Focus on Geriatric Medicine and Aging

Guest: Rajagopal Sekhar, MD

Clinicians are still working to understand the mechanisms behind age-related declines and what interventions might help promote healthy aging. Could supplementation with the nutritional compounds glycine and n-acetylcysteine (GlyNAC) play a role by improving intracellular antioxidant levels? Dr. Rajagopal Sekhar shares the latest clinical data on GlyNAC supplementation in older adults.

Host: Matt Birnholz, MD

Guest: Slavica Janeva, MD

Despite the increasing number of elderly patients diagnosed with breast cancer, few clinical trials focus on this age group. That’s why Dr. Slavica Janeva's team focused on the impacts of adjuvant chemotherapy on survival rates in this patient population, the results of which may change clinical practice paradigms moving forward, as he discusses with Dr. Matt Birnholz.

Host: Dr. Andrew Wilner

Guest: Daniel E. Kremens, MD, JD

Guest: Michael S. Okun, MD

Parkinson’s disease (PD) affects roughly one million Americans and more than 10 million people worldwide. It is a progressive neurologic disorder characterized by motor and nonmotor symptoms. Key motor symptoms include resting tremor, bradykinesia, rigidity, and postural instability. Nonmotor symptoms include psychosis, depression, anxiety, impulse control disorders, cognitive impairment, and sleep disturbances. Significant progress has been made in the management of motor and nonmotor symptoms experienced by patients with PD. This activity will examine advances in pharmacologic and nonpharmacologic interventions that are improving patient outcomes for this incurable condition.

Host: Brian P. McDonough, MD, FAAFP

Several studies have shown that therapy dogs help to reduce people’s pain levels and anxiety. Therapy dogs have also been found to increase patients’ physical, mental, emotional and social states and improve their quality of life.

Host Dr. Brian McDonough talks with David Frei, co-creator of Angel on a Leash, a charity supporting therapy dog programs that serve health care facilities, about how therapy dogs bring comfort, affection and happiness to people in confined living situations. Frei is the former host of The Westminster Kennel Club Dog Show and expert analyst for The National Dog Show on NBC Thanksgiving Day.

Host: Brian P. McDonough, MD, FAAFP

Out of the approximately 340,000 hip fractures that occur in the US each year, 9 out of 10 of them happen to people older than 65. Hip fractures in an older population can result in significant complications including pneumonia and blood clots, among others.

Host Dr. Brian McDonough sits down with Dr. Derek Donegan, Assistant Professor of Orthopedic Surgery in the Division of Orthopedic Trauma at the Hospital of the University of Pennsylvania to talk about some of the challenges physicians face when treating hip fractures in elderly patients.

Host: Brian P. McDonough, MD, FAAFP

Out of the approximately 340,000 hip fractures that occur in the US each year, 9 out of 10 of them happen to people older than 65. Hip fractures in an older population can result in significant complications including Pneumonia and blood clots among others. Host Dr. Brian McDonough sits down with Dr. Derek Donegan, Assistant Professor of Orthopedic Surgery, Division of Orthopedic Trauma at the Hospital of the University of Pennsylvania to talk about some of the challenges physicians face when treating hip fractures in elderly patients.

Host: Jennifer Caudle, DO

The burden of deciding end-of-life care often falls on family and friends when patients are no longer able to make decisions regarding their own care. What do physicians need to know when guiding families through these tough situations?

Host Dr. Jennifer Caudle is joined by Dr. Marianne Holler, Medical Director of Hospice and Palliative Programs for the VNA Health Group of New Jersey. They talk about what physicians can do to aid families when faced with end-of-life decisions.

Host: Maurice Pickard, MD

Dr. Maurice Pickards talks with Dr. Edward Shaw about his book Keeping Love Alive as Memories Fade: The 5 Love Languages and the Alzheimer's Journey. Dr. Shaw shares how love can lift a corner of dementia’s dark curtain to cultivate an emotional connection amid memory loss. The book provides focused help for those feeling overwhelmed by the relational toll of Alzheimer’s.

Host: Kathy King, RDN

Can good nutrition improve cognition in the aging brain, as well as expand life spans in older adults? Host Kathy King speaks with dietitian and nutrition consultant Matthew Ruscigno about the latest research and subsequent dietetic recommendations aimed at seniors. They discuss which foods and dietary practices are now associated with helping seniors preserve cognition and live longer.

A protein homeostasis signature in healthy brains recapitulates tissue vulnerability to Alzheimer’s disease

Rosie Freer, Pietro Sormanni, Giulia Vecchi, Prajwal Ciryam, Christopher M. Dobson, and Michele Vendruscolo

Science Advances 10 Aug 2016: Vol. 2, no. 8, e1600947 DOI: 10.1126/sciadv.1600947

Abstract: In Alzheimer’s disease, aggregates of Aβ and tau in amyloid plaques and neurofibrillary tangles spread progressively across brain tissues following a characteristic pattern, implying a tissue-specific vulnerability to the disease. We report a transcriptional analysis of healthy brains and identify an expression signature that predicts—at ages well before the typical onset—the tissue-specific progression of the disease. We obtain this result by finding a quantitative correlation between the histopathological staging of the disease and the expression patterns of the proteins that coaggregate in amyloid plaques and neurofibrillary tangles, together with those of the protein homeostasis components that regulate Aβ and tau. Because this expression signature is evident in healthy brains, our analysis provides an explanatory link between a tissue-specific environmental risk of protein aggregation and a corresponding vulnerability to Alzheimer’s disease.