Principal Investigators, Drs. Michael Steinman and John Boscardin, co-authored a study that investigates the association between lower socioeconomic status and increased potentially inappropriate medications among older adults, as seen in some studies, is infrequently studied in persons with dementia.

The study was published in the Journal of American Geriatrics Society.

You can read it here: https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19585

Dr. Steinman was also quoted The Washington Post article “Taking too many prescription drugs can be very risky for older people”, discussing the challenges and dangers of polypharmacy in older adults.

You can read it here: https://www.washingtonpost.com/health/2025/06/29/polypharmacy-old-people-risks/

The global shortage of Geriatricians poses a dilemma: older adults are living longer, often with multiple chronic conditions, but the workforce of specialists in Geriatrics remains insufficient.

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Principal Investigator, Dr. Sei Lee, discussed this issue in an editorial he co-authored titled, “Geriatricians: Maximizing Impact Now While Aiming for a Stronger Future”, in the Journal of the American Geriatrics Society.

In May, Principal Investigator, Dr. Kenneth Covinsky, spoke on a panel at the 2025 California Academic Institutions (CAGI) Conference in Irvine, CA about the future of Geriatrics research programs.

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One aspect of that future is the likelihood of patient requests to test for Alzheimer disease to become more common in primary care due to the advent of blood-based biomarkers. Dr. Covinsky cautions about this future in the editorial he co-authored in the Journal of the American Medical Association - Internal Medicine titled, “The Limited Role of Alzheimer Disease Blood-Based Biomarkers in Primary Care”.

Principal Investigator, Dr. Duygu Tosun-Turgut, co-published the study titled, “Timing of Changes in Alzheimer's Disease Plasma Biomarkers as Assessed by Amyloid and Tau PET Clocks”, which presents new Alzheimer’s research exploring whether blood tests can reveal not just the presence of brain changes related to the disease but also when they begin and how they progress.

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Study results from the Foundation for the National Institutes of Health’s Plasma Aβ project, published in Annals of Neurology, demonstrate that only one blood biomarker becomes abnormal very early, while others show up later and can be used to reliably track disease stage and progression. The findings suggest that blood tests could be used to enhance clinical trial design, guide treatment strategies, and ultimately improve outcomes for patients.

Women experience differential risk for childhood trauma and posttraumatic stress disorder (PTSD) when compared to men. Recent research has indicated lasting effects of childhood trauma across the lifespan and a bidirectional relationship between gonadal hormones like anti-Müllerian hormone (AMH) and PTSD that may help explain sex differences in PTSD. However, there is little data to support this hypothesized relationship, the potential direction of this relationship, or its effect in women and men across a large age range.  #MentalHealth #PTSD #Research #WomensHealth #Science

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Principal Investigator Dr. Sabra Inslicht and researcher Dr. Shira Maguen examined this hypothesis in the co-published study titled “Low anti-Müllerian hormone mediates the association between childhood trauma and PTSD in women but not in men”. Dr. Inslicht is the Senior Author of the study, co-written by Dr. Shane W. Adams.

Congratulations to Principal Investigators, Drs. Alexander K. Smith and Sei Lee for being honored at the UC San Francisco Department of Medicine’s 27th Annual Holly Smith Dinner and Faculty Awards!

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The Lloyd Holly Smith Award for Exceptional Service to the School of Medicine was established in 2000 to recognize exceptional career service that has resulted in broad and long-lasting benefit to the School of Medicine. The award is named for Lloyd H. (Holly) Smith, Jr., whose 35-year career as chair of medicine and associate dean exemplified such an outstanding career effort.

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Dr. Smith also received the 2025 Excellence in Faculty Advising Award from the Training in Clinical Research Program at its End of Year Celebration in May.

NCIRE Board Members, Drs. Louise C. Walter and Salomeh Keyhani, co-published the study titled “Cannabis Use Among Older Adults” with their fellow NCIRE-supported Principal Investigators Drs. Beth E. Cohen, Emily Lum, Katherine J. Hoggatt, and Amy L. Byers.

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The research team found that use was common, and more than one-third who used in the past 30 days had any Cannabis Use Disorder (CUD). The prevalence of past 30-day cannabis use was close to tobacco use prevalence, and risk factors for cannabis use were similar to those observed in other populations. Frequent and inhaled cannabis use was associated with higher odds of any CUD. Routine health screening for cannabis use in Veterans Health Administration clinical settings is necessary to identify older adults with cannabis use.

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These findings are published on May 14, 2025 in the JAMA Network Open.

NCIRE-supported Principal Investigator, Dr. Rebecca Sudore, co-published the study “‘They Were Talking to Each Other but Not to Me’: Examining the Drivers of Patients' Poor Experiences During the Transition From the Hospital to Skilled Nursing Facility” in the journal Health Expectations.

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NCIRE-supported researchers, Dr. Sabra Inslicht, and NCIRE Board Member, Dr. Thomas C. Neylan, co-published the study in Psychoneuroendocrinology, the official journal of the International Society of Psychoneuroendocrinology.

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Exciting new research has identified PACAP38 as a sex-specific marker for PTSD, with significant implications for women. This study, titled “PACAP associated with precise PTSD and fear extinction response in women”, found distinct PTSD symptoms and fear extinction impairments linked to higher PACAP38 levels. These insights pave the way for more tailored PTSD treatments and further research.

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Dr. Inslicht is the Principal Investigator and Senior Author of the study, co-written by Dr. Shane W. Adams.

NCIRE-supported researchers, Dr. John Boscardin and NCIRE Board Member Dr. Kristine Yaffe, co-published a study that investigated geographic differences in dementia incidence across the US among older adults enrolled in the Veterans Health Administration (VHA) system.

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The study, titled “Regional Differences in Dementia Incidence Among US Veterans”, was published by JAMA Neurology.

Dementia often goes undetected in hospital settings, where cognitive assessments are challenging due to illness severity and delirium.

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NCIRE-supported researcher, Dr. Kenneth Covinsky, co-published the study titled “Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant-Based Clinical Dementia Rating”.

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The study aimed to evaluate the accuracy of the Clinical Dementia Rating (CDR), based solely on knowledgeable informant reports, for detecting preexisting dementia and cognitive impairment in hospitalized patients compared to a gold-standard diagnosis; and compare its performance to the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16).

NCIRE congratulates Principal Investigator, Dr. Rebecca Sudore, for receiving the UCSF Founders Day Award for Exceptional Public Service.  This award honors her decades-long dedication to ensuring that every person has a voice in their healthcare. Dr. Sudore's PREPARE program was developed out of a deep passion to empower patients and their caregivers to obtain and understand medical information and to make informed medical decisions.​

NCIRE congratulates its supported Principal Investigator, Dr. Lynn Pulliam, for receiving a Lifetime Achievement Award on June 6, 2025, at the International Society for Neurovirology (ISNV) meeting in Denver, Colorado. The award recognized Dr. Pulliam for her exceptional contributions and unwavering dedication to the ISNV community throughout the years. 

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She was a founding member of the ISNV in 1998, has served as its President and was Co-Chair of the Meetings Committee for the past 13 years.  In 2019, she received the Pioneer in NeuroVirology award for her outstanding individual research achievement in the field of neurovirology. Dr. Pulliam’s research has focused on HIV and COVID-19 neuroimmunology, biomarkers of HIV neurocognitive impairment and neuro LongCOVID and their effects on aging.

NCIRE-supported researchers Drs. Sabra Inslicht, Aoife O’Donovan, and NCIRE Board Member, Dr. Thomas C. Neylan, co-published the study “PACAP a mediator of inflammation following trauma exposure and mild traumatic brain injury: Differential effects in males and females”.

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The study investigated sex differences in the association between neuroendocrine (pituitary adenylate cyclase-activating polypeptide [PACAP]) and inflammatory markers following lifespan trauma exposure, PTSD, and mTBI in 71 trauma-exposed veteran and non-veteran males (n = 41) and females (n = 30). 

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The study was published in the Psychoneuroimmunology Research Society journal Brain, Behavior, and Immunity. Dr. Inslicht is the Senior Author and Principal Investigator of the study, co-written by Dr. Shane W. Adams.

NCIRE-supported Principal Investigator and Board Member, Dr. Kristine Yaffe, was part of a select group of global leaders in dementia and cognitive aging research invited to participate in "The Memory: A Symposium Addressing the Opportunities and Challenges of an Aging Global Population," a symposium focusing on brain health organized at the request of the late Pope Francis. The event took place May 9-10, 2025, at the Palazzo San Calisto in Vatican City.

NCIRE-supported researcher, Dr. Shira Maguen, was recently awarded the 2025 International Society for Traumatic Stress Studies Robert S. Laufer, PhD, Memorial Award for Outstanding Scientific Achievement! 

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Dr. Maguen is the Mental Health Director of the Post-9/11 Integrated Care Clinic and Staff Psychologist on the Posttraumatic Stress Disorder Clinical Team (PCT) at the San Francisco VA Health Care System (SFVAHCS). She is also a Professor in the Department of Psychiatry and Behavioral Sciences in the UCSF School of Medicine. 

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Dr. Maguen received this award based on her scientific achievements which have advanced knowledge in the field of traumatic stress, the originality and significance of these achievements, and the impact of these achievements on the field of traumatic stress.

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NCIRE congratulates Dr. Maguen in this important recognition!

Drs. Michael Steinman, W. John Boscardin, and Alexander K. Smith were part of the research team that co-authored the study titled “Continued Use of Cholinesterase Inhibitors and Memantine in Hospice”, which assessed the prevalence of continued use of cholinesterase inhibitors and memantine, identified predictors of continuation, and identified payment sources (hospice agency or Part D) for Medicare beneficiaries admitted to hospice for dementia.

NCIRE Board Member, Dr. Salomeh Keyhani, joined fellow NCIRE-supported Principal Investigators Drs. Amy L. Byers, Carolyn J. Gibson, Beth E. Cohen and Anita S. Hargrave in co-authoring the study titled “Sexual Trauma, Suicide, and Overdose in a National Cohort of Older Veterans”.

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Published in the Annals of Internal Medicine, the longitudinal cohort study set out to determine the association between military sexual trauma and risk for suicide, overdose, and related mortality among older men and women at specific age landmarks and to investigate whether posttraumatic stress disorder modifies risk.​

NCIRE-supported Principal Investigators Drs. Alexander K. Smith and W. John Boscardin, co-authored the study, “Hospice Use Among Medicare Beneficiaries With Parkinson Disease and Dementia With Lewy Bodies”.

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Published in the Journal of the American Medical Association (JAMA) Network Open, the study centered on the objective to compare patient characteristics, hospice agency characteristics, and patterns of use for beneficiaries with Parkinson disease and Lewy Body Dementia versus those with Alzheimer disease.​

Moral injury affects a variety of populations who make ethically complex decisions involving their own and others' well-being, including combat veterans, healthcare workers, and first responders. Yet little is known about occupational differences in the prevalence of morally injurious exposures and outcomes in nationally representative samples of such populations.

In a recent study led by NCIRE-supported Principal Investigator, Dr. Shira Maguen, researchers examine the prevalence of potentially morally injurious event (PMIE) exposure and clinically meaningful moral injury in three high-risk groups.

On May 13th NCIRE CEO Rebecca Rosales had the pleasure to attend the VA Research Week kick-off ceremonial event with Deputy Secretary, Veterans Affairs Paul R. Lawrence, PhD at the VA Headquarters in Washington, D.C. This year the VA celebrated the 100th Anniversary of VA Research. The ceremony recognized 6 extraordinary VA Researchers.

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A recent study of NCIRE-supported Principal Investigator, Dr. Mehrdad Arjomandi, was cited in the Annals of the American Thoracic Society in an editorial titled “Lung Volumes in Smokers without COPD – A Pointer to Disease Development?”

The article cited Dr. Arjomandi’s November 2024 study titled “Phenotypes and Trajectories of Tobacco-exposed Persons with Preserved Spirometry: Insights from Lung Volumes”.

Read the editorial here: https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202502-146ED

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Read the study here: https://pubmed.ncbi.nlm.nih.gov/39586032/

NCIRE-supported Principal Investigators, Drs. Theresa Allison, Deborah Barnes, Kenneth Covinsky, and Alexander K. Smith, co-published a study in the Journal of Applied Gerontology concerning the lived experiences of spouses and partners providing dementia care at home.

The article, titled “I Aim to Fulfill My Promise”: Dementia Caregiving from the Perspective of Spouses and Partners “, explores the challenges and bright spots of dementia caregiving within relationships of up to 60 years.

NCIRE-supported Principal Investigator, Dr. Rebecca Sudore, is collaborating with the San Francisco Palliative Care Work Group on a 2024-2025 PCORI Dissemination Award. The project aims to empower the city’s Latinx Community members to engage in high-quality advance care planning, aligning healthcare with their wishes and values and reducing the decision-making burden on families and caregivers. This goal will be achieved by developing, implementing, evaluating, and disseminating a culturally tailored train-the-trainer program. Catholic Charities, Centro Latino de San Francisco, Family Caregiver Alliance, the Latino Task Force, Mission Neighborhood Centers, Mission YMCA, On Lok 30th Street Senior Center, and San Francisco In-Home Supportive Services (IHSS) Public Authority will be critical partners for this work.

Congratulations to NCIRE-supported Principal Investigator, Dr. Sei Lee, who was recently selected as one of three inaugural recipients of the San Francisco Campus for Jewish Living (SFCJL) Research Scholars program. As part of this program, Dr. Lee will be the Interim Director for Research at the SFCJL, working to enhance research opportunities at the organization, formerly known as "The Jewish Home".

On January 7, 2025, NCIRE-supported cardiology Principal Investigator, Dr. Joseph Yang, performed the first ever percutaneous coronary intervention in the Northern California VA Health Care System at the Mather VA Hospital, in conjunction with the cardiac catheterization laboratory team led by Drs. Amogh Bhat and Marty Denny.

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Dr. Yang and his fellow NCIRE-supported colleague, Dr. Jeffrey Zimmet, from San Francisco VA have been collaborating with the cardiac catheterization team at Mather VA to further expand care for veterans in the region. Additionally, by strengthening the clinical collaboration with their colleagues in the Northern California VAHCS, the ongoing research efforts will be further expanded with enrollment in clinical trials at SFVA.

Congratulations to NCIRE-supported Principal Investigator, Dr. Alexander K. Smith, for receiving the Award for Excellence in Scientific Research in Palliative Care at the Annual Assembly of Hospice and Palliative Medicine in Denver, on Saturday February 8th.  Dr. Smith regaled the audience with a song during his acceptance speech, which you can view online here: https://www.youtube.com/watch?v=BF2KxAzjxK8

Congratulations to NCIRE-supported Principal Investigator, Dr. Duygu Tosun-Turgut, for her induction into the 2025 Class of the American Institute for Medical and Biological Engineering (AIMBE) College of Fellows at its induction ceremony on March 31st!

Election to the AIMBE College of Fellows is among the highest professional distinctions granted to medical and biological engineers, comprised of the top two percent of engineers in these fields. College membership honors those who have made outstanding contributions to "engineering and medicine research, practice, or education” and to "the pioneering of new and developing fields of technology, making major advancements in traditional fields of medical and biological engineering or developing/implementing innovative approaches to bioengineering education."

Dr. Karen Seal is the Chief of Integrative Health and serves as the Medical Director of the Integrated Pain Team (IPT), an interdisciplinary clinic model first established at the San Francisco VA Health Care System (SFVAHCS) for Veterans with chronic pain and opioid dependence.

NCIRE-supported Principal Investigator and Board Member, Dr. Karen Seal is the senior author of the article in JAMA titled, “Care Models to Improve Pain and Reduce Opioids Among Patients Prescribed Long-Term Opioid Therapy: The VOICE Randomized Clinical Trial”. In the VOICE trial—among 820 veterans at 10 VA sites across the country—the SFVAHCS IPT model consisting of a medical provider with expertise in pain management, a pain pharmacist, and pain psychologist was equally effective as another care model (Pharmacist Collaborative Management) in reducing pain and opioid dosage in Veterans. The SFVAHCS IPT clinic is staffed by Elizabeth Gregg, NP (Clinical Director); Kim Banks, NP; Donovan Jenkins, NP; Erin Watson, PsyD; Payal Mapara, PsyD; Cecelia Bess, PhD; Emily Yao, Pharm D; and Nisha Iyer, Pharm D. Other VOICE IPT clinicians were Christina Tat, Pharm D; Sara Librodo, Pharm D; Elizabeth Son, Pharm D; and Caitlin Garvey, NP.

The article was also co-authored by NCIRE-supported Principal Investigators Drs. Jennifer Manual, Brian Borsari, Natalie Purcell, and Ellen Herbst.

NCIRE-supported Principal Investigators Drs. Natalie Purcell, Shira Maguen, Jennifer Manuel, and Board Member Dr. Karen Seal co-published the following articles concerning the impact of COVID-19 on the relationships between health care workers, their patients, and their workplace.:

“When clinicians and patients disagree on vaccination: what primary care clinicians can learn from COVID-19-vaccine-hesitant patients about communication, trust, and relationships in healthcare” (Purcell, Seal, Maguen) https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02665-1

“Moral injury and mental health in healthcare workers are linked to organizational culture and modifiable workplace conditions: Results of a national, mixed-methods study conducted at Veterans Affairs (VA) medical centers during the COVID-19 pandemic” (Purcell, Seal, Manuel) https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000085

NCIRE-supported Principal Investigator, Dr. Alexander K. Smith, co-published "By the Time We Knew …”: Poetic Analysis of End-of-Life Caregiving Experiences for Rapidly Progressive and Slower-Duration Dementia Syndromes in the Journal of the American Geriatric Society (JAGS).

This secondary qualitative analysis compares end-of-life experiences for caregivers of decedents with different dementia subtypes. It includes 10 poems whittled from interview transcripts and a new conceptual model of dementia end-of-life experience. The interdisciplinary team includes former MSTAR students, postdocs, GBHI Atlantic Fellows, and faculty colleagues across UCSF and the U.S.

NCIRE Board Member, Dr. Louise C. Walter, and her fellow NCIRE-supported investigators, Drs. John Boscardin, Sei J. Lee, Kenneth E. Covinsky, and Alexander K. Smith join a research team to investigate whether the Walter Index predicts posthospitalization mortality in older adults outside the U.S.

The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear. The research team evaluates the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.

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Deception is a universal human behavior. Yet longstanding skepticism about the validity of measures used to characterize the biological mechanisms underlying deceptive behavior has relegated such studies to the scientific periphery.

NCIRE-supported Principal Investigator, Dr. Andrew Kayser, and his colleagues dive into the fringe by applying machine learning methods and functional magnetic resonance imaging (fMRI) to measure human deception.

In 2024, NCIRE-supported Principal Investigator, Dr. Judith Ford, had the bittersweet honor to fulfil the role of Dr.  Herbert Pardes, founding president of Brain & Behavior Research Foundation’s (BBRF) Scientific Council, after his passing in April of last year. With the esteemed support of the BBRF Board, Dr. Ford was selected to lead her council colleagues into its new chapter.

The Winter 2025 issue of BBRF’s magazine Brain & Behavior introduces the new BBRF Scientific Council President, Dr. Judith Ford, in its BBRF Leadership story here: https://bbrfoundation.org/sites/default/files/bb-magazine-february-2025_0.pdf

The Northern California Institute for Research and Education, Inc. (NCIRE) is excited to welcome new Board members, Drs. Salomeh Keyhani and Karen Seal, to its Board of Directors!

Dr. Salomeh Keyhani is a Professor of Medicine at the University of California, San Francisco (UCSF), and Staff Physician and Investigator at the San Francisco VA Health Care System (SFVAHCS). She is also the Director of the Center for Data to Discovery and Delivery Innovation (3DI), a VA-funded Center of Innovation focused on improving health and health care delivery.

Dr. Karen Seal is the Service Chief of Integrative Health at SFVAHCS, and Professor of Medicine and Psychiatry in Residence at UCSF. She serves in leadership roles with the 3DI Center for Innovation and NCIRE’s Women Veterans Research Collaborative, through which she is mentoring the next generation of health services researchers.

The Northern California Institute for Research and Education, Inc. (NCIRE) is excited to endorse our supported Principal Investigators (PIs), Drs. Karen Seal and Carolyn Gibson, in their creation of the Women Veterans Research Collaborative!

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The Women Veterans Research Collaborative (WVRC) is a women-led team of health services clinician researchers and project management staff focused on advancing comprehensive, trauma-informed health care for women Veterans. WVRC specializes in priority areas for women Veterans like chronic pain, PTSD, opioid dependence, menopause-related health, sleep disorders, and complementary and integrative health interventions, spearheaded by WVRC’s nationally recognized experts.