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  415-221-4810 x 25450  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:    Alex Smith, MD, MS, MPH   Alexander.Smith@ucsf.edu
Leader 2:    Sei Lee, MD   Sei.Lee@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
  • Grant Title: Loneliness and Social Isolation among Older Adults with and without Alzheimer’s Disease and Related Dementia in the Last Years of Life (K23AG065438) Grant Type: K23 Career Development Award Grant Funder: NIA
  • Grant Title: Developing an Intervention for Loneliness and Social Isolation among Older Adults with Cognitive Impairment Grant Type: Foundation Award Grant Funder: Hellman Family Foundation

 2019-2021  13 (6 1st/Sr)
Sarah Nouri, MD, MPH
Clinical Instructor / General Internal Medicine, UCSF
Evaluating the association between advance care planning among older adults and neighborhood socioeconomic status using geocoded electronic health record data
  • Grant Title: Changes in primary care management and utilization and impact on control of type 2 diabetes mellitus after wide-scale telehealth implementation Grant Type: Pilot & Feasibility Program Grant Funder: Health Delivery Systems Center for Diabetes Translational Research, funded by NIDDK (grant number P30DK092924)
  • Grant Title: Changes in primary care management and utilization and impact on control of type 2 diabetes mellitus after wide-scale telehealth implementation Grant Type: Research and Policy Initiative Award Grant Funder: UCSF Center for Healthcare Value

 2020-2021  9 (6 1st/Sr)
Li-Wen Huang, MD
Assistant Professor / Division of Hematology/Oncology, UCSF
Impact of diagnosis type on cognitive trajectories of older adults with hematologic malignancies
 2020-2021  6 (3 1st/Sr)
James Iannuzzi, MD, MPH
Assistant Professor / Surgery, UCSF
Cognitive Impairment Prevalence and impact on Surgical Treatment among Older Adults with Peripheral Arterial Disease
 2020-2021  15 (1 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 (4 Pilot Projects Listed)
1. Project Title: Cost-Effectiveness of Monitored Anesthesia Care in Cataract Surgery
  Leader: Catherine Chen, MD
 

Over 3.7 million cataract surgeries are performed in the United States each year. Consequently, even a small increase in adverse surgical outcomes can negatively impact tens of thousands of patients.  Approximately 80% of patients in the US undergo cataract surgery with 1-to-1 intraoperative monitoring and intravenous sedation administered by an anesthesiologist or nurse anesthetist, which is commonly referred to as “monitored anesthesia care” or “MAC.  However, there are no nationally representative studies that directly assess the role of MAC in preventing ophthalmic complications and their associated costs in cataract patients.  Therefore, it is unknown if eliminating MAC as a routine cataract surgery component would worsen surgical outcomes.  With increasing pressure from payers to optimize the value of cataract surgical care, it is critical to determine MAC’s impact on surgical outcomes and evaluate MAC’s cost-effectiveness in preventing ophthalmic complications. 

 

Through this pilot, Dr. Chen aims to assess the value of MAC for cataract surgery care. Her central hypothesis is that the provision of anesthesia services is unnecessary for most patients undergoing routine cataract surgery.  She will perform quantitative analysis of Medicare claims and cost-effectiveness analysis of cataract surgery with and without MAC to determine how MAC’s provision affects cataract surgery outcomes.  Through this work, Dr. Chen hopes to improve our understanding of the safety and value of MAC for cataract surgery care, with potential implications for ophthalmologists, anesthesia providers, healthcare payers, and policymakers, as well as patients.  The results of this study will build the scientific foundation for future studies that will prospectively evaluate medical and ophthalmic outcomes in cataract patients receiving MAC compared to other sedation approaches. 
 
2. Project Title: Impact of SNAP on Health Outcomes in a High-Risk Older Adult Population
  Leader: Hilary Seligman, MD, MAS
 

The Supplemental Nutrition Assistance Program (SNAP) provides 1 in 7 Americans with money to buy food. Known as CalFresh in California, SNAP is the nation’s most effective and comprehensive strategy for reducing food insecurity.  Historically, California residents in the Supplemental Security Income (SSI) program, a federal program that provides monthly cash payments to low-income adults aged 65 years and older and is blind or disabled, have not been eligible to receive SNAP benefits.  In California, almost half (n= 581,083) of all SSI recipients are over 65.  However, California is the last state in the nation to extend SNAP benefits to SSI recipients; SSI recipients in all other states have been eligible for SNAP benefits for many years (generally decades) if they meet other eligibility criteria.  

 

On June 1, 2019, California State Assembly Bill 1811 changed this policy, allowing California’s SSI recipients access to SNAP for the first time.  To date, definitive studies that prove the impact of SNAP on health care outcomes and health care costs have not been possible, as SNAP, which is an entitlement program, cannot be randomized nor manipulated experimentally in any way.  Therefore, this policy change provided a unique and time-sensitive opportunity to rigorously assess to what extent SNAP receipt impacts older adult health.  Taking advantage of this rare natural experiment, Dr. Seligman quickly mobilized a plan to use primary and secondary data collection methods to explore the extent to which SNAP improves health outcomes, reduces health care expenditures, and improves the capacity to age in place among older adults. 

 

This proposal seeks to leverage the infrastructure of an existing parent study, funded by the Archstone Foundation (PI: Seligman), which uses a mixed-methods approach to evaluate the impact of the policy change on health outcomes and expenditures.  The funded evaluation includes three data sources:  

  1. Administrative data. Using administrative data from the California Department of Social Services (CalFresh), Department of Healthcare Services (DHCS), and the Office of Statewide Health Planning and Development (OSHPD), this analysis will use quasi-experimental methods to examine the impact of the policy change on the following primary outcomes: emergency room visits, hospitalizations, hospital length of stay, total healthcare expenditures, and long-term placement.  

  1. Survey. Primary data collection from 236 SSI recipients in the San Francisco Bay Area, pre and post-policy change, with 73% follow-up. Surveys included the following topic areas: CalFresh participation, food insecurity, stress, and self-reported health. All data was collected between May 2019 and December 2019. 

  1. Dietary recalls.  All survey participants were asked to complete three dietary recalls at the time of project enrollment (pre-policy change), and three dietary recalls at six-month follow up (post-policy change). More than 75% of baseline study participants completed at least one dietary recall. 

 

This study and its works in progress will inform and add critical preliminary data to Dr. Seligman’s future NIH R01 application evaluating the health and cost effects of the SNAP policy change on type 2 diabetes outcomes and disparities among SSI recipients. This is particularly relevant as type 2 diabetes is linked to higher mortality, reduced functional status, and increased institutionalization risk among older adults.  Dr. Seligman is considering an additional R01 application examining the policy change’s impact on the capacity to age in place among older adults.  This analysis will provide critical preliminary data.  Note that CalFresh is the only state SNAP program implemented at the county’s level rather than the state.  Although this piecemeal system creates enormous challenges for CalFresh recipients and administrators, it provides the opportunity to conduct rigorous quasi-experimental studies by leveraging differences in implementation from county to county as an instrumental variable. 

 
 
3. Project Title: Dementia on Death Row: An Examination of Cruel and Usual Punishment for Prisoners with Dementia
  Leader: Jalayne Arias, JD
 

The aging prison population has been understudied – likely, in part, due to challenges and increased ethical and regulatory barriers to conducting research with prisoners. In the context of dementia, prior work has focused on treating of prisoners and providing health care for these individuals’ unique needs.  Research and policies that improve older prisoners’ treatment, particularly those with neurodegeneration related cognitive impairment, are urgently needed.  Yet, what is lacking is a closer examination of policies and guidelines to determine when the implementation or completion of a sentence for a prisoner with dementia would be so averse to their health that it would constitute cruel and unusual punishment.  

 

This study will collect preliminary data that support future studies aimed at developing and implementing guidelines tailored to dementia for sentencing decisions broadly (i.e., initial sentencing, pardons, paroles, and sentence commutations).  After this study, Dr. Arias will collaborate with members of the ARCH Network to submit an R03 (or potentially an R01) with the National Institutes of Aging to conduct a study that (a) examines broader issues in sentencing decisions (parole, pardon, commuting, and appeals) for individuals with dementia who have non-capital punishment sentences, and (b) will propose policies and guidelines to mitigate the unnecessary harms of sentencing for an individual with dementia.  The study will serve a critical role in establishing collaborations within the ARCH Network and providing a mechanism to begin work in criminal health that harnesses my training and experience in law and ethics.  This preliminary study will bridgework in the legal/ethical issues related to Alzheimer’s disease and Related Dementias (ADRD) and questions relevant to criminal health. 
 
4. Project Title: Improving Health Disparities by Promoting Physical Activity Among Asian American Older Adults with Cardiovascular Disease: A Pilot Study
  Leader: Linda Park, RN, PhD, FNP
 

Cardiovascular disease (CVD) is the leading cause of mortality, affecting 43.7 million older adults age 60 and over.  To ameliorate this, cardiac rehabilitation (CR) is a highly effective, Class I level guideline-recommended 12-week group program that offers supervised physical activity (PA) after cardiac events (e.g., myocardial infarction, revascularization, valve replacement).  It has been shown to improve physical function and decrease morbidity and mortality in older adults.  Thus, maintaining PA after CR is essential in older adults to gain and maintain the critical benefits of improved physical function (balance, gait, strength, and endurance).  PA maintenance after CR is also linked to reduced adverse geriatric outcomes such as falls and mobility impairment but thereby increases susceptibility to adverse secondary cardiac events, functional decline, and depression.  Although it is estimated that minority individuals from diverse racial/ethnic backgrounds will comprise ~50% of the total U.S. population, minority older adults have more CVD burden than non-Hispanic Whites and have disproportionately lower rates of enrollment and adherence to CR (20% enrollment in Whites vs.8% in non-Whites).  Asian Americans (AA) have been identified as a high-risk population for CVD based on genetic predisposition, coronary risk factor profile, and behaviors (e.g., PA and diet).  In general, AA are less physically active than non-Hispanic Whites. Specific for CR participation, barriers may include cultural, socioeconomic, and linguistic challenges but it is unknown what the perceived barriers and facilitators are to continue PA behaviors after CR completion.  Modifiable targets related to sustained PA may include depression and anxiety and slower self-efficacy, motivation, and social support.  Tailored, accessible, and culturally appropriate interventions are urgently needed for AA older adults to promote sustained PA after CR to reduce future cardiac events. 

 

The objective of this mixed-methods proposal is to conduct a pilot study that will collect the critical data needed for a clinical trial to promote sustained PA through digital coaching after CR completion with a focus on improving physical function for AA older adults.  This pilot work will reduce persistent health disparities that exist for ethnic minorities so we can target modifiable factors for sustained PA after CR.  The under  
DEVELOPMENT PROJECTS (4 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.
 
3. Project Title: Developing an Algorithm to Identify Older Persons with Unmet Need for Equipment in National Datasets
  Leader: Kenneth Lam MD, John Boscardin PhD
  Core(s):
 

Dr. Kenny Lam (VA Quality Scholar) and DAC collaborated on developing a novel algorithm that has since resulted in a high-profile publication. The team first approached the development of this algorithm by creating a cohort of older adults aged 65 and above from the nationally representative National Health and Aging Trends Study (NHATS) and selecting participants with bathing and toileting equipment needs. Next, they cross referenced this cohort with Medicare claims data. Afterwards, the team examined how many participants did not receive equipment based on the NHATS annual follow up interviews, where interviewers meet annually with participants in person to ask about health, function, living environment, and finances and to conduct an objective assessment of physical performance. Lastly, the team used data from the 2016 to 2019 waves to determine the incidence of equipment acquisition among those with unmet need in 2015. 


The description of this methodology and the analysis made possible with this novel algorithm has been published in JAMA Internal Medicine, as cited below: 

 Lam K, Shi Y, Boscardin J, Covinsky KE. Unmet Need for Equipment to Help With Bathing and Toileting Among Older US Adults. JAMA Intern Med. 2021 Mar 22:e210204. doi: 10.1001/jamainternmed.2021.0204. Epub ahead of print. PMID: 33749707; PMCID: PMC7985819. 
 
4. Project Title: Deep Natural Language Processing Identifies Variation in Care Preference Documentation
  Leader: Rebecca Sudore, MD
  Core(s):
 

Retrospective chart reviews are one of many methods for researchers and clinicians to extract key information about subjects and patients. However, this is usually a time-intensive process. In the past year, Dr. Sudore and her collaborators have explored the use of natural language processing (NLP) and how it may increase efficiency in performing chart review. NLP (i.e., computer identification of phrases within electronic records) can be combined with deep learning (i.e., computer systems that can access and use information in an adaptive way) to create tools to aid in the rapid identification of care preference documentation. Neural network models are commonly used in deep learning. Similar to the neural networks in the human brain, computational neural networks include a series of statistical algorithms capable of modeling and processing nonlinear relationships between inputs and outputs in parallel and real time. These algorithms generate rules to associate sequences of words or images on a prespecified concept, such as care preferences, and become more accurate (i.e., learn) with more data over time. This adaptive learning process can be used to abstract complex information from clinical data with an accuracy similar to highly trained humans. As an example of this application, Dr. Sudore and her collaborators have developed and validated deep natural language processing in the identification of documentation of care preferences for patients admitted to the ICU. Their methods and findings can be found in the following manuscript:  

 

Udelsman BV, Moseley ET, Sudore RL, Keating NL, Lindvall C. Deep Natural Language Processing Identifies Variation in Care Preference Documentation. J Pain Symptom Manage. 2020 Jun;59(6):1186-1194.e3. doi: 10.1016/j.jpainsymman.2019.12.374. Epub 2020 Jan 9. PMID: 31926970. 
 
RESEARCH (12 Projects Listed)
1. 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 ...
 
2. 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...
 
3. 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 ...
 
4. 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 ...
 
5. 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...
 
6. 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...
 
7. 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...
 
8. 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...
 
9. 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...
 
10. 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...
 
11. 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...
 
12. 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...
 
PUBLICATIONS
2021
  1. Effect of reductions in amyloid levels on cognitive change in randomized trials: instrumental variable meta-analysis.
    Ackley SF, Zimmerman SC, Brenowitz WD, Tchetgen Tchetgen EJ, Gold AL, Manly JJ, Mayeda ER, Filshtein TJ, Power MC, Elahi FM, Brickman AM, Glymour MM
    BMJ, 2021 Feb 25, 372: n156
    https://doi.org/10.1136/bmj.n156 | PMID: 33632704 | PMCID: PMC7905687
    Citations: | AltScore: 165.65
  2. The COVID-19 Pandemic and Ethical Challenges Posed by Neoliberal Healthcare.
    Ahlbach C, King T, Dzeng E
    J Gen Intern Med, 2021 Jan, 36(1): 205-206
    https://doi.org/10.1007/s11606-020-06316-w | PMID: 33111238 | PMCID: PMC7592127
    Citations: | AltScore: 15.05
  3. Pre-estimating subsets: A new approach for unavailable predictors in prognostic modeling.
    Aliberti MJR, Kotwal AA, Smith AK, Lee SJ, Banda S, Boscardin WJ
    J Am Geriatr Soc, 2021 May 17
    https://doi.org/10.1111/jgs.17278 | PMID: 34002370
    Citations: | AltScore: NA
  4. Do Caregiving Factors Affect Hospitalization Risk Among Disabled Older Adults?
    Amjad H, Mulcahy J, Kasper JD, Burgdorf J, Roth DL, Covinsky K, Wolff JL
    J Am Geriatr Soc, 2021 Jan, 69(1): 129-139
    https://doi.org/10.1111/jgs.16817 | PMID: 32964422 | PMCID: PMC7856284
    Citations: 1 | AltScore: 107.19
  5. Older Adults' Persistence to Antihypertensives Prescribed at Hospital Discharge: a Retrospective Cohort Study.
    Anderson TS, Jing B, Fung K, Steinman MA
    J Gen Intern Med, 2021 Jan 19
    https://doi.org/10.1007/s11606-020-06401-0 | PMID: 33469765
    Citations: | AltScore: 16.4
  6. Population-Based Screening for Functional Disability in Older Adults.
    Ankuda CK, Freedman VA, Covinsky KE, Kelley AS
    Innov Aging, 2021, 5(1): igaa065
    https://doi.org/10.1093/geroni/igaa065 | PMID: 33506111 | PMCID: PMC7817111
    Citations: | AltScore: 1
  7. Ten Urgent Priorities Based on Lessons Learned From More Than a Half Million Known COVID-19 Cases in US Prisons.
    Barnert E, Kwan A, Williams B
    Am J Public Health, 2021 Jun, 111(6): 1099-1105
    https://doi.org/10.2105/AJPH.2021.306221 | PMID: 33856887 | PMCID: PMC8101573
    Citations: | AltScore: 16.2
  8. Variation in COVID-19 Mortality Across 117 US Hospitals in High- and Low-Burden Settings.
    Block BL, Martin TM, Boscardin WJ, Covinsky KE, Mourad M, Hu LL, Smith AK
    J Hosp Med, 2021 Apr, 16(4): 215-218
    https://doi.org/10.12788/jhm.3612 | PMID: 33734977 | PMCID: PMC8025591
    Citations: 1 | AltScore: 32.04
  9. Identification of non-Hodgkin lymphoma patients at risk for treatment-related vertebral density loss and fractures.
    Bodden J, Sun D, Joseph GB, Huang LW, Andreadis C, Hughes-Fulford M, Lang TF, Link TM
    Osteoporos Int, 2021 Feb, 32(2): 281-291
    https://doi.org/10.1007/s00198-020-05577-9 | PMID: 32803319 | PMCID: PMC7838070
    Citations: | AltScore: 11
  10. Difficulty Taking Medications: a Corollary to Dementia Risk.
    Chen P, Covinsky K
    J Gen Intern Med, 2021 Apr, 36(4): 861-862
    https://doi.org/10.1007/s11606-020-06531-5 | PMID: 33532953 | PMCID: PMC8041952
    Citations: | AltScore: 6.1
  11. A Novel Method for Identifying a Parsimonious and Accurate Predictive Model for Multiple Clinical Outcomes.
    Diaz-Ramirez LG, Lee SJ, Smith AK, Gan S, Boscardin WJ
    Comput Methods Programs Biomed, 2021 Jun, 204: 106073
    https://doi.org/10.1016/j.cmpb.2021.106073 | PMID: 33831724 | PMCID: PMC8098121
    Citations: 1 | AltScore: NA
  12. Polypharmacy among older adults with dementia compared with those without dementia in the United States.
    Growdon ME, Gan S, Yaffe K, Steinman MA
    J Am Geriatr Soc, 2021 Jun 8
    https://doi.org/10.1111/jgs.17291 | PMID: 34101822
    Citations: | AltScore: 42.08
  13. A Web-Based eHealth Intervention to Improve the Quality of Life of Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Controlled Trial.
    Gustafson DH Sr, Mares ML, Johnston DC, Mahoney JE, Brown RT, Landucci G, Pe-Romashko K, Cody OJ, Gustafson DH Jr, Shah DV
    JMIR Res Protoc, 2021 Feb 19, 10(2): e25175
    https://doi.org/10.2196/25175 | PMID: 33605887 | PMCID: PMC7935655
    Citations: | AltScore: 7.25
  14. Virtual Research Stakeholder Groups with Isolated Homebound Elders and Caregivers: Lessons Learned Relevant to Research during Pandemics.
    Harrison KL, Leff B, Garrigues SK, Eaton England AL, Perissinotto CM, Sheehan OC, Mickler AK, Basyal PS, Ritchie CS
    J Palliat Med, 2021 Apr, 24(4): 481-483
    https://doi.org/10.1089/jpm.2020.0778 | PMID: 33395555 | PMCID: PMC7987355
    Citations: | AltScore: 2.25
  15. Do Life-sustaining Treatment Orders Match Patient and Surrogate Preferences? The Role of POLST.
    Hickman SE, Torke AM, Sachs GA, Sudore RL, Tang Q, Bakoyannis G, Smith NH, Myers AL, Hammes BJ
    J Gen Intern Med, 2021 Feb, 36(2): 413-421
    https://doi.org/10.1007/s11606-020-06292-1 | PMID: 33111241 | PMCID: PMC7878602
    Citations: | AltScore: 34.75
  16. High incidence of fractures after R-CHOP-like chemotherapy for aggressive B-cell non-Hodgkin lymphomas.
    Huang LW, Sun D, Link TM, Lang T, Ai W, Kaplan LD, Steinman MA, Andreadis C
    Support Care Cancer, 2021 Mar 10
    https://doi.org/10.1007/s00520-021-06120-0 | PMID: 33694088
    Citations: | AltScore: 1.85
  17. Examining the bidirectional relationship between food insecurity and healthcare spending.
    Johnson KT, Palakshappa D, Basu S, Seligman H, Berkowitz SA
    Health Serv Res, 2021 Feb 17
    https://doi.org/10.1111/1475-6773.13641 | PMID: 33598952
    Citations: | AltScore: 17.65
  18. A Novel Metric for Developing Easy-to-Use and Accurate Clinical Prediction Models: The Time-cost Information Criterion.
    Lee SJ, Smith AK, Diaz-Ramirez LG, Covinsky KE, Gan S, Chen CL, Boscardin WJ
    Med Care, 2021 May 1, 59(5): 418-424
    https://doi.org/10.1097/MLR.0000000000001510 | PMID: 33528231 | PMCID: PMC8026517
    Citations: 1 | AltScore: 8.1
  19. Genetic Risk of Alzheimer's Disease and Sleep Duration in Non-Demented Elders.
    Leng Y, Ackley SF, Glymour MM, Yaffe K, Brenowitz WD
    Ann Neurol, 2021 Jan, 89(1): 177-181
    https://doi.org/10.1002/ana.25910 | PMID: 32951248 | PMCID: PMC8048405
    Citations: 2 | AltScore: 44
  20. Policy in Clinical Practice: Choosing Post-Acute Care in the New Decade.
    Makam AN, Grabowski DC
    J Hosp Med, 2021 Mar, 16(3): 171-174
    https://doi.org/10.12788/jhm.3577 | PMID: 33617438 | PMCID: PMC7929615
    Citations: | AltScore: NA
  21. Agent Orange Exposure and Dementia Diagnosis in US Veterans of the Vietnam Era.
    Martinez S, Yaffe K, Li Y, Byers AL, Peltz CB, Barnes DE
    JAMA Neurol, 2021 Apr 1, 78(4): 473-477
    https://doi.org/10.1001/jamaneurol.2020.5011 | PMID: 33492338 | PMCID: PMC7835948
    Citations: 1 | AltScore: 97.08
  22. Deconstructing the Complexities of Advance Care Planning Outcomes: What Do We Know and Where Do We Go? A Scoping Review.
    McMahan RD, Tellez I, Sudore RL
    J Am Geriatr Soc, 2021 Jan, 69(1): 234-244
    https://doi.org/10.1111/jgs.16801 | PMID: 32894787 | PMCID: PMC7856112
    Citations: 5 | AltScore: 34.64
  23. Perspective: The Convergence of Coronavirus Disease 2019 (COVID-19) and Food Insecurity in the United States.
    Nagata JM, Seligman HK, Weiser SD
    Adv Nutr, 2021 Mar 31, 12(2): 287-290
    https://doi.org/10.1093/advances/nmaa126 | PMID: 32970098 | PMCID: PMC7543276
    Citations: 3 | AltScore: 26.65
  24. A Toolkit for Community-Based, Medicaid-Funded Case Managers to Introduce Advance Care Planning to Frail, Older Adults: A Pilot Study.
    Nouri SS, Ritchie C, Volow A, Li B, McSpadden S, Dearman K, Kotwal A, Sudore RL
    J Palliat Med, 2021 Mar, 24(3): 428-432
    https://doi.org/10.1089/jpm.2020.0200 | PMID: 32865472 | PMCID: PMC7894043
    Citations: | AltScore: 9.15
  25. Engagement in Meaningful Activities Among Older Adults With Disability, Dementia, and Depression.
    Oh A, Gan S, Boscardin WJ, Allison TA, Barnes DE, Covinsky KE, Smith AK
    JAMA Intern Med, 2021 Apr 1, 181(4): 560-562
    https://doi.org/10.1001/jamainternmed.2020.7492 | PMID: 33492334 | PMCID: PMC7835951
    Citations: | AltScore: 68.6
  26. Feasibility of a Brief Intervention to Facilitate Advance Care Planning Conversations for Patients with Life-Limiting Illness in the Emergency Department.
    Pajka SE, Hasdianda MA, George N, Sudore R, Schonberg MA, Bernstein E, Tulsky JA, Block SD, Ouchi K
    J Palliat Med, 2021 Jan, 24(1): 31-39
    https://doi.org/10.1089/jpm.2020.0067 | PMID: 32471321 | PMCID: PMC7757694
    Citations: | AltScore: 7.7
  27. Long-term individual and population functional outcomes in older adults with atrial fibrillation.
    Parks AL, Jeon SY, Boscardin WJ, Steinman MA, Smith AK, Fang MC, Shah SJ
    J Am Geriatr Soc, 2021 Mar 5, 69(6): 1570-1578
    https://doi.org/10.1111/jgs.17087 | PMID: 33675093
    Citations: | AltScore: 7.95
  28. The Effects of the COVID-19 Pandemic on the Lived Experience of Diverse Older Adults Living Alone With Cognitive Impairment.
    Portacolone E, Chodos A, Halpern J, Covinsky KE, Keiser S, Fung J, Rivera E, Tran T, Bykhovsky C, Johnson JK
    Gerontologist, 2021 Feb 23, 61(2): 251-261
    https://doi.org/10.1093/geront/gnaa201 | PMID: 33404634 | PMCID: PMC7901518
    Citations: 2 | AltScore: 58.45
  29. Prisons and COVID-19: A Desperate Call for Gerontological Expertise in Correctional Health Care.
    Prost SG, Novisky MA, Rorvig L, Zaller N, Williams B
    Gerontologist, 2021 Jan 21, 61(1): 3-7
    https://doi.org/10.1093/geront/gnaa088 | PMID: 32706885 | PMCID: PMC7454571
    Citations: 1 | AltScore: 52.25
  30. Use of Services by People Living Alone With Cognitive Impairment: A Systematic Review.
    Rosenwohl-Mack A, Dubbin L, Chodos A, Dulaney S, Fang ML, Merrilees J, Portacolone E
    Innov Aging, 2021, 5(1): igab004
    https://doi.org/10.1093/geroni/igab004 | PMID: 33796795 | PMCID: PMC7990060
    Citations: | AltScore: 1
  31. Comparative Outcomes for Pelvic Organ Prolapse Surgery among Nursing Home Residents and Matched Community Dwelling Older Adults.
    Suskind AM, Zhao S, Boscardin WJ, Covinsky K, Finlayson E
    J Urol, 2021 Jan, 205(1): 199-205
    https://doi.org/10.1097/JU.0000000000001331 | PMID: 32808855 | PMCID: PMC7725928
    Citations: | AltScore: 0.5
  32. Association of Coronary Artery Bypass Grafting vs Percutaneous Coronary Intervention With Memory Decline in Older Adults Undergoing Coronary Revascularization.
    Whitlock EL, Diaz-Ramirez LG, Smith AK, Boscardin WJ, Covinsky KE, Avidan MS, Glymour MM
    JAMA, 2021 May 18, 325(19): 1955-1964
    https://doi.org/10.1001/jama.2021.5150 | PMID: 34003225 | PMCID: PMC8132142
    Citations: | AltScore: 123.02
  33. Formal and informal social participation and elder mistreatment in a national sample of older adults.
    Yang EZ, Kotwal AA, Lisha NE, Wong JS, Huang AJ
    J Am Geriatr Soc, 2021 Jun 9
    https://doi.org/10.1111/jgs.17282 | PMID: 34105769
    Citations: | AltScore: 65.11
  34. Evaluation of Time to Benefit of Statins for the Primary Prevention of Cardiovascular Events in Adults Aged 50 to 75 Years: A Meta-analysis.
    Yourman LC, Cenzer IS, Boscardin WJ, Nguyen BT, Smith AK, Schonberg MA, Schoenborn NL, Widera EW, Orkaby A, Rodriguez A, Lee SJ
    JAMA Intern Med, 2021 Feb 1, 181(2): 179-185
    https://doi.org/10.1001/jamainternmed.2020.6084 | PMID: 33196766 | PMCID: PMC7670393
    Citations: | AltScore: 275.39
 
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, 180(11): 1459-1460
    https://doi.org/10.1001/jamainternmed.2020.3937 | PMID: 32749452 | PMCID: PMC7858686
    Citations: 1 | 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: 65.3
  4. Implications of 2020 Skilled Home Healthcare Payment Reform for Persons with Dementia.
    Ankuda CK, Leff B, Ritchie CS, Rahman OK, Ferreira KB, Bollens-Lund E, Ornstein KA
    J Am Geriatr Soc, 2020 Oct, 68(10): 2303-2309
    https://doi.org/10.1111/jgs.16654 | PMID: 32562569 | PMCID: PMC7718285
    Citations: | AltScore: 3.25
  5. Switching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability.
    Ankuda CK, Ornstein KA, Covinsky KE, Bollens-Lund E, Meier DE, Kelley AS
    Health Aff (Millwood), 2020 May, 39(5): 809-818
    https://doi.org/10.1377/hlthaff.2019.01070 | PMID: 32364865 | PMCID: PMC7951954
    Citations: 2 | AltScore: 11.6
  6. 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: 8 | AltScore: 28.05
  7. 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, 148: 230-234
    pii: S0090-4295(20)31249-8. https://doi.org/10.1016/j.urology.2020.09.041 | PMID: 33049232 | PMCID: PMC7870540
    Citations: | AltScore: NA
  8. 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: 12.75
  9. Association of Lower Urinary Tract Symptom Severity with Kidney Function among Community Dwelling Older Men.
    Bauer SR, Scherzer R, Zhao S, Breyer BN, Kenfield SA, Shlipak M, Marshall LM, Osteoporotic Fractures in Men (MrOS) Research Group.
    J Urol, 2020 Dec, 204(6): 1305-1311
    https://doi.org/10.1097/JU.0000000000001310 | PMID: 32924780 | PMCID: PMC7665901
    Citations: | AltScore: 2.25
  10. Using care navigation to address caregiver burden in dementia: A qualitative case study analysis.
    Bernstein A, Merrilees J, Dulaney S, Harrison KL, Chiong W, Ong P, Heunis J, Choi J, Walker R, Feuer JE, Lee K, Dohan D, Bonasera SJ, Miller BL, Possin KL
    Alzheimers Dement (N Y), 2020, 6(1): e12010
    https://doi.org/10.1002/trc2.12010 | PMID: 32377557 | PMCID: PMC7201177
    Citations: 1 | AltScore: 1.75
  11. Patterns and Trends in Advance Care Planning Among Older Adults Who Received Intensive Care at the End of Life.
    Block BL, Jeon SY, Sudore RL, Matthay MA, Boscardin WJ, Smith AK
    JAMA Intern Med, 2020 May 1, 180(5): 786-789
    https://doi.org/10.1001/jamainternmed.2019.7535 | PMID: 32119031 | PMCID: PMC7052782
    Citations: 6 | AltScore: 181.75
  12. Apathy and risk of probable incident dementia among community-dwelling older adults.
    Bock MA, Bahorik A, Brenowitz WD, Yaffe K
    Neurology, 2020 Dec 15, 95(24): e3280-e3287
    https://doi.org/10.1212/WNL.0000000000010951 | PMID: 33055276 | PMCID: PMC7836653
    Citations: | AltScore: 210.216
  13. 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: 2 | AltScore: 44.28
  14. 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: 2 | AltScore: 38
  15. Incident dementia and faster rates of cognitive decline are associated with worse multisensory function summary scores.
    Brenowitz WD, Kaup AR, Yaffe K
    Alzheimers Dement, 2020 Oct, 16(10): 1384-1392
    https://doi.org/10.1002/alz.12134 | PMID: 32657033 | PMCID: PMC7901640
    Citations: | AltScore: 291.91
  16. 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: 1 | AltScore: NA
  17. A Society of General Internal Medicine Position Statement on the Internists' Role in Social Determinants of Health.
    Byhoff E, Kangovi S, Berkowitz SA, DeCamp M, Dzeng E, Earnest M, Gonzalez CM, Hartigan S, Karani R, Memari M, Roy B, Schwartz MD, Volerman A, DeSalvo K, Society of General Internal Medicine.
    J Gen Intern Med, 2020 Sep, 35(9): 2721-2727
    https://doi.org/10.1007/s11606-020-05934-8 | PMID: 32519320 | PMCID: PMC7459005
    Citations: 6 | AltScore: 94.95
  18. 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
  19. Performance of matching methods in studies of rare diseases: a simulation study.
    Cenzer I, Boscardin WJ, Berger K
    Intractable Rare Dis Res, 2020 May, 9(2): 79-88
    https://doi.org/10.5582/irdr.2020.01016 | PMID: 32494554 | PMCID: PMC7263993
    Citations: | AltScore: NA
  20. Long-Term Trends in Postoperative Opioid Prescribing, 1994 to 2014.
    Chen CL, Jeffery MM, Krebs EE, Thiels CA, Schumacher MA, Schwartz AJ, Thombley R, Finlayson E, Rodriguez-Monguio R, Ward D, Dudley RA
    J Am Acad Orthop Surg Glob Res Rev, 2020 Jan, 4(1):
    pii: e19.00171. https://doi.org/10.5435/JAAOSGlobal-D-19-00171 | PMID: 32159068 | PMCID: PMC7028788
    Citations: | AltScore: NA
  21. 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, 69(1): 8-11
    https://doi.org/10.1111/jgs.16868 | PMID: 33047812 | PMCID: PMC7675665
    Citations: | AltScore: 51.25
  22. \Social Distancing\ Amid a Crisis in Social Isolation and Loneliness.
    Cudjoe TKM, Kotwal AA
    J Am Geriatr Soc, 2020 Jun, 68(6): E27-E29
    https://doi.org/10.1111/jgs.16527 | PMID: 32359072 | PMCID: PMC7267573
    Citations: 15 | AltScore: 26
  23. 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: 2 | AltScore: 8.4
  24. Resident Physician Experiences With and Responses to Biased Patients.
    de Bourmont SS, Burra A, Nouri SS, El-Farra N, Mohottige D, Sloan C, Schaeffer S, Friedman J, Fernandez A
    JAMA Netw Open, 2020 Nov 2, 3(11): e2021769
    https://doi.org/10.1001/jamanetworkopen.2020.21769 | PMID: 33226429 | PMCID: PMC7684448
    Citations: | AltScore: 271.45
  25. Ethics and Spheres of Influence in Addressing Social Determinants of Health.
    DeCamp M, DeSalvo K, Dzeng E
    J Gen Intern Med, 2020 Sep, 35(9): 2743-2745
    https://doi.org/10.1007/s11606-020-05973-1 | PMID: 32572766 | PMCID: PMC7459019
    Citations: 1 | AltScore: 10.55
  26. Language-Related Disparities in Pain Management in the Post-Anesthesia Care Unit for Children Undergoing Laparoscopic Appendectomy.
    Dixit AA, Elser H, Chen CL, Ferschl M, Manuel SP
    Children (Basel), 2020 Oct 4, 7(10):
    pii: E163. https://doi.org/10.3390/children7100163 | PMID: 33020409 | PMCID: PMC7600632
    Citations: 1 | AltScore: 5.2
  27. 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
  28. Difficulty and help with activities of daily living among older adults living alone with cognitive impairment.
    Edwards RD, Brenowitz WD, Portacolone E, Covinsky KE, Bindman A, Glymour MM, Torres JM
    Alzheimers Dement, 2020 Aug, 16(8): 1125-1133
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  29. Patients' Use of Social Media for Diabetes Self-Care: Systematic Review.
    Elnaggar A, Ta Park V, Lee SJ, Bender M, Siegmund LA, Park LG
    J Med Internet Res, 2020 Apr 24, 22(4): e14209
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  30. The New Normal: Key Considerations for Effective Serious Illness Communication Over Video or Telephone During the Coronavirus Disease 2019 (COVID-19) Pandemic.
    Flint L, Kotwal A
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  31. 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
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  32. Identifying tests related to breast cancer care in claims data.
    Franc BL, Thombley R, Luo Y, Boscardin WJ, Rugo HS, Seidenwurm D, Dudley RA
    Breast J, 2020 Jun, 26(6): 1227-1230
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  33. Using diagnosis codes in claims data to identify cohorts of breast cancer patients following initial treatment.
    Franc BL, Thombley R, Luo Y, John Boscardin W, Rugo HS, Seidenwurm D, Dudley RA
    Breast J, 2020 Jul, 26(7): 1472-1474
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  34. Empowering Older Adults to Discuss Advance Care Planning During Clinical Visits: The PREPARE Randomized Trial.
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  35. Rapid transition of a preclinical health systems science and social justice course to remote learning in the time of coronavirus.
    Garg M, Eniasivam A, Satterfield J, Norton B, Austin E, Dohan D
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  36. Before Consent: Qualitative Analysis of Deliberations of Patients With Advanced Cancer About Early-Phase Clinical Trials.
    Garrett SB, Matthews TM, Abramson CM, Koenig CJ, Hlubocky FJ, Daugherty CK, Munster PN, Dohan D
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  37. Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review.
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    Med Decis Making, 2020 Feb, 40(2): 119-143
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  38. Improving Health Equity for Women Involved in the Criminal Legal System.
    Golembeski CA, Sufrin CB, Williams B, Bedell PS, Glied SA, Binswanger IA, Hylton D, Winkelman TNA, Meyer JP
    Womens Health Issues, 2020 Sep - Oct, 30(5): 313-319
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  39. Food Insecurity May Be an Independent Risk Factor Associated with Nonalcoholic Fatty Liver Disease among Low-Income Adults in the United States.
    Golovaty I, Tien PC, Price JC, Sheira L, Seligman H, Weiser SD
    J Nutr, 2020 Jan 1, 150(1): 91-98
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  40. 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
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  41. Medical Multimorbidity, Mental Illness, and Substance Use Disorder among Middle-Aged and Older Justice-Involved Adults in the USA, 2015-2018.
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    J Gen Intern Med, 2020 Oct 13, 36(5): 1258-1263
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  42. Does Feedback to Physicians of a Patient-Reported Readiness for Discharge Checklist Improve Discharge?
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    J Palliat Med, 2020 Mar 4, 23(8): 1013-1020
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  44. Community-Based Palliative Care Consultations: Comparing Dementia to Nondementia Serious Illnesses.
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    J Palliat Med, 2020 Jan 22, 23(8): 1021-1029
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  46. What's Happening at Home: A Claims-based Approach to Better Understand Home Clinical Care Received by Older Adults.
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  47. \I didn't know you were such a good cook\: Photos as a tool for primary care clinician-patient communication.
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    Patient Educ Couns, 2020 Nov 1, 104(6): 1356-1363
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  49. Inflammatory biomarkers and patient-reported outcomes in acute myeloid leukemia: Refocusing on older adults.
    Huang LW, Olin RL
    J Geriatr Oncol, 2020 Apr, 11(3): 395-398
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  50. Functional Status as Measured by Geriatric Assessment Predicts Inferior Survival in Older Allogeneic Hematopoietic Cell Transplantation Recipients.
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  51. \Goals of Care Conversations Don't Fit in a Box\: Hospice Staff Experiences and Perceptions of Advance Care Planning Quality Measurement.
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  52. Palliative Care in the Nursing Home-Shifting Paradigms.
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  53. Dual sensory impairment in older adults and risk of dementia from the GEM Study.
    Hwang PH, Longstreth WT Jr, Brenowitz WD, Thielke SM, Lopez OL, Francis CE, DeKosky ST, Fitzpatrick AL
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  54. Assessment of Potentially Inappropriate Prescribing of Opioid Analgesics Requiring Prior Opioid Tolerance.
    Jeffery MM, Chaisson CE, Hane C, Rumanes L, Tucker J, Hang L, McCoy R, Chen CL, Bicket MC, Hooten WM, Larochelle M, Becker WC, Kornegay C, Racoosin JA, Sanghavi D
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  55. Barriers and Solutions to Advance Care Planning among Homeless-Experienced Older Adults.
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    J Palliat Med, 2020 Mar 17, 23(10): 1300-1306
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  56. 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
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  57. School Closures During COVID-19: Opportunities for Innovation in Meal Service.
    Kinsey EW, Hecht AA, Dunn CG, Levi R, Read MA, Smith C, Niesen P, Seligman HK, Hager ER
    Am J Public Health, 2020 Nov, 110(11): 1635-1643
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  58. 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, 69(1): 20-29
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  59. Cancer Screening in Older Adults: Individualized Decision-Making and Communication Strategies.
    Kotwal AA, Walter LC
    Med Clin North Am, 2020 Nov, 104(6): 989-1006
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  60. Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic.
    Lam K, Lu AD, Shi Y, Covinsky KE
    JAMA Intern Med, 2020 Oct 1, 180(10): 1389-1391
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  61. Impact of the coronavirus disease 2019 pandemic on an academic vascular practice and a multidisciplinary limb preservation program.
    Lancaster EM, Wu B, Iannuzzi J, Oskowitz A, Gasper W, Vartanian S, Wick E, Hiramoto J, Eichler C, Lobo E, Reyzelman A, Reilly L, Sosa JA, Conte MS
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  62. A conceptual model for understanding the rapid COVID-19-related increase in food insecurity and its impact on health and healthcare.
    Leddy AM, Weiser SD, Palar K, Seligman H
    Am J Clin Nutr, 2020 Nov 11, 112(5): 1162-1169
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  63. Glycemic Over- and Undertreatment in VA Nursing Home Residents with Type 2 Diabetes: a Retrospective Cohort Study.
    Lederle L, Jing B, Rodriguez A, Hunt LJ, Lee SJ
    J Gen Intern Med, 2020 Jun, 35(6): 1900-1902
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  64. Improving the American Diabetes Association Framework for individualizing treatment in older adults: evaluating life expectancy.
    Lee AK, Steinman MA, Lee SJ
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  65. Patient and clinician perspectives on a patient-facing dashboard that visualizes patient reported outcomes in rheumatoid arthritis.
    Liu LH, Garrett SB, Li J, Ragouzeos D, Berrean B, Dohan D, Katz PP, Barton JL, Yazdany J, Schmajuk G
    Health Expect, 2020 Aug, 23(4): 846-859
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  66. Effectiveness of Advance Care Planning Group Visits Among Older Adults in Primary Care.
    Lum HD, Dukes J, Daddato AE, Juarez-Colunga E, Shanbhag P, Kutner JS, Levy CR, Sudore RL
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  67. 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, 12(4): 563-571
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  68. Comparative effectiveness of long-term acute care hospital versus skilled nursing facility transfer.
    Makam AN, Nguyen OK, Miller ME, Shah SJ, Kapinos KA, Halm EA
    BMC Health Serv Res, 2020 Nov 11, 20(1): 1032
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  69. Anxious, Depressed, and Planning for the Future: Advance Care Planning in Diverse Older Adults.
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  70. Dyadic Group Exercises for Persons with Memory Deficits and Care Partners: Mixed-Method Findings from the Paired Preventing Loss of Independence through Exercise (PLI?) Randomized Trial.
    Mehling WE, Scott TM, Duffy J, Whitmer RA, Chesney MA, Boscardin WJ, Barnes DE
    J Alzheimers Dis, 2020, 78(4): 1689-1706
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  71. 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
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  72. Evaluation of Neighborhood Socioeconomic Characteristics and Advance Care Planning Among Older Adults.
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  73. Supporting In-Home Caregivers in Symptom Assessment of Frail Older Adults with Serious Illness: A Pilot Study.
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    J Palliat Med, 2020 Dec, 23(12): 1631-1638
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  74. Patient characteristics associated with objective measures of digital health tool use in the United States: A literature review.
    Nouri SS, Adler-Milstein J, Thao C, Acharya P, Barr-Walker J, Sarkar U, Lyles C
    J Am Med Inform Assoc, 2020 May 1, 27(5): 834-841
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  75. Geriatric assessment in older alloHCT recipients: association of functional and cognitive impairment with outcomes.
    Olin RL, Fretham C, Pasquini MC, Arora M, Bhatt VR, Derman B, Giralt SA, Huang LW, Koll T, Lee SM, Lin RJ, Pang L, Popat UR, Weisdorf DJ, Artz A
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  76. Association Between Alzheimer Disease and Cancer With Evaluation of Study Biases: A Systematic Review and Meta-analysis.
    Ospina-Romero M, Glymour MM, Hayes-Larson E, Mayeda ER, Graff RE, Brenowitz WD, Ackley SF, Witte JS, Kobayashi LC
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  77. Perceptions and experiences of using mobile technology for medication adherence among older adults with coronary heart disease: A qualitative study.
    Park LG, Ng F, K Shim J, Elnaggar A, Villero O
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  78. Long-term individual and population functional outcomes in older adults with atrial fibrillation.
    Parks AL, Jeon SY, Boscardin WJ, Steinman MA, Smith AK, Fang MC, Shah SJ
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  79. Long-term individual and population functional outcomes in older adults with atrial fibrillation.
    Parks AL, Jeon SY, Boscardin WJ, Steinman MA, Smith AK, Fang MC, Shah SJ
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  80. Patient-Reported Use of the After Visit Summary in a Primary Care Internal Medicine Practice.
    Pathak S, Summerville G, Kaplan CP, Nouri SS, Karliner LS
    J Patient Exp, 2020 Oct, 7(5): 703-707
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  81. Moral distress and burnout in caring for older adults during medical school training.
    Perni S, Pollack LR, Gonzalez WC, Dzeng E, Baldwin MR
    BMC Med Educ, 2020 Mar 23, 20(1): 84
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  82. Expectations and Concerns of Older Adults With Cognitive Impairment About Their Relationship With Medical Providers: A Call for Therapeutic Alliances.
    Portacolone E, Covinsky KE, Johnson JK, Halpern J
    Qual Health Res, 2020 Aug, 30(10): 1584-1595
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  83. 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
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  84. Antegrade common femoral artery closure device use is associated with decreased complications.
    Ramirez JL, Zarkowsky DS, Sorrentino TA, Hicks CW, Vartanian SM, Gasper WJ, Conte MS, Iannuzzi JC
    J Vasc Surg, 2020 Nov, 72(5): 1610-1617.e1
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  85. Unintended Consequences of Opioid Regulations in Older Adults with Multiple Chronic Conditions.
    Ritchie CS, Garrett SB, Thompson N, Miaskowski C
    Gerontologist, 2020 Sep 15, 60(7): 1343-1352
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  86. Factors Associated with the Adoption and Closure of Hospital Palliative Care Programs in the United States.
    Rogers MM, Meier DE, Morrison RS, Moreno J, Aldridge M
    J Palliat Med, 2020 Oct 15, 24(5): 712-718
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  87. Understanding Experiences of Moral Distress in End-of-Life Care Among US and UK Physician Trainees: a Comparative Qualitative Study.
    Rosenwohl-Mack S, Dohan D, Matthews T, Batten JN, Dzeng E
    J Gen Intern Med, 2020 Oct 27
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  88. 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, 69(2): 349-356
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  89. \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
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  90. 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
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  91. 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
  92. 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: 21.75
  93. Association of Functional, Cognitive, and Psychological Measures With 1-Year Mortality in Patients Undergoing Major Surgery.
    Tang VL, Jing B, Boscardin J, Ngo S, Silvestrini M, Finlayson E, Covinsky KE
    JAMA Surg, 2020 May 1, 155(5): 412-418
    https://doi.org/10.1001/jamasurg.2020.0091 | PMID: 32159753 | PMCID: PMC7066523
    Citations: 1 | AltScore: 78.1
  94. 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: 5.45
  95. 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
  96. 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
  97. 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, 26(3): e435-e444
    https://doi.org/10.1002/onco.13527 | PMID: 32951293 | PMCID: PMC7930405
    Citations: | AltScore: 12.15
  98. Examining the Association of Social Determinants of Health with Missed Clinic Visits in Patients with Heart Failure in the Veterans Health Administration.
    Wray CM, Vali M, Byers A, Keyhani S
    J Gen Intern Med, 2020 May, 35(5): 1591-1592
    https://doi.org/10.1007/s11606-019-05507-4 | PMID: 31713034 | PMCID: PMC7210371
    Citations: | AltScore: 1.5
  99. Syndemic conditions and medication adherence in older men living with HIV who have sex with men.
    Zepf R, Greene M, Hessol NA, Johnson MO, Santos GM, John MD, Dawson-Rose C
    AIDS Care, 2020 Dec, 32(12): 1610-1616
    https://doi.org/10.1080/09540121.2020.1772954 | PMID: 32468831 | PMCID: PMC7784841
    Citations: | AltScore: NA
  100. Effects of Statins for Secondary Prevention on Functioning and Other Outcomes Among Nursing Home Residents.
    Zullo AR, Ofori-Asenso R, Wood M, Zuern A, Lee Y, Wu WC, Rudolph JL, Liew D, Steinman MA
    J Am Med Dir Assoc, 2020 Apr, 21(4): 500-507.e8
    https://doi.org/10.1016/j.jamda.2020.01.102 | PMID: 32144051 | PMCID: PMC7127965
    Citations: 1 | AltScore: 3.1
  101. Comparative Effectiveness of Angiotensin II Receptor Blockers and Angiotensin-Converting Enzyme Inhibitors in Older Nursing Home Residents After Myocardial Infarction: A Retrospective Cohort Study.
    Zullo AR, Riester MR, Erqou S, Wu WC, Rudolph JL, Steinman MA
    Drugs Aging, 2020 Oct, 37(10): 755-766
    https://doi.org/10.1007/s40266-020-00791-w | PMID: 32808250 | PMCID: PMC7530043
    Citations: | AltScore: NA


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)
Ashwin Kotwal, MD (2020)
  • New Investigator Award Health in Aging Foundation
  • Best Abstract, Epidemiology Section American Geriatrics Society Conference
Li-Wen Huang, MD (2020)
  • Clinician Specialists’ Rising Stars in Aging Research Mentoring Program
Sarah Nouri, MD, MPH (2020)
  • SGIM Finalist, Mack Lipkin Sr. Associate Member Scientific Presentation Award

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.
  • Linda Park, RN, PhD, FNP, Associate Professor
    UCSF RCMAR (Center for Aging in Diverse Communities or CADC) has been dedicated to eliminating health disparities in minority aging populations. Their goal is to support work that focuses on understanding health disparities and building and testing community-engaged interventions to reduce disparities among older adults. Like the UCSF Pepper Center, one of our most important missions is to train and mentor talented, underrepresented junior investigators to develop independent research careers focused on health disparities and aging issues. During this year, CADC and UCSF Pepper Center have provided joint support for the following project and investigator: Improving Health Disparities by Promoting Physical Activity Among Asian American Older Adults with Cardiovascular Disease: A Pilot Study Cardiovascular disease (CVD) is the leading cause of mortality, affecting 43.7 million older adults age 60 and over. To ameliorate this, cardiac rehabilitation (CR) is a highly effective, Class I level guideline-recommended 12-week group program that offers supervised physical activity (PA) after cardiac events (e.g., myocardial infarction, revascularization, valve replacement). It has been shown to improve physical function and decrease morbidity and mortality in older adults. Thus, maintaining PA after CR is essential in older adults to gain and maintain the critical benefits of improved physical function (balance, gait, strength, and endurance). PA maintenance after CR is also linked to reduced adverse geriatric outcomes such as falls and mobility impairment but thereby increases susceptibility to adverse secondary cardiac events, functional decline, and depression. Although it is estimated that minority individuals from diverse racial/ethnic backgrounds will comprise ~50% of the total U.S. population, minority older adults have more CVD burden than non-Hispanic Whites and have disproportionately lower rates of enrollment and adherence to CR (20% enrollment in Whites vs.8% in non-Whites). Asian Americans (AA) have been identified as a high-risk population for CVD based on genetic predisposition, coronary risk factor profile, and behaviors (e.g., PA and diet). In general, AA are less physically active than non-Hispanic Whites. Specific for CR participation, barriers may include cultural, socioeconomic, and linguistic challenges but it is unknown what the perceived barriers and facilitators are to continue PA behaviors after CR completion. Modifiable targets related to sustained PA may include depression and anxiety and slower self-efficacy, motivation, and social support. Tailored, accessible, and culturally appropriate interventions are urgently needed for AA older adults to promote sustained PA after CR to reduce future cardiac events. The objective of this mixed-methods proposal is to conduct a pilot study that will collect the critical data needed for a clinical trial to promote sustained PA through digital coaching after CR completion with a focus on improving physical function for AA older adults. This pilot work will reduce persistent health disparities that exist for ethnic minorities so we can target modifiable factors for sustained PA after CR. The under lying hypothesis is that there are distinct differences in barriers, facilitators, and preferences for interventions that aim to sustain PA after CR, thus requiring cultural tailoring for AA. My long-term career goal is to become a leading academic investigator who develops and tests behavioral interventions to improve older adults’ health and well-being with CVD. While the COVID-19 pandemic led to delays in the initiation of this project, work on this project has now resumed, and Dr. Park plans to complete the survey distribution and conduct individual interviews by June 2021. Dr. Park and her team are IRB approved to achieve the study aims.

Minority Grant(s):