Geriatric Medicine & Palliative Care Current Research | NYU Langone Health

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The Michael L. Freedman Research Center on Aging, Technology & Cognitive Health Geriatric Medicine & Palliative Care Current Research

Geriatric Medicine & Palliative Care Current Research

Scientists at The Michael L. Freedman Research Center on Aging, Technology, and Cognitive Health collaborate with basic, translational, and clinical researchers from NYU Langone and other academic institutions on an array of research projects. Our goal is to support the prevention and treatment of cognitive disorders in aging and at the end of life; to improve chronic disease management using goal-concordant approaches; to influence healthcare policy through relevant health services studies; and to facilitate and leverage the career trajectories of other NYU Langone and NYU investigators.

Areas of Interest

Our researchers are assessing telehealth, therapies, care partner support, Alzheimer’s disease and related dementias, hearing loss, and the relationship between chronic conditions and cognitive function.

Telehealth

Our scientists are developing and testing novel strategies in telehealth to improve clinical and health service outcomes for affected patients and their families. One project involves building and testing a suite of telehealth strategies for reaching homebound and other clinically underrepresented groups with Alzheimer’s disease and related dementias.

Therapies

We are testing point-of-care therapies for patients with newly recognized cognitive disorders and their care partners to reduce unnecessary and potentially harmful medical care. In addition, we are developing novel nonpharmacological approaches for better brain health and cognitive function.

Hearing Loss

Our research team is investigating the relationship between hearing loss and acute care and the impact of hearing loss mitigation strategies on health service use and health status. We are identifying hearing impairment prevalence, assessing its relationship to cognitive impairment and adverse health outcomes, and testing the influence of mitigation strategies on adverse outcomes.

Chronic Conditions

We are evaluating primary care clinical practice interventions in diabetes and other chronic diseases and the interrelationship between chronic diseases and dementia.

Funded Research

Center scientists are engaged in cutting-edge, technologically supported interventions to address chronic conditions.

Alzheimer’s Disease and Related Dementias (ADRD) Research

Funded by the National Institute on Aging (NIA), the Engagement in Longevity and Medicine (ELM) project, co-led by Joshua Chodosh, MD, MSHS, Chau Trinh-Shevrin, DrPH, and Scott Sherman, MD, aims to establish a centralized research infrastructure that harnesses NYU Langone’s clinical and community partnerships throughout New York City to strengthen and advance the science of community engagement, recruitment, and retention in aging and Alzheimer’s disease and related dementias (ADRD) research. Innovative community-based approaches including the use of community health navigators, simulation training, and electronic medical record direct messaging to patients will engage, educate, and increase recruitment and retention of older age subjects for clinical trials and other aging research.

The Centers for Disease Control and Prevention (CDC) has named NYU Grossman School of Medicine a public health center of excellence as part of the CDC’s Alzheimer’s disease initiative. The initiative is part of the Building Our Largest Dementia (BOLD) Infrastructure for Alzheimer’s Act. NYU Grossman School of Medicine has been designated as the only CDC center focusing on the early detection of dementia in the country, and our center, under the leadership of Dr. Chodosh, will work closely with the CDC’s other two newly awarded national centers: one on dementia risk reduction (led by the Alzheimer’s Association) and one on dementia caregiving (led by the University of Minnesota). Center researchers will identify, translate, and disseminate promising research findings and evidence-informed best practices that address social determinants of health, and use a nationwide systematic public health uptake by state, local, tribal, and other public health programs.

Social Isolation in Older Adults

Led by Joshua Chodosh, MD, MSHS, and in collaboration with colleagues at SCAN Health Plan and the University of California, Los Angles (UCLA), Providing Hearing Assistance to Socially Isolated Older Adults in Los Angeles Communities (PHASE) seeks to test whether the use of hearing amplifiers among community-dwelling older adults who experience hearing impairment is associated with change in self-reported psychosocial measures including mood, anxiety, sense of social support, and loneliness. PHASE is funded by SCAN Health Plan.

Improving Sleep in Nursing Homes

VIDEO: Researchers at NYU Langone are studying health and environmental factors that affect sleep to develop strategies to improve the lives of nursing home residents and staff.

The National Institutes of Health (NIH) and National Institute of Nursing Research (NINR) are funding the study Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER). Led by Joshua Chodosh, MD, MSHS, this research is evaluating an educational program for nursing facility staff that teaches strategies for improving common sleep-related symptoms among residents. The study investigates whether the SLUMBER intervention improves nighttime sleep quality and resident-reported symptoms of poor sleep, depressed mood, anxiety, pain, and cognitive and physical function.

COVID-19 Serologic Strategies in Skilled Nursing Facilities

In response to the effect of the 2019 coronavirus disease (COVID-19) in nursing facilities nationwide, the NIA, through a supplement awarded to the IMPACT Collaboratory, is funding COVID-19 Serologic Strategies in Skilled Nursing Facilities (CERO) to rapidly plan and pilot test an intervention that leverages COVID-19 antibody and PCR status to pair skilled nursing facility staff with residents in the safest way possible. Specifically, project researchers will pair COVID-19 negative residents with antibody-positive (and PCR-negative) staff, and COVID-19 antibody positive (and PCR-negative) residents with antibody-negative staff. We will test whether this novel staff assignment strategy leads to a reduced COVID-19 incidence rate compared to skilled nursing facilities not using this approach. We anticipate that this pilot study will set the stage for a larger trial that will ultimately set evidence-based policy for skilled nursing facility staff–resident assignments that minimize the risk of acquiring COVID-19, and directly improve the care of millions of people with ADRD. Joshua Chodosh, MD, MSHS, will lead the study as principal investigator at NYU Langone, in collaboration with other experts from our institution.

Support in Emergency Departments for Older Adults and Their Care Partners

Joshua Chodosh, MD, MSHS, principal investigator, oversees the Program of Intensive Support in Emergency Departments for Care Partners of Cognitively Impaired Patients (POISED-CPCIP) study, funded by the NIH and National Institute on Aging (NIA). Researchers are evaluating whether a novel care management program for family care partners of patients with cognitive impairment can reduce recurrent emergency department use and increase caregiver activation, while also improving caregivers’ symptoms of depressed mood and anxiety.

The U.S. Department of Veterans Affairs (VA) Office of Research and Development is funding Hearing Impairment, Strategies, and Outcomes in Emergency Departments (Hear-VA). The study is assessing the benefit of hearing screening for emergency department patients and the impact of hearing assistive devices on ease of communication and preparation for discharge in individuals who have difficulty hearing. Dr. Chodosh leads this work with hearing experts Jan Blustein, MD, and Barbara L. Weinstein, PhD.

Care for Older Adults with Diabetes and Dementia

Funded by the NIH and NIA, Enhanced Quality in Primary Care for Elders with Diabetes and Dementia (EQUIPED-ADRD) is developing and testing a panel management program for older patients with diabetes and Alzheimer’s disease and related dementia (DM-ADRD) under the leadership of Joshua Chodosh, MD, MSHS. Caroline S. Blaum, MD, who formerly co-led this study, continues to provide her consultative expertise.

Our EQUIPED-ADRD research team reviewed the best possible evidence and formulated guidelines for treatment of adults with DM-ADRD, which were reviewed and approved by NYU Langone’s Clinically Integrated Network Quality Committee. These guidelines address many aspects of quality care for DM-ADRD patients, including screening for cognitive impairment in older DM patients with out-of-desired range of HbA1c or BP but no ADRD diagnosis; support; and treatment based on caregiver preferences.

A list of programs that provide community resources offering psychosocial support for patients with diabetes and dementia and their caregivers is also available:

These programs are available both within and outside of NYU Langone.

Individualized Care for Older Adults

Cardiovascular Disease (CVD) Risk and Outcome Heterogeneity in Older Adults with Diabetes, a study led by Hua Zhong, PhD, and funded by the NIH and NIA, seeks to provide evidence for individualizing care of older adults with prediabetes and diabetes by investigating their risks of CVD, its development, and subsequent disability.

Palliative Care and Kidney Disease

The National Kidney Foundation Young Investigator Award funds A Pilot Randomized-Controlled Trial of Integrated Palliative and Nephrology Care Versus Standard Nephrology. Researchers are investigating the impact of integrated palliative and nephrology care versus standard nephrology care on quality of life, symptom burden, and documentation of advance directives in patients with advanced chronic kidney disease not yet on dialysis. Jennifer S. Scherer, MD, a rising expert in renal palliative care and director of the Kidney CARES (Comprehensive Advanced Renal Disease and End Stage Renal Disease Support) Program at NYU Langone Nephrology Associates, leads this work.

Internal Research Partners

Collaborating with divisions, departments, and programs throughout NYU Langone and NYU broadens and strengthens research at the center.

Leon H. Charney Division of Cardiology

The Geriatric Cardiology Program in the Leon H. Charney Division of Cardiology pursues clinical studies in older patients with cardiovascular disease, many of whom have other underlying health conditions. Through research, our scientists address gaps in our understanding of best care practices for older adults with cardiovascular disease. Our investigators study trends in the use of cardiac procedures in seniors, as well as outcomes after cardiac interventions such as percutaneous coronary intervention, valve surgery, and implantation of cardioverter defibrillators.

Department of Neurology

The center partners with the Department of Neurology to conduct basic, translational, and clinical research on neurological diseases affecting cognition in the aging brain. We collaborate with scientists and clinicians at the Center for Cognitive Neurology, Pearl I. Barlow Center for Memory Evaluation and Treatment, Alzheimer’s Disease Center, New York State Center of Excellence for Alzheimer’s Disease, for which Joshua Chodosh, MD, MSHS, serves as program director of medical education, and Alzheimer’s Disease and Related Dementias Family Support Program, of which Dr. Chodosh is co-director.

NYU Aging Incubator

Academic leaders across NYU launched the NYU Aging Incubator in 2016 to bring together students and faculty who study aging. The mission of the incubator is to support the development of innovative and interdisciplinary research initiatives and educational programs that improve the health and wellbeing of the oldest segment of the population. Joshua Chodosh, MD, MSHS, is a co-director of this initiative, and Caroline S. Blaum, MD, is on the steering committee.

Department of Population Health

Faculty in the Department Population Health work closely with our center staff to conduct research on the care for older adults by community health workers, improved dementia prevention strategies, hearing, and smoking cessation, among other initiatives.

Department of Emergency Medicine

Our center faculty are studying cognitive impairment detection via pragmatic trials in the emergency departments of NYU Langone Hospital—Brooklyn and NYU Langone’s Tisch Hospital (see “Support in Emergency Departments for Older Adults and Their Care Partners” above for additional information). Another pragmatic trial of hearing loss is planned for the emergency departments of the VA NY Harbor Healthcare System, Brooklyn and Manhattan campuses, and five other facilities throughout the country. In the area of palliative care, our faculty lead NIH- and PCORI-level investigations.

Division of Endocrinology, Diabetes, and Metabolism

Center investigators are working closely with colleagues in the Division of Endocrinology, Diabetes, and Metabolism to develop guidance around care for joint comorbidity of diabetes and dementia. The plan is for this guidance to support primary care practices throughout NYU Langone.

Division of General Internal Medicine and Clinical Innovation

Close collaboration with colleagues in the Division of General Internal Medicine and Clinical Innovation strengthens our commitment to mentorship and education. Senior faculty in both divisions provide mentorship to junior faculty across specialties and wide-ranging interests, including community health centers, nutrition, and complex interventions. We partner on educational initiatives for both trainees and faculty, including career development and situational objective structured clinical examination (OSCE) in the New York Simulation Center for the Health Sciences. These longstanding collaborative efforts have culminated in the Engagement in Longevity and Medicine (ELM) study on recruitment and retention in clinical trials, which utilizes group objective structured clinical examination (GOSCE) training for research staff to build a model of best practices for recruiting ADRD patients.

External Research Partners

To promote resource sharing and multisite trials, we foster and maintain close collaborations with other academic institutions, including Indiana University; the University of California, Los Angeles; University of Minnesota; and The Graduate Center of The City University of New York. We also work closely with public health institutions including the Alzheimer’s Association, CaringKind, Department for the Aging in New York, and SCAN Health Plan.