Aging research is critically important for medicine and public health with the anticipated surge in the older population with the aging of the Baby Boom generation. Investigators within the Division are conducting studies designed to improve our understanding and management of acute and chronic health conditions among older adults, with the goal of promoting quality of life and functional independence. Below is a sampling of some of the ongoing work in the Division focused on aging and older adults.
Delirium, or acute confusion, is a common, morbid, and costly complication of acute hospitalization in older adults, with substantial negative impact on long term cognitive and physical functioning. Dr. Edward Marcantonio conducts research to improve our understanding of delirium in older hospitalized patients. He is developing and testing new interventions to prevent delirium during hospital stays, and to reduce its long term persistence and adverse sequelae after hospitalization. Dr. Sarinnapha Vasunilashorn also studies the biological basis of delirium, including its genetic and proteomic underpinnings.
Falls and Disability
Falls and disability are critical concerns for the older population. Dr. Suzanne Leveille's research examines causes and prevention of falls and disability, with particular attention to the problem of chronic musculoskeletal pain. Dr. Leveille is also developing and testing innovative interventions to improve self-management of chronic conditions, such as pain and disability in the ambulatory primary care setting.
Medical decision-making can be challenging in older adults. On one hand, given the increased morbidity associated with aging, medical interventions have a strong potential to improve quality of life and functional independence. On the other hand, each intervention must be considered in the context of the whole patient, who may have multiple co-morbidities, functional dependencies, and potentially, a shortened life span. Several researchers are conducting investigations within this context:
Dr. Mary Beth Hamel is studying decision-making about treatment for elderly patients with severe osteoarthritis of the hip or knee and clinical outcomes after joint replacement surgery. Dr. Mara Schonberg examines issues of breast cancer screening and treatment in older women, informing re-evaluations of current guidelines. Dr. Schonberg also conducts studies of other preventive health measures, such as exercise counseling, among older adults, and how to optimally target these measures to those who would most benefit.
Optimizing Medication Prescribing
Medications are among the most frequent interventions prescribed by internists. When used appropriately, they have great potential to benefit patients, but they also carry substantial risks. Dr. Shoshana Herzig's research focuses on optimizing medication use in the inpatient setting, a crucial issue for older adults and all hospitalized patients. Her work focuses on optimizing use of acid-suppressive medications among inpatients, including identifying risks and benefits. Dr. Tim Anderson studies the factors driving the prescription and de-prescription of medications, including physician and patient characteristics.