeking medical attention for TBI in 2013. Older adults with TBIexperience higher mortality, slower recovery, wo...
 
13. Project Title: IMMEDIATE AND LONG-TERM OUTCOMES OF COMMON UROLOGIC PROCEDURES IN NURSING HOME RESIDENTS
  Leader(s): SUSKIND, ANNE M.
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG050872 / (2015-2018)
  Core(s):
  DESCRIPTION (provided by applicant): There is a fundamental gap in our understanding of outcomes related to common urologic procedures in frail nursing home residents. The decision to perform surgery in this unique population, however 'minor' or 'routine', is complex and should be considered carefully by balancing the risks and benefits in each individual with the ultimate goal of impro...
 
14. Project Title: IDENTIFYING AND ASSESSING FOOD INSECURITY IN OLDER DIVERSE PRIMARY CARE PATIENTS
  Leader(s): JIH, JANE
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG050880 / (2015-2019)
  Core(s):
  DESCRIPTION (provided by applicant): Food insecurity, defined as uncertain or limited access to nutritionally adequate and safe foods, has important implications in the geriatric primary care of growing numbers of older adult patients with multiple chronic conditions (MCC). An estimated 60-75% of older adults have MCC, many of which are nutrition sensitive conditions (e.g. diabetes, hyp...
 
15. Project Title: GERIATRIC FACTORS AND OUTCOMES AFTER HIGH RISK SURGERY IN OLDER ADULTS
  Leader(s): TANG, VICTORIA LAI-YEN
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG056342 / (2017-2019)
  Core(s):
  Project Summary/AbstractOver four million older adults undergo high-risk surgery every year; yet geriatric-specific risk factors and long-term outcomes after high-risk surgery are not well studied. Improving our understanding of functional, mental,and social factors beyond medical factors and their associations with outcomes is essential to providingpatient-centered geriatric surgical care. The lo...
 
16. Project Title: EXPANDING THE DEFINITION OF TREATMENT TOXICITY IN OLDER ADULTS WITH LUNG CANCER
  Leader(s): WONG, MELISA L
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG056439 / (2017-2019)
  Core(s):
  PROJECT SUMMARY/ABSTRACTLung cancer is a disease of older adults with a median age at diagnosis of 70. Older adults with lung cancerare at increased risk for treatment toxicity, which can result in functional impairment and decreased quality oflife (QOL). These outcomes are critically important to patients, yet fundamental gaps exist in our knowledge ofhow lung cancer treatment impacts functional ...
 
17. Project Title: IMPACT OF CORONARY REVASCULARIZATION ON LONGITUDINAL COGNITIVE CHANGE IN THE ELDERLY
  Leader(s): WHITLOCK, ELIZABETH LOUISA
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG059822 / (2018-2020)
  Core(s):
  Project Summary/Abstract:Elders undergoing cardiac surgery are at particular risk of postoperative cognitive dysfunction (POCD), anacute decline in cognition persisting days, weeks, or months following surgery. Nonetheless, thousands ofelders undergo coronary artery bypass grafting (CABG) each year in the United States in hopes of improvingtheir health and function. Percutaneous coronary intervent...
 
18. Project Title: SOCIAL VULNERABILITY OF OLDER ADULTS AND THE RISK OF MEDICAL HOSPITALIZATION
  Leader(s): SHAH, SACHIN J
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG060090 / (2019-2021)
  Core(s):
  Project Summary/AbstractDecades of research establish that social determinants of older adults affect their health, yet, we lack ways toimplement this knowledge. We fall short without a coherent synthesis: What basic social determinants shouldan investigator include in their aging cohort study How can a Medicare accountable care organization includesocial determinants to identify at-risk patients...
 
19. Project Title: IDENTIFYING CONTRIBUTING FACTORS TO BURDENSOME ICU TREATMENTS IN OLDER ADULTS WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS IN THE UNITED STATES AND UNITED KINGDOM
  Leader(s): DZENG, ELIZABETH
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG060098 / (2018-2020)
  Core(s):
  PROJECT SUMMARY/ABSTRACTFor the 5.3 million older Americans with Alzheimer s disease and related dementias (ADRD), end-of life-care isincreasingly marked by intensive medical treatments that are goal-discordant, confer no benefit, and likelycauses harm. Compared to a decade ago, older adults with advanced dementia in the United States (US) aretwice as likely to receive mechanical ventilation and b...
 
20. Project Title: IDENTIFYING SCALABLE AND CULTURALLY RELEVANT STRATEGIES FOR RECRUITMENT OF AFRICAN AMERICANS WITH COGNITIVE IMPAIRMENT INTO DEMENTIA RESEARCH
  Leader(s): PORTACOLONE, ELENA
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R03AG060354 / (2018-2020)
  Core(s):
  ABSTRACTAfrican Americans are twice as likely to have Alzheimer s disease than Whites, yet they are underrepresentedin dementia research. The low rate of participation among African Americans hinders the understanding of themechanisms of dementia in this population, further widening health disparities. To date, partnerships with faith-based organizations are the most common strategy used to recrui...
 
21. Project Title: IMPACT OF INTENSIVE BLOOD PRESSURE TREATMENT ON CLINICAL OUTCOMES OF HOSPITALIZED OLDER ADULTS
  Leader(s): ANDERSON, TIMOTHY S
    BETH ISRAEL DEACONESS MEDICAL CENTER
    NIH R03AG064373 / (2019-2021)
  Core(s):
  PROJECT SUMMARY/ABSTRACTOlder adults accounted for over 12 million hospitalizations in 2015. During hospitalization, blood pressure (BP)may fluctuate as a result of acute illness, stress, and new medication exposures. Though the long-termbenefits of strict BP control on older adults cardiovascular risk are well established, no research has shown ashort-term benefit to treating asymptomatic elevat...
 
22. Project Title: STATE OF THE FUTURE IN GLOBAL AGING, DEMENTIA & MENTAL HEALTH: BRIDGING LEADERSHIP, SCIENCE, PRACTICE AND POLICY
  Leader(s): STEPHENS, CAROLINE
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R13AG056140 / (2017-2019)
  Core(s):
  Project Summary/AbstractThis proposal requests partial support for a unique and innovative international aging conference focused onbridging interdisciplinary leadership, science, practice and policy in aging, dementia and mental health. Thegoals of this conference are to: actively engage key patient-oriented interdisciplinary stakeholders in aging,dementia and mental health; evolve a research age...
 
23. Project Title: ACCESS AND USE OF LONG-TERM SERVICES AND SUPPORTS FOR OLDER ADULTS LIVING ALONE WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS FROM FOUR RACIAL/ETHNIC GROUPS
  Leader(s): PORTACOLONE, ELENA
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH R56AG062165 / (2018-2019)
  Core(s):
  ABSTRACTMore than one million older adults (age >65) with Alzheimer s disease and related dementias (ADRD), i.e.almost one-third of the ADRD population in the United States, live alone. Older racial/ethnic minorities arelikely to make up a considerable proportion of older adults with ADRD living alone because they are at anincreased risk for ADRD compared to Whites. In addition, living alone in ol...
 
24. Project Title: TRANSFORMING RESEARCH AND CLINICAL KNOWLEDGE IN TRAUMATIC BRAIN INJURY
  Leader(s): MANLEY, GEOFFREY T; DIAZ-ARRASTIA, RAMON ; GIACINO, JOSEPH THOMAS ; MUKHERJEE, PRATIK ; OKONKWO, DAVID O ; ROBERTSON, CLAUDIA S ; TEMKIN, NANCY R ;
    UNIVERSITY OF CALIFORNIA SAN FRANCISCO
    NIH U01NS086090 / (2013-2019)
  Core(s):
  DESCRIPTION (provided by applicant): Effective treatment of traumatic brain injury (TBI) remains one of the greatest unmet needs in public health. Each year in the US, at least 1.7 million people suffer TBI; an estimated 3.2 to 5.3 million people live with the long-term physical,cognitive, and psychological health disabilities of TBI, with annual direct and indirect costs estimated at over $60 bi...
 
PUBLICATIONS
2021
 
2020
  1. Multi-cultural perspectives on group singing among diverse older adults.
    Allison TA, N?poles AM, Johnson JK, Stewart AL, Rodriguez-Salazar M, Peringer J, Sherman S, Ortez-Alfaro J, Villero O, Portacolone E
    Geriatr Nurs, 2020 Nov - Dec, 41(6): 1006-1012
    https://doi.org/10.1016/j.gerinurse.2020.07.011 | PMID: 32778434 | PMCID: PMC7738424
    Citations: | AltScore: NA
  2. Extreme Vulnerability of Home Care Workers During the COVID-19 Pandemic-A Call to Action.
    Allison TA, Oh A, Harrison KL
    JAMA Intern Med, 2020 Aug 4
    https://doi.org/10.1001/jamainternmed.2020.3937 | PMID: 32749452
    Citations: | AltScore: 53.3
  3. Prevalence of Diabetes Medication Intensifications in Older Adults Discharged From US Veterans Health Administration Hospitals.
    Anderson TS, Lee S, Jing B, Fung K, Ngo S, Silvestrini M, Steinman MA
    JAMA Netw Open, 2020 Mar 2, 3(3): e201511
    https://doi.org/10.1001/jamanetworkopen.2020.1511 | PMID: 32207832 | PMCID: PMC7093767
    Citations: 1 | AltScore: 65.15
  4. Prisons: Amplifiers of the COVID-19 Pandemic Hiding in Plain Sight.
    Barnert E, Ahalt C, Williams B
    Am J Public Health, 2020 Jul, 110(7): 964-966
    https://doi.org/10.2105/AJPH.2020.305713 | PMID: 32407126 | PMCID: PMC7287517
    Citations: 4 | AltScore: 26.15
  5. Association Between Lower Urinary Tract Symptoms and Frailty in Older Men Presenting for Urologic Care.
    Bauer SR, Jin C, Kamal P, Suskind AM
    Urology, 2020 Oct 10
    pii: S0090-4295(20)31249-8. https://doi.org/10.1016/j.urology.2020.09.041 | PMID: 33049232
    Citations: | AltScore: NA
  6. Co-Occurrence of Lower Urinary Tract Symptoms and Frailty among Community-Dwelling Older Men.
    Bauer SR, Scherzer R, Suskind AM, Cawthon P, Ensrud KE, Ricke WA, Covinsky K, Marshall LM, Osteoporotic Fractures in Men (MrOS) Research Group.
    J Am Geriatr Soc, 2020 Dec, 68(12): 2805-2813
    https://doi.org/10.1111/jgs.16766 | PMID: 32822081 | PMCID: PMC7744321
    Citations: | AltScore: 12.5
  7. Clinician-judged hearing impairment and associations with neuropathologic burden.
    Brenowitz WD, Besser LM, Kukull WA, Keene CD, Glymour MM, Yaffe K
    Neurology, 2020 Sep 22, 95(12): e1640-e1649
    https://doi.org/10.1212/WNL.0000000000010575 | PMID: 32759190 | PMCID: PMC7713726
    Citations: | AltScore: 44.03
  8. Association of genetic risk for Alzheimer disease and hearing impairment.
    Brenowitz WD, Filshtein TJ, Yaffe K, Walter S, Ackley SF, Hoffmann TJ, Jorgenson E, Whitmer RA, Glymour MM
    Neurology, 2020 Oct 20, 95(16): e2225-e2234
    https://doi.org/10.1212/WNL.0000000000010709 | PMID: 32878991 | PMCID: PMC7713783
    Citations: | AltScore: 38
  9. Moving prevention of functional impairment upstream: is middle age an ideal time for intervention?
    Brown RT, Covinsky KE
    Womens Midlife Health, 2020, 6: 4
    https://doi.org/10.1186/s40695-020-00054-z | PMID: 32695430 | PMCID: PMC7366897
    Citations: | AltScore: NA
  10. Patient-reported measures of well-being in older multiple myeloma patients: use of secondary data source.
    Cenzer I, Berger K, Rodriguez AM, Ostermann H, Covinsky KE
    Aging Clin Exp Res, 2020 Jan 22, 32(6): 1153-1160
    https://doi.org/10.1007/s40520-019-01465-3 | PMID: 31970671 | PMCID: PMC7260254
    Citations: | AltScore: 0.25
  11. Succeeding in Aging Research During the Pandemic: Strategies for Fellows and Junior Faculty.
    Cohen AB, Parks AL, Whitson HE, Zieman S, Brown CJ, Boyd C, Covinsky KE, Steinman MA
    J Am Geriatr Soc, 2020 Oct 13
    https://doi.org/10.1111/jgs.16868 | PMID: 33047812 | PMCID: PMC7675665
    Citations: | AltScore: 47.5
  12. Postoperative delirium: why, what, and how to confront it at your institution.
    Curtis MS, Forman NA, Donovan AL, Whitlock EL
    Curr Opin Anaesthesiol, 2020 Oct, 33(5): 668-673
    https://doi.org/10.1097/ACO.0000000000000907 | PMID: 32796170 | PMCID: PMC7489931
    Citations: 1 | AltScore: 8.15
  13. An Implementation-Effectiveness Study of a Perioperative Delirium Prevention Initiative for Older Adults.
    Donovan AL, Braehler MR, Robinowitz DL, Lazar AA, Finlayson E, Rogers S, Douglas VC, Whitlock EL, Anesthesia Resident Quality Improvement Committee.
    Anesth Analg, 2020 Dec, 131(6): 1911-1922
    https://doi.org/10.1213/ANE.0000000000005223 | PMID: 33105281 | PMCID: PMC7669669
    Citations: 1 | AltScore: 2.6
  14. Frailty Is Associated With Increased Rates of Acute Cellular Rejection Within 3 Months After Liver Transplantation.
    Fozouni L, Mohamad Y, Lebsack A, Freise C, Stock P, Lai JC
    Liver Transpl, 2020 Mar, 26(3): 390-396
    https://doi.org/10.1002/lt.25669 | PMID: 31655014 | PMCID: PMC7036016
    Citations: 2 | AltScore: NA
  15. Transforming Undergraduate Student Perceptions of Dementia through Music and Filmmaking.
    Gubner J, Smith AK, Allison TA
    J Am Geriatr Soc, 2020 May, 68(5): 1083-1089
    https://doi.org/10.1111/jgs.16418 | PMID: 32372442
    Citations: | AltScore: 62.78
  16. Medical Multimorbidity, Mental Illness, and Substance Use Disorder among Middle-Aged and Older Justice-Involved Adults in the USA, 2015-2018.
    Han BH, Williams BA, Palamar JJ
    J Gen Intern Med, 2020 Oct 13
    https://doi.org/10.1007/s11606-020-06297-w | PMID: 33051837
    Citations: | AltScore: NA
  17. Hospice Staff Perspectives on Caring for People with Dementia: A Multisite, Multistakeholder Study.
    Harrison KL, Allison TA, Garrett SB, Thompson N, Sudore RL, Ritchie CS
    J Palliat Med, 2020 Mar 4, 23(8): 1013-1020
    https://doi.org/10.1089/jpm.2019.0565 | PMID: 32130076 | PMCID: PMC7404831
    Citations: | AltScore: 2.6
  18. Community-Based Palliative Care Consultations: Comparing Dementia to Nondementia Serious Illnesses.
    Harrison KL, Bull JH, Garrett SB, Bonsignore L, Bice T, Hanson LC, Ritchie CS
    J Palliat Med, 2020 Jan 22, 23(8): 1021-1029
    https://doi.org/10.1089/jpm.2019.0250 | PMID: 31971857 | PMCID: PMC7404819
    Citations: | AltScore: 4.85
  19. What's Happening at Home: A Claims-based Approach to Better Understand Home Clinical Care Received by Older Adults.
    Harrison KL, Leff B, Altan A, Dunning S, Patterson CR, Ritchie CS
    Med Care, 2020 Apr, 58(4): 360-367
    https://doi.org/10.1097/MLR.0000000000001267 | PMID: 31876645 | PMCID: PMC7071951
    Citations: 2 | AltScore: 1.85
  20. Palliative Care in the Nursing Home-Shifting Paradigms.
    Hunt LJ, Stephens CE, Smith AK
    JAMA Intern Med, 2020 Feb 1, 180(2): 243-244
    https://doi.org/10.1001/jamainternmed.2019.5359 | PMID: 31710331
    Citations: | AltScore: 30.25
  21. Barriers and Solutions to Advance Care Planning among Homeless-Experienced Older Adults.
    Kaplan LM, Sudore RL, Cuervo IA, Bainto D, Olsen P, Kushel M
    J Palliat Med, 2020 Mar 17, 23(10): 1300-1306
    https://doi.org/10.1089/jpm.2019.0550 | PMID: 32182155 | PMCID: PMC7523016
    Citations: | AltScore: 4.45
  22. Advance Care Planning Prior to Death in Older Adults with Hip Fracture.
    Kata A, Cenzer I, Sudore RL, Covinsky KE, Tang VL
    J Gen Intern Med, 2020 May 4, 35(7): 1946-1953
    https://doi.org/10.1007/s11606-020-05644-1 | PMID: 32367390 | PMCID: PMC7351969
    Citations: 2 | AltScore: 1.75
  23. Social Isolation and Loneliness Among San Francisco Bay Area Older Adults During the COVID-19 Shelter-in-Place Orders.
    Kotwal AA, Holt-Lunstad J, Newmark RL, Cenzer I, Smith AK, Covinsky KE, Escueta DP, Lee JM, Perissinotto CM
    J Am Geriatr Soc, 2020 Sep 23
    https://doi.org/10.1111/jgs.16865 | PMID: 32965024 | PMCID: PMC7536935
    Citations: 1 | AltScore: 603.872
  24. Improving the American Diabetes Association Framework for individualizing treatment in older adults: evaluating life expectancy.
    Lee AK, Steinman MA, Lee SJ
    BMJ Open Diabetes Res Care, 2020 Sep, 8(1):
    pii: e001624. https://doi.org/10.1136/bmjdrc-2020-001624 | PMID: 32988850 | PMCID: PMC7523213
    Citations: | AltScore: 12.1
  25. Toxicity and survival outcomes in older adults receiving concurrent or sequential chemoradiation for stage III non-small cell lung cancer in Alliance trials (Alliance A151812).
    Maggiore RJ, Zahrieh D, McMurray RP, Feliciano JL, Samson P, Mohindra P, Chen H, Wong ML, Lafky JM, Jatoi A, Le-Rademacher JG
    J Geriatr Oncol, 2020 Sep 16
    pii: S1879-4068(20)30432-X. https://doi.org/10.1016/j.jgo.2020.09.005 | PMID: 32950428
    Citations: 1 | AltScore: NA
  26. What Is a Medication-Related Problem? A Qualitative Study of Older Adults and Primary Care Clinicians.
    Nicosia FM, Spar MJ, Stebbins M, Sudore RL, Ritchie CS, Lee KP, Rodondi K, Steinman MA
    J Gen Intern Med, 2020 Mar, 35(3): 724-731
    https://doi.org/10.1007/s11606-019-05463-z | PMID: 31677102 | PMCID: PMC7080912
    Citations: | AltScore: 75.77
  27. Ethical Issues Raised by the Introduction of Artificial Companions to Older Adults with Cognitive Impairment: A Call for Interdisciplinary Collaborations.
    Portacolone E, Halpern J, Luxenberg J, Harrison KL, Covinsky KE
    J Alzheimers Dis, 2020, 76(2): 445-455
    https://doi.org/10.3233/JAD-190952 | PMID: 32250295 | PMCID: PMC7437496
    Citations: | AltScore: 1.1
  28. Geriatric Syndromes and Atrial Fibrillation: Prevalence and Association with Anticoagulant Use in a National Cohort of Older Americans.
    Shah SJ, Fang MC, Jeon SY, Gregorich SE, Covinsky KE
    J Am Geriatr Soc, 2020 Sep 28
    https://doi.org/10.1111/jgs.16822 | PMID: 32989731
    Citations: | AltScore: 19.65
  29. \We Have a Long Way to Go:\ A Case Study Examination of Older Women Veterans' Experiences in VA Primary Care.
    Silvestrini M, Nicosia F, Spar MJ, Gibson CJ, Brown RT
    Inquiry, 2020 Jan-Dec, 57: 46958020931311
    https://doi.org/10.1177/0046958020931311 | PMID: 32525421 | PMCID: PMC7290258
    Citations: | AltScore: 2.25
  30. Meeting the Care Needs of Older Adults Isolated at Home During the COVID-19 Pandemic.
    Steinman MA, Perry L, Perissinotto CM
    JAMA Intern Med, 2020 Jun 1, 180(6): 819-820
    https://doi.org/10.1001/jamainternmed.2020.1661 | PMID: 32297903
    Citations: 25 | AltScore: 407.84
  31. Time Spent Away from Home in the Year Following High-Risk Cancer Surgery in Older Adults.
    Suskind AM, Zhao S, Boscardin WJ, Smith A, Finlayson E
    J Am Geriatr Soc, 2020 Mar, 68(3): 505-510
    https://doi.org/10.1111/jgs.16344 | PMID: 31981366 | PMCID: PMC7161704
    Citations: 1 | AltScore: 22.75
  32. Preoperative Depressive Symptoms Associated with Poor Functional Recovery after Surgery.
    Tang VL, Cenzer I, McCulloch CE, Finlayson E, Cooper Z, Silvestrini M, Ngo S, Schmitt EM, Inouye SK
    J Am Geriatr Soc, 2020 Sep 8, 68(12): 2814-2821
    https://doi.org/10.1111/jgs.16781 | PMID: 32898280 | PMCID: PMC7744402
    Citations: | AltScore: 21.5
  33. Derivation, Validation, Sustained Performance, and Clinical Impact of an Electronic Medical Record-Based Perioperative Delirium Risk Stratification Tool.
    Whitlock EL, Braehler MR, Kaplan JA, Finlayson E, Rogers SE, Douglas V, Donovan AL
    Anesth Analg, 2020 Dec, 131(6): 1901-1910
    https://doi.org/10.1213/ANE.0000000000005085 | PMID: 33105280 | PMCID: PMC7669577
    Citations: 1 | AltScore: 5.2
  34. Implications of postoperative cognitive decline for satisfaction with anaesthesia care.
    Whitlock EL, Liu X, Lin HM, Deiner S
    Br J Anaesth, 2020 Sep, 125(3): e273-e275
    https://doi.org/10.1016/j.bja.2020.05.023 | PMID: 32611526 | PMCID: PMC7539663
    Citations: | AltScore: 4.1
  35. The Frailty Syndrome: Anesthesiologists Must Understand More and Fear Less.
    Whitlock EL, Whittington RA
    Anesth Analg, 2020 Jun, 130(6): 1445-1448
    https://doi.org/10.1213/ANE.0000000000004789 | PMID: 32384332 | PMCID: PMC7678012
    Citations: | AltScore: 0.25
  36. Expanding Beyond Maximum Grade: Chemotherapy Toxicity over Time by Age and Performance Status in Advanced Non-Small Cell Lung Cancer in CALGB 9730 (Alliance A151729).
    Wong ML, Gao J, Thanarajasingam G, Sloan JA, Dueck AC, Novotny PJ, Jatoi A, Hurria A, Walter LC, Miaskowski C, Cohen HJ, Wood WA, Feliciano JL, Stinchcombe TE, Wang X
    Oncologist, 2020 Sep 20
    https://doi.org/10.1002/onco.13527 | PMID: 32951293
    Citations: | AltScore: 11.4


EXTERNAL ADVISORY BOARD MEMBERS

Jean Kutner, MD, MPH/MSPH
School of Medicine, University of Colorado
Serving since 2013 (8 years)

Mark S. Lachs, MD
Weil Cornell Medicine
Serving since 2013 (8 years)

Seth Landefeld, MD
School of Medicine, University of Alabama at Birmingham
Serving since 2013 (8 years)

RECOGNITION AND AWARDS (2020-2021)

Recognition and Awards not specified.

MINORITY RESEARCH

General Brief Description of Minority Activities:
Not defined.

Minority Trainee(s):
  • Jennifer E. James, PhD, MSW, MS, Assistant Professor, Institute for Health & Aging at UCSF
    Incarceration and the health of currently and formerly incarcerated individuals was highlighted as an important social determinant of health in Healthy People 2020. Individuals with a history of incarceration report more chronic health problems after incarceration than before (Schnittker & John, 2007), in many cases regardless of the length of time served (Schnittker & John, 2007; Massoglia, 2008). Compared to the general population, incarcerated persons are more likely to have high blood pressure, asthma, cancer, arthritis and infectious diseases (Healthy People 2020) and studies have shown that women with a history of incarceration face a greater disease burden than men with a history of incarceration (Healthy People 2020; Covington, 2007). Ninety percent of recently released women have chronic medical, mental health, or substance use disorders, which is significantly higher than the general population (Mallik-Kane & Visher, 2005; Schnittker, Massoglia & Uggen, 2012). Additionally, within the first two weeks after release, recently released individuals have a 12.7 times higher mortality rate than the general population and that relative risk is higher for women than men (Binswanger et al., 2007). Being Black, being a woman, being poor and having a history of incarceration each confer serious health risks (Braithwaite, Treadwell, & Arriola, 2008). The overall goal of this study is to use interviews and ethnographic observation to better understand the intersection of these interconnected forms of risk. Dr. James will use a novel qualitative interview approach called “collective dialogue”, grounded in Black Feminist Epistemology, that engages participants in the analysis of the data they produce with the researcher over the course of open-ended interviews about their lives. This method, which Dr. James developed and piloted in her dissertation, enables her to center the lived experience of older, formerly incarcerated Black women and enables the women to participate in the production of knowledge about themselves. These interviews, combined with ethnographic observations of organizations advocating for the health and welfare of currently and formerly incarcerated women, will produce a multi-faceted and multilayered account of post-incarceration experiences of women with chronic disease and how they access healthcare. Currently, she is continuing to recruit participants for interviews. Her interviews to date have produced incredibly rich data. She is currently working with two research assistants to analyze the data, and have submitted abstracts based on preliminary findings to four conferences, and have been invited to present at two conferences this summer. However, attendance for conferences have been placed on hold due to COVID 19 safety protocols.

Minority Grant(s):