Geriatrics Commons^™

Smartboot: Real-Time Monitoring Of Patient Activity Via Remote Edge Computing Technologies, Gozde Cay, Myeounggon Lee, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high recurrence and amputation rates. Adherence to offloading devices is critical for wound healing but remains inadequately monitored in real-world settings. This study evaluates the SmartBoot edge-computing system-a wearable, real-time remote monitoring solution integrating an inertial measurement unit (Sensoria Core) and smartwatch-for its validity in quantifying cadence and step count as digital biomarkers of frailty, and for detecting adherence. Twelve healthy adults wore two types of removable offloading boots (Össur and Foot Defender) during walking tasks at varied speeds; system outputs were validated against a gold-standard wearable and …

Integrative Spatial Omics Reveals Distinct Tumor-Promoting Multicellular Niches And Immunosuppressive Mechanisms In Black American And White American Patients With Tnbc, Qian Zhu, Akhila Balasubramanian, Jaya Ruth Asirvatham, Megha Chatterjee, Badrajee Piyarathna, Jaspreet Kaur, Nada Mohamed, Ling Wu, Stacy Wang, Niloufar Pourfarrokh, Paula Danika Binsol, Mahak Bhargava, Uttam Rasaily, Yitian Xu, Junjun Zheng, Deborah Jebakumar, Arundhati Rao, Carolina Gutierrez, Angela R Omilian, Carl Morrison, Gokul M Das, Christine Ambrosone, Erin H Seeley, Shu-Hsia Chen, Yi Li, Eric Chang, Xiaoxian Li, Elizabeth Baker, Ritu Aneja, Xiang H-F Zhang, Arun Sreekumar

Center on Aging Staff Publications

Racial disparities in the clinical outcomes of triple-negative breast cancer (TNBC) have been well-documented, but the underlying biological mechanisms remain poorly understood. To investigate these disparities, we employed a multi-omic approach integrating imaging mass cytometry and spatial transcriptomics to characterize the tumor microenvironment (TME) in self-identified Black American (BA) and White American (WA) TNBC patients. Our analysis revealed that the TME in BA patients is marked by a network of endothelial cells, macrophages, and mesenchymal-like cells, which correlates with reduced patient survival. In contrast, the WA TNBC microenvironment is enriched in T-cells and neutrophils, indicative of T-cell exhaustion and suppressed …

The Somatic Mosaicism Across Human Tissues Network, Tim H H Coorens, Ji Won Oh, Yujin Angelina Choi, Nam Seop Lim, Boxun Zhao, Adam Voshall, Alexej Abyzov, Lucinda Antonacci-Fulton, Samuel Aparicio, Kristin G Ardlie, Thomas J Bell, James T Bennett, Bradley E Bernstein, Thomas G Blanchard, Alan P Boyle, Jason D Buenrostro, Kathleen H Burns, Fei Chen, Rui Chen, Sangita Choudhury, Harsha V Doddapaneni, Evan E Eichler, Gilad D Evrony, Melissa A Faith, Thomas G Fazzio, Robert S Fulton, Manuel Garber, Nils Gehlenborg, Soren Germer, Gad Getz, Richard A Gibbs, Raquel G Hernandez, Fulai Jin, Jan O Korbel, Dan A Landau, Heather A Lawson, Niall J Lennon, Heng Li, Yan Li, Po-Ru Loh, Gabor Marth, Michael J Mcconnell, Ryan E Mills, Stephen B Montgomery, Pradeep Natarajan, Peter J Park, Rahul Satija, Fritz J Sedlazeck, Diane D Shao, Hui Shen, Andrew B Stergachis, Hunter R Underhill, Alexander E Urban, Melissa W Vondran, Christopher A Walsh, Ting Wang, Tao P Wu, Chenghang Zong, Eunjung Alice Lee, Flora M Vaccarino

Center on Aging Staff Publications

From fertilization onwards, the cells of the human body acquire variations in their DNA sequence, known as somatic mutations. These postzygotic mutations arise from intrinsic errors in DNA replication and repair, as well as from exposure to mutagens. Somatic mutations have been implicated in some diseases, but a fundamental understanding of the frequency, type and patterns of mutations across healthy human tissues has been limited. This is primarily due to the small proportion of cells harbouring specific somatic variants within an individual, making them more challenging to detect than inherited variants. Here we describe the Somatic Mosaicism across Human Tissues …

Enzyme-Independent Functions Of Hdac3 In The Adult Hear, Sichong Qian, Chen Zhang, Wenbo Li, Shiyang Song, Guanqiao Lin, Zixiu Cheng, Wenjun Zhou, Huiqi Yin, Yueli Wang, Haiyang Li, Ying H Shen, Zheng Sun

Center on Aging Staff Publications

The cardioprotective effects of histone deacetylase (HDAC) inhibitors (HDIs) are at odds with the deleterious effects of HDAC depletion. Here, we use HDAC3 as a prototype HDAC to address this contradiction. We show that adult-onset cardiac-specific depletion of HDAC3 in mice causes cardiac hypertrophy and contractile dysfunction on a high-fat diet (HFD), excluding developmental disruption as a major reason for the contradiction. Genetically abolishing HDAC3 enzymatic activity without affecting its protein level does not cause cardiac dysfunction on HFD. HDAC3 depletion causes robust downregulation of lipid oxidation/bioenergetic genes and upregulation of antioxidant/anti-apoptotic genes. In contrast, HDAC3 enzyme activity abolishment causes …

Muscle Rev-Erb Controls Time-Dependent Adaptations To Chronic Exercise In Mice, Jidong Liu, Fang Xiao, Abhinav Choubey, Udhaya Kumar S, Yanxiang Wang, Sungguan Hong, Tingting Yang, Husniye Gul Otlu, Ege Sanem Oturmaz, Emanuele Loro, Yuxiang Sun, Pradip Saha, Tejvir S Khurana, Li Chen, Xinguo Hou, Zheng Sun

Center on Aging Staff Publications

The best time of the day for chronic exercise training and the mechanism underlying the timing effects is unclear. Here, we show that low-intensity, low-volume treadmill training in mice before sleep yields greater benefits than after waking for muscle contractile performance and systemic glucose tolerance. Baseline muscle performance also exhibits diurnal variations, with higher strength but lower endurance before sleep than after waking. Muscle-specific knockout of circadian clock genes Rev-erbα/β (Rev-MKO) in male mice eradicates the diurnal variations in both training and baseline conditions without affecting muscle mass, mitochondrial content, food intake, or spontaneous activities. Multi-omics and metabolic measurements reveal …

Reduction Of Neuronal Activity Mediated By Blood-Vessel Regression In The Adult Brain, Xiaofei Gao, Xing-Jun Chen, Meng Ye, Jun-Liszt Li, Nannan Lu, Di Yao, Bo Ci, Fei Chen, Lijun Zheng, Yating Yi, Shiwen Zhang, Zhanying Bi, Xinwei Gao, Yuanlei Yue, Tingbo Li, Jiafu Lin, Ying-Chao Shi, Kaibin Shi, Nicholas E Propson, Yubin Huang, Katherine Poinsatte, Zhaohuan Zhang, Dale B Bosco, Shi-Bing Yang, Ralf H Adams, Volkhard Lindner, Fen Huang, Long-Jun Wu, Hui Zheng, Simon Hippenmeyer, Ann M Stowe, Bo Peng, Marta Margeta, Qingchun Guo, Xiaoqun Wang, Qiang Liu, Jakob Körbelin, Martin Trepel, Hui Lu, Guoen Cai, Bo O Zhou, Bo Shen, Ying-Mei Lu, Wenzhi Sun, Jie-Min Jia, Feng Han, Hu Zhao, Robert M Bachoo, Woo-Ping Ge

Center on Aging Staff Publications

The brain vasculature supplies neurons with glucose and oxygen, but little is known about how vascular plasticity contributes to brain function. Using longitudinal in vivo imaging, we report that a substantial proportion of blood vessels in the adult mouse brain sporadically occlude and regress. Their regression proceeds through sequential stages of blood-flow occlusion, endothelial cell collapse, relocation or loss of pericytes, and retraction of glial endfeet. Regressing vessels are found to be widespread in mouse, monkey and human brains. We further reveal that blood vessel regression cause a reduction of neuronal activity due to a dysfunction in mitochondrial metabolism and …

Tata Laksana Fraktur Panggul Pada Geriatri: Sudut Pandang Internis, Laila M. Jannah, Noto Dwimartutie

Jurnal Penyakit Dalam Indonesia

Hip fracture are a common issue in geriatric patients, associated with increased risk of morbidity and mortality. The complex and multimorbid characteristics of geriatric patients presents significant challenge in their management. Optimal outcomes require a comprehensive interdisciplinary approach to care, aiming to restore functional status and reduce postoperative complications. A holistic strategy, grounded in thorough Comprehensive Geriatric Assessment (CGA), is essential to guide individualized treatment and ensure effective, patient-centered management.

Correlation Between Drug-Related Problems And The Treatment Cost For Geriatric Ischemic Stroke Patients In Tulungagung, Dhanang Prawira Nugraha, Martanty Aditya

Jurnal Ekonomi Kesehatan Indonesia

Ischemic stroke was one of the diseases that frequently occurred in geriatric patients, while hemorrhagic stroke had a higher prevalence. Geriatric patients who experienced a stroke were not exempt from drug-related problems (DRP) due to the complexity of treatment and comorbid factors they encountered. This study aimed to determine the correlation between DRP and the cost of care for ischemic stroke patients, particularly in the geriatric population. The study design was cross-sectional, with data collected retrospectively, and the sample comprised 53 geriatric stroke patients who met the inclusion and exclusion criteria. DRP was assessed using the PCNE 6.2 criteria, and …

Senior Health (Age 65+) In The Mountain West, 2024, Taylor Volk, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents senior health care statistics for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The “2024 Senior Report – State Summaries,” study from America’s Health Rankings, United Foundation provided the data for all fifty states and Washington, D.C.

Interprofessional Education: A Geriatric Immersion Experiential, Emily J. Balog, Jennifer Degennaro, Lisa Bodenheimer, Stephanie Berdugo-Hernandez, Isabella Berdugo-Hernandez, Matthew Mclaughlin, Kevin Overbeck, Elyse Perweiler

Rowan-Virtua SOM Faculty Teaching & Learning Seminar

The Geriatric Interprofessional Education Immersion (GIPEI) course was developed using a mixed methods design guided by the Knowledge-to-Action (KTA) Framework and embedded data-driven decision-making (DDDM). The eight-week, tri-weekly immersion integrates Experiential and Adult Learning Theories, the 4Ms Framework, IPEC competencies, and TeamSTEPPS to foster age-friendly clinical decision-making. Quantitative and qualitative data, including pre/post-tests, rubrics, observations, and student interviews, inform iterative improvement. The somato-psycho-socio-semiotic model of health further anchors student reflection and care planning. Findings aim to demonstrate improved learner ability to recognize and apply age-friendly care, while supporting evidence-informed curriculum refinement. The course is funded by the geriatric workforce enhancement …

Assessing Older Adult Behavioral Health Diagnoses In Oregon By Geographical Area, Physical Disability Status, And Age., N F. Parsons, Allyson Stodola, Ellis Hews, Nirmala Dhar, Sheryl Elliott, Sarah Dys, Walter D. Dawson

Institute on Aging Publications

This repeated cross-sectional study aims to assess potential differences among behavioral health (BH) diagnoses for older adults. Differences in services across urban versus rural/remote areas may contribute to deeply entrenched barriers to improved BH for this population.

Managing Hypercholesterolemia In Adults Older Than 75 Years Without A History Of Atherosclerotic Cardiovascular Disease: An Expert Clinical Consensus From The National Lipid Association And The American Geriatrics Society, Vera Bittner, Sunny A Linnebur, Dave L Dixon, Daniel E Forman, Ariel R Green, Terry A Jacobson, Ariela R Orkaby, Joseph J Saseen, Salim S Virani

Faculty, Staff and Students Publications

The risk of atherosclerotic cardiovascular disease increases with advancing age. Elevated LDL-cholesterol and non-HDL-cholesterol levels remain predictive of incident atherosclerotic cardiovascular events among individuals older than 75 years. Risk prediction among older individuals is less certain because most current risk calculators lack specificity in those older than 75 years and do not adjust for co-morbidities, functional status, frailty, and cognition which significantly impact prognosis in this age group. Data on the benefits and risks of lowering LDL-cholesterol with statins in older patients without atherosclerotic cardiovascular disease are also limited since most primary prevention trials have included mostly younger patients. Available …

Association Of The G8 Screening Tool With Neoadjuvant Chemotherapy Outcomes In Older Adults With Urothelial Carcinoma, Kendall Ozorowski, Umma Fatema, Amman Bhasin, Julia Palecki, Michael Zimmerman, Kristine Swartz, Kevin Zarrabi, Kuang-Yi Wen

Health Equity and Quality Improvement (HEQI) Summit

Intro

• Urothelial carcinoma (UC) predominately affects older adults who often face increased adverse outcomes and reduced survival.
• Standard of care treatment entails neoadjuvant cisplatin- based chemotherapy followed by cystectomy with urinary diversion.
• The American Society of Clinical Oncology recommends older patients with cancer undergo Comprehensive Geriatric Assessment (CGA) prior to cancer treatment.
• The G8, a geriatric assessment tool, is a validated screening tool for identifying frailty requiring CG

Incorporation Of The 4ms, With A Focus On Mentation, Into The H&P For Older Adults Hospitalized With A Hip Fracture And Its Effect On Delirium Documentation, Emily Custer, Do, Kristine Swartz, Md, Lily Ackermann, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Delirium affects 15% to over 50% of patients with hip fractures during their hospital stay (1) and is associated with increased mortality, increased length of hospital stay, poorer functional outcomes, and higher risk of nursing home placement (1,2). However, at Thomas Jefferson University Hospital, the prevalence of documented delirium post-hip fracture is only 5.22%, suggesting potential under recognition. Additionally, at the end of 2025, a new CMS inpatient quality metric will require public reporting on a hospital's capability to provide age-appropriate care for older adults, which can be done by utilizing the 4M framework of age-friendly health care. The …

Deprescribing Type 2 Diabetes Mellitus Medications In Older Adults In An Urban Primary Care Setting, Katelyn Koons, Md, Eugenie Hughes, Md, Eunice Choe, Md, Julio Garcia, Md, Munifa King, Md, Emily Lavell, Md, Michael Danielewicz, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Adults 65+ take on average five medications daily
• Polypharmacy increases risks of drug interactions and adverse events
• About 29% adults 65+ in developed countries have type 2 diabetes mellitus (T2DM) and the number of older adults living with these conditions is expected to increase rapidly in the coming decades
• Over-treatment of DM in older adults is common and increases risks of serios adverse outcomes including hypoglycemia
• Older adults with T2DM should have higher A1c goal consistent with ADA guidelines: [See Table on Poster]

Dnmt3a Regulates Murine Megakaryocyte-Biased Hematopoietic Stem Cell Fate Decisions, Sarah M Waldvogel, Virginia Camacho, Dandan Fan, Anna G Guzman, Alejandra Garcia-Martell, Elmira Khabusheva, Jacey Rodriguez Pridgen, Josephine De La Fuente, Rachel Rau, Ashlyn G Laidman, Maria N Barrachina, Estelle Carminita, Justin A Courson, Michael R Williamson, Joanne I Hsu, Chun-Wei Chen, Jaime Reyes, Subhashree Pradhan, Rolando E Rumbaut, Alan R Burns, Benjamin Deneen, Jianzhong Su, Kellie R Machlus, Margaret A Goodell

Center on Aging Staff Publications

Hematopoietic stem cells (HSCs) are defined by their capacity to regenerate all main components of peripheral blood, but individual HSCs exhibit a range of preferences for generating downstream cell types. Their propensities are thought to be epigenetically encoded, but few differential regulatory mechanisms have been identified. In this work, we explored the role of DNA methyltransferase 3A (DNMT3A) in the megakaryocyte-biased HSC population, which is thought to reside at the top of the hematopoietic hierarchy. We demonstrate that heterozygous loss of DNMT3A (Dnmt3a+/-) in these megakaryocyte-biased HSCs has distinct consequences compared with the rest of the HSC pool. These megakaryocyte-biased …

Long-Term Care Services And Support In The Mountain West, 2023, Taylor Volk, Ivan Sun, Miguel Soriano Ralston, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data from the American Association of Retired Persons (AARP) report, “Long-Term Services and Supports 2023 State Scorecard Report,” comparing Long-Term Services and Supports (LTSS) systems across multiple dimensions of performance for older adults, people with physical disabilities, and family caregivers for all 50 states. This fact sheet focuses on state-level LTSS system data for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah.

Enhancing The Eden Alternative Model With Well Standards: A Case Study Analysis, Mariah Stoner

Architecture Masters of Science Program: Theses

This thesis investigates the potential for improving the Eden Alternative Model, a person-centered approach to elder care that emphasizes creating a homelike environment and meaningful relationships, using WELL Standards, a building certification system focused on enhancing human health and well-being through improvements in environmental quality. Through a mixed-methods approach involving quantitative data analysis and qualitative case studies, this research examines how WELL Standards, which cover aspects such as air quality, water quality, lighting, and thermal comfort, can improve environmental quality and resident satisfaction within the Eden Alternative Model. This research introduces a tailored approach to elder care by combining these …

Clinical Outcomes For Patients With Obstructive Shock With Pe In Octogenarians, Nonagenarians, And Centenarians: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Wasim Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

One of the most common causes of obstructive shock is massive pulmonary embolism. I these patients with compounded morbidities and limited filling of the heart we sought to sample databases to analyze the inpatient outcomes of the population.

Outcomes Of Octogenarians, Nonagenarians, And Centenarians That Underwent Left Atrial Appendage Occlusion: A Population-Based Study, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

An evaluation of that national inpatient sample database to explore the outcomes for patients above the age of seventy who underwent left atrial appendage occlusion.