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One Mission, One Goal: Veterans Health
Research News
Congratulations to Dr. Theresa Allison for her new NIH Award!
Congratulations to NCIRE-supported researcher Dr. Theresa Allison for receiving a NIH Award to support her research project titled “The impact of music on well-being after diagnosis with Alzheimer's disease or its related dementias”!
The project focuses on using music as a focal point to prospectively examine changes to a patient’s experience with dementia over time. It is believed that music’s role in supporting a sense of personal identity and social music activities translates to supporting dementia caregiving relationships, as well as a patient’s individual identity.
“This project is built on the belief that a new dementia diagnosis does not have to be terrible for either the people diagnosed or their family and close friends,” Allison said. “A new dementia diagnosis, adequately supported, can offer opportunities to figure out what is most important to us, to heal and support our relationships, and to find support in the community around us.”
But in order to do that, researchers need to understand how the diagnosis affects people and what sources of support help reinforce their personal identity, their social relationships and their place in the community, she explained.
Allison’s musical approach to dementia treatment is informed by her unique research background. She is a music anthropologist (ethnomusicologist) as well as a geriatric physician, with a Master of Music and a PhD in musicology as well as an MD.
As a geriatric physician and music anthropologist, Allison studies the role of music in daily life for older adults. This includes the impact of music on social well-being for older adults living in nursing home, the cognitive and social effects of singing in choirs, and the impact of everyday music activities for older adults living with dementia.
Currently, Allison’s research team is in the final months of a small, two-year longitudinal, observational study examining music in daily life in dementia caregiving relationships. For that study, researchers go into participants' homes to interview people living with dementia and their care partners and engage in usual music activities during those visits.
“We are learning about the different ways in which music and other favorite activities are used to support individual well-being and dementia caregiving relationships,” she said.
When asked of her future plans for the project, Allison said the study is designed to produce basic social science (observational) findings that can be used in two ways.
“First, it should produce the key information needed to the develop music-based research interventions that will have long-term impact on identity and social well-being as dementia progresses,” she said. “Second, these findings will be distributed to community-based organizations that provide dementia-related services so that they can develop innovative new services to support the abilities and identities of people living with dementia.”
NCIRE wishes Dr. Allison and her team the best of luck with their research endeavors!
Theresa Allison, MD, PhD is a Professor of Medicine and Family & Community Medicine with the University of California, San Francisco’s Division of Geriatrics, and a Staff Physician in Geriatrics with the Palliative and Extended Care Service Line at the San Francisco Veterans Affairs Health Care System.
Dr. Bruce Ovbiagele, 2023-2024 recipient of the W. Lester Henry Award for Diversity, Equity and Inclusion
Congratulations to Dr. Bruce Ovbiagele for being the 2023-2024 recipient of the W. Lester Henry Award for Diversity, Equity, and Inclusion!
This award is one of 23 awards bestowed by the American College of Physicians (ACP) for 2023-2024. Recipients of the W. Lester Henry Award are recognized for advancing diversity in medicine or research and/or access to care for diverse populations.
The ACP also bestowed 58 Masterships.
Bruce Ovbiagele, MD, MSc, MAS, MBA, MLS, is a vascular neurologist, clinical epidemiologist, and health equity scholar, with a focus on reducing the burden of stroke. He is Professor of Neurology and Associate Dean at UCSF, as well as Chief of Staff at SFVAHCS, and serves a Statuary Director on the NCIRE Board.
The American College of Physicians (ACP) is a diverse community of internal medicine specialists and subspecialists united by a commitment to excellence. Internal medicine physicians apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. With 161,000 members in countries across the globe, ACP is the largest medical-specialty society in the world. ACP and its physician members lead the profession in education, standard-setting, and the sharing of knowledge to advance the science and practice of internal medicine.
Dr. Dolores Shoback honored with Outstanding Scholarly Physician Award from the Endocrine Society
Please join NCIRE in celebrating Dr. Shoback and her prestigious achievement!
On August 14, the Endocrine Society announced the 14 leading endocrinologists as winners of its prestigious 2024 Laureate Awards, the top honors in the field.
Among those awarded was NCIRE-supported Principal Investigator Dolores Shoback, MD, who received the Outstanding Scholarly Physician Award, recognizing her outstanding contributions to the practice of clinical endocrinology in academic settings.
Dr. Shoback cares for patients who have endocrine disorders such as metabolic bone disease, parathyroid disorders and osteoporosis at the San Francisco Veteran Affairs Health Medical Center and the University of California San Francisco (UCSF). She is also the Associate Program Director of UCSF's physician training program in diabetes, endocrinology and metabolism.
Dr. Shoback’s research interests include metabolic bone disease, the calcium-sensing receptor and parathyroid hormone. She is a basic and clinical investigator who has made contributions to our understanding of metabolic bone diseases. She has been an effective educator of physicians and patients for three decades.
Since becoming an Endocrine Society member in 1987, Dr. Shoback has held several service positions, including Secretary-Treasurer of its Board of Directors and Chair of the Finance and Audit Committee. She has been the Co-Chair of The Journal of Clinical Endocrinology & Metabolism Working Group, a member of the Editor-in-Chief Search Committee for Endocrinology and a member of the Osteoporosis Clinical Practice Guideline Writing Committee.
Established in 1944, the Society’s Laureate Awards recognize the highest achievements in the endocrinology field, including groundbreaking research and innovations in clinical care. The Endocrine Society will present the awards to the winners at ENDO 2024 in Boston June 1 – 4.
With its beginnings in 1917, the Endocrine Society is a global community of physicians and scientists dedicated to accelerating scientific breakthroughs and improving patient health and well-being.
Read More: https://endocrinenews.endocrine.org/meet-the-2024-endocrine-society-laureates/
Dr. Bruce Ovbiagele honored with the inaugural American Academy of Neurology Health Care Equity Research Award and Lectureship
Please join NCIRE in celebrating our supported Principal Investigator and Board Member Dr. Bruce Ovbiagele who has received the inaugural American Academy of Neurology Health Care Equity Research Award and Lectureship!
Dr. Ovbiagele was honored with the award during the Health Care Equity Symposium, which took place as part of the Main Events at the American Academy of Neurology Annual Meeting in Boston, on April 24, 2023. He presented the lecture “Racial Disparities in Stroke: Metrics, Specifics, and Psycho-Socioeconomics’.
According to the American Academy of Neurology’s website, the award recognizes a neurologist or neuroscientist who has demonstrated their commitment to health equity and addressing health disparities through their clinical research, service, or leadership role.
Dr. Ovbiagele has been a member of the American Academy of Neurology since 1998 and serves as a Director on its Board.
Congratulations Dr. Ovbiagele for this inaugural achievement!
Bruce Ovbiagele, MD, MSc, MAS, MBA, MLS, is a vascular neurologist, clinical epidemiologist, and health equity scholar, with a focus on reducing the burden of stroke. He is Professor of Neurology and Associate Dean at UCSF, as well as Chief of Staff at SFVAHCS, and serves a Statuary Director on the NCIRE Board.
Incorporating Prognosis into Clinical Decision-Making for Older Adults with Diabetes
When it comes to diabetes, a patient’s prognosis of life expectancy and/or co-morbidities contribute to making sure treatments are not worse than the disease.
NCIRE-supported clinician-researcher Dr. Kenneth Covinsky co-wrote an editorial published in the Journal of General Internal Medicine that speaks to the vital role prognosis plays in guiding discussions between clinicians, patients, families, and caregivers around clinical decisions, such as diabetic care.
Quoted from the article: “Considerations around remaining life expectancy (LE) are particularly important in caring for older persons with diabetes. For example, the benefit of strict glycemic control in preventing vascular complications of type 2 diabetes is generally seen after several years. For older adults with diabetes and limited LE, intensive diabetes treatment using glucose-lowering medications exposes them to short-term harms and burdens with a potentially low likelihood of them surviving long enough to benefit from long-term glycemic control. One notable immediate harm is hypoglycemia, particularly with insulin and sulfonylureas, which can result in emergency department visits, hospitalizations, and cognitive decline.”
Kenneth E. Covinsky, MD, MPH is a clinician-researcher in the UCSF Division of Geriatrics. His research seeks to understand the factors that lead to disability in older persons and to improve the quality of life of those with older age disability and their caregivers. He holds the Edmund G. Brown, Sr. Distinguished Professorship in Geriatrics and is Principal Investigator of the UCSF Older Americans Independence Center.
Read more: https://link.springer.com/article/10.1007/s11606-023-08326-w
Dr. Michael Steinman contributed to Verywell Health article “Is It Time to Review the Medications You Take?”
NCIRE-supported Principal Investigator Dr. Michael Steinman contributed to the August 2, 2023 Verywell Health article “Is It Time to Review the Medications You Take?”, advocating for deprescribing excessive medication in older populations.
“A review of all the drugs you take—including over-the-counter products and supplements—can help your doctor determine the ones you need, the ones you don’t, best doses and also whether there are new and better drugs that might be good choices for you,” Steinman said.
Some examples of reasons to assess medication intake: patient was prescribed a short-term drug yet received no instructions of when to stop; patient was prescribed medication that may interact with an existing prescription of which a provider has no knowledge; patient’s medical condition may be resolved, and medication is no longer needed.
Such steps can help mitigate the adverse effects of over-prescribing and could very well save your life.
Learn More: https://www.verywellhealth.com/is-it-time-to-review-the-medications-you-take-7568542
Disparities in advance care planning among older US immigrants
While racial disparities in Advanced Care Planning (ACP) are known, NCIRE-supported researchers Drs. Rebecca Sudore and Alexander Smith sought to discover what disparities may be experienced by United States immigrants.
Their findings are featured in the co-authored study “Disparities in advance care planning among older US immigrants”, published in the Journal of the American Geriatrics Society.
The research team used data from the 2016 Health and Retirement Study, and defined ACP engagement as self-reported end-of-life discussions, designation of a power of attorney, documented living will, or “any” of the three behaviors. Immigration status was determined by respondent-reported birth outside the United States. Time in the United States was calculated by subtracting the year of arrival in the U.S. from the 2016 survey year.
Sudore, Smith, and their colleagues found that compared to US-born older adults, ACP engagement was lower for U.S. immigrants, particularly for those that recently immigrated. The group advocates future studies to explore ACP needs in the geriatric immigrant population and ways to address disparities in care.
Rebecca Sudore, MD is a Staff Physician, Geriatrics Service with the SF VA Health Care System, and Professor of Medicine at UCSF.
Alexander Smith, MD, MS, MPH is a Staff Physician with the SF VA Health Care System, and Associate Professor of Medicine at UCSF. He co-developed ePrognosis, an online guide for older patients seeking to determine if they should be screened for cancer.
Read More: https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.18498
Dementia Risk and Disadvantaged Neighborhoods
In a recent co-authored study, NCIRE Supported scientist and Board Member Dr. Kristine Yaffe and her colleagues sought to answer the question: “Is there a difference in dementia incidence among Veterans Health Administration enrollees by neighborhood disadvantage as assessed by the Area Deprivation Index?”
Published in the Journal of the American Medical Association’s JAMA Neurology, the cohort study used a random sample of more than 1.6 million Veterans Health Administration (VHA) patients aged 55 years or older, who received care from the VHA between October 1999 and September 2021. Eligible participants also had to have had at least one visit and no diagnosis of prevalent Alzheimer disease and related dementias (ADRD) in the two years prior to their inclusion in the study and at least one follow-up visit.
To date, it is the largest study of its kind that combined health, demographic, and geographic data to paint a more complete and representative picture of dementia risk factors among older adults in relation to their socioeconomic environment.
The findings of the studies suggest that one’s socioeconomic environment does have a significant impact on one’s health; and that those living in socioeconomically disadvantaged neighborhoods are at higher risk of developing late-life cognitive impairment, resulting in increased risk for ADRD.
Dr. Yaffe discussed the findings of her co-authored study as part of JAMA Neurology's podcast series JN Learning. You may listen to it here: https://edhub.ama-assn.org/jn-learning/audio-player/18800154
To read the study article in full visit the JAMA Neurology site here: https://jamanetwork.com/journals/jamaneurology/fullarticle/2806622
The University of California San Francisco’s Weill Institute for Neurosciences also provides a brilliant write-up of the study here: https://psychiatry.ucsf.edu/news/study-finds-possible-link-between-disadvantaged-neighborhoods-and-dementia-risk
Kristen Yaffe, MD is Director of NeuroPsychiatry and Director of the Memory Evaluation Clinic at SFVAHCS. She is also the Scola Endowed Chair and Vice Chair, Professor of Psychiatry, Neurology, and Epidemiology, and Director of the Center for Population Brain Health at UCSF, and NCIRE Board Member.