In today’s episode, Matt and Lauren discuss the new CMS GUIDE model for dementia care with Dr. Brystana Kaufman, MSPH, PhD – a health services researcher at the Duke-Margolis Institute for Health Policy at Duke University. The GUIDE model aims to improve the quality of life for people living with dementia by reducing strain on caregivers and enabling individuals to remain in their homes.  

Brystana talks with the Minding Memory team about a spectrum of topics as related to the GUIDE model including, what motivated CMS to develop and implement the model; what defines a serious illness; how the model supports caregivers; and what an organization needs to have in terms of services in order to participate in the implementation of the GUIDE model. Dr. Kaufman is the co-author of an article in the Journal of the American Geriatrics Society titled “GUIDE Dementia Model: Opportunities for Serious Illness Care” which provides additional insight into the model.    

Episode Transcript

Brystana Kaufman, PhD, MSPH Faculty Profile 

Article referenced in this episode:  

Kaufman BG, Grant M. GUIDE dementia model: Opportunities for serious illness care. J Am Geriatr Soc. 2024 Jun;72(6):1935-1938. doi: 10.1111/jgs.18787. Epub 2024 Feb 5. PMID: 38315037. 

Additional Resources:  

Guiding an Improved Dementia Experience (GUIDE) Model 

Health and Aging Policy Fellows 

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In this episode, Matt and Lauren speak with Drs. Elizabeth Frankenberg at the University of North Carolina at Chapel Hill and Duncan Thomas at Duke University about their research which focuses on understanding how survival and physical health evolve after exposure to large scale shocks like the 2004 Indian Ocean Earthquake and Tsunami. They will specifically speak about the STAR Study and what they’re learning about long-term effects on cognitive outcomes.   

Faculty Profiles:  

Elizabeth Frankenberg, PhD 

Duncan Thomas, PhD 

Resources from the Episode:  

Study of the Tsunami Aftermath and Recovery (STAR) 

STAR Study Design and Results 

The transcript for this episode can be found here.

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In this episode, Matt and Lauren speak with Dr. Tiffany Kindratt whose research focuses on examining health outcomes among the Middle Eastern and North African (MENA) population, a group that was – until recently – categorized as “white” by the US government despite. Evidence showing their health and lived experiences are different. We’ll get into a recent American Journal of Public Health article authored by Dr. Kindratt that that examines how cognitive difficulties differ among the MENA population when compared with other racial and ethnic categories.   

Faculty Profile: Tiffany Kindratt, PhD, MPH 

Health Survey Research (HSR) Lab @ University of Texas at Arlington 

American Community Survey (ACS)  

AJPH Article:   

Kindratt TB, Smith A. Cognitive Difficulty in Middle Eastern and North African Adults Living in the United States Compared With Other Racial and Ethnic Categories, 2017-2021. Am J Public Health. 2024 Nov;114(11):1265-1274. doi: 10.2105/AJPH.2024.307803. PMID: 39357001; PMCID: PMC11447784. 

The transcript for this episode can be found here.

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In this episode, Matt & Lauren have the unique opportunity to talk with Dr. Helen C. Kales, a geriatric psychiatrist and health services researcher who has participated in the previous Lancet Commissions on Dementia Prevention, Intervention and Care – including the most recent one released in 2024. Dr. Kales discusses how the commission puts together all the evidence to make recommendations that can play a crucial role in dementia prevention. Dr. Kales is the Chair of the Department of Psychiatry and Behavioral Sciences and Joe P. Tupin Professor of Psychiatry at the University of California at Davis and has dedicated much of her career to improving the lives of patients living with dementia.   

Helen C. Kales, MD Faculty Profile 

2024 Lancet Commission: Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission 

The transcript for this episode can be found here.

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Hearing loss is one of the most common conditions of aging, affecting nearly two-thirds of older adults over the age of 70, but it’s not just a matter of diminished hearing. Hearing loss can contribute to poor psychosocial outcomes for patients including loneliness, depression, and social isolation. New research also shows that hearing loss is linked to a higher risk of cognitive decline and dementia. In fact, the 2024 Lancet Commission on Dementia Prevention, Intervention, and Care identified hearing loss as one of 14 modifiable risk factors for dementia. According to the commission, treating hearing loss could prevent up to 7% of dementia cases globally, making it one of the most impactful areas for potential prevention. This raises the question of whether use of hearing aids in people with hearing loss can reduce or mitigate this increased dementia risk. 

To help us understand these connections and the latest research in this area, we are joined today by Dr. Alison Huang, an epidemiologist and Senior Research Associate from the Johns Hopkins Cochlear Center for Hearing and Public Health. Her research studies the impact of sensory loss on cognitive and mental health in older adults. Dr. Huang was an author of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, a large, multicenter randomized controlled trial that tested whether treating hearing loss in older adults could help slow cognitive decline published in the Lancet.  

Alison Huang, PhD, MPH  

Link to article:  

Lin FR, Pike JR, Albert MS, Arnold M, Burgard S, Chisolm T, Couper D, Deal JA, Goman AM, Glynn NW, Gmelin T, Gravens-Mueller L, Hayden KM, Huang AR, Knopman D, Mitchell CM, Mosley T, Pankow JS, Reed NS, Sanchez V, Schrack JA, Windham BG, Coresh J; ACHIEVE Collaborative Research Group. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet. 2023 Sep 2;402(10404):786-797. doi: 10.1016/S0140-6736(23)01406-X. Epub 2023 Jul 18. PMID: 37478886; PMCID: PMC10529382. 

The transcript for this episode can be found here.

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In this episode Matt and Lauren will speak with Dr. Marcia Pescador Jimenez, an Assistant Professor in the Department of Epidemiology at Boston University whose research focuses on understanding the relationship between exposure to green space and health outcomes (including hypertension and cognitive measures). Emerging research has shown that midlife risk factors may delay or even prevent the onset of dementia later in life - among these include physical activity and social interaction. It’s not a stretch to imagine how a person’s environment may impact behaviors such as physical activity. For instance, there are places that lack sidewalks and parks that make exercising exceedingly difficult. Among environmental epidemiologists, there is growing interest in understanding how the built and natural environment influence our behaviors that, in turn, influence our health.   

We encourage you to listen to this episode while on a walk outside!  

Dr. Marcia Pescador Jimenez Faculty Profile 

Article Referenced in Podcast:  

Pescador Jimenez M, Wagner M, Laden F, Hart JE, Grodstein F, James P. Midlife Residential Greenness and Late-Life Cognitive Decline among Nurses' Health Study Participants. Environ Health Perspect. 2024 Jul;132(7):77003. doi: 10.1289/EHP13588. Epub 2024 Jul 17. PMID: 39016600; PMCID: PMC11253812. 

Nurses’ Health Study 

The social engagement scale that was referenced in the podcast is called the “Berkman-Syme Social Network Index”

The transcript for this episode can be found here.

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While memory loss is generally thought of as the hallmark of dementia, behavioral and psychological symptoms of dementia like agitation, aggression, anxiety, and hallucinations are nearly universal, affecting almost all patients with advanced dementia. These behavioral disturbances are often the trigger for nursing home placement, and they can be highly distressing for both patients and their care partners. In today’s episode, Matt and Lauren speak with Dr. Ellen McCreedy, a researcher from the Brown School of Public Health who has conducted a study of personalized music intervention called Music & Memory for people living with dementia in nursing homes. Dr. McCreedy is a gerontologist and health services researcher who focuses on evaluation of non-pharmacologic interventions for managing behavioral disturbances of people living with dementia.   

Ellen McCreedy, PhD, MPH Faculty Profile 

Articles from Episode:  

Sisti A, Gutman R, Mor V, Dionne L, Rudolph JL, Baier RR, McCreedy EM. Using Structured Observations to Evaluate the Effects of a Personalized Music Intervention on Agitated Behaviors and Mood in Nursing Home Residents With Dementia: Results From an Embedded, Pragmatic Randomized Controlled Trial. Am J Geriatr Psychiatry. 2024 Mar;32(3):300-311. doi: 10.1016/j.jagp.2023.10.016. Epub 2023 Nov 2. PMID: 37973488; PMCID: PMC10922136. 

McCreedy EM, Gutman R, Baier R, Rudolph JL, Thomas KS, Dvorchak F, Uth R, Ogarek J, Mor V. Measuring the effects of a personalized music intervention on agitated behaviors among nursing home residents with dementia: design features for cluster-randomized adaptive trial. Trials. 2021 Oct 7;22(1):681. doi: 10.1186/s13063-021-05620-y. PMID: 34620193; PMCID: PMC8496617. 

The transcript for this episode can be found here.

You can subscribe to Minding Memory on Apple Podcasts, Spotify, or wherever you listen to podcasts.

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In this episode, Matt & Lauren speak with Dr. Lianlian Lei, an Assistant Professor in the Department of Psychiatry at the University of Michigan. Dr. Lei discusses a recent study that looks at the impact of partner’s plan choice on the likelihood of Medicare Advantage disenrollment and how that may impact older adults living with dementia. Unlike traditional Medicare that's administered by the federal government, Medicare Advantage are healthcare plans that are administered by private health insurance companies. These plans can vary a lot and typically cover additional services not covered by traditional Medicare. Navigating the various plan options can be a challenge for older adults, and it's not uncommon for individuals to change plans depending on their current needs. 

Dr. Lianlian Lei Faculty Profile 

Article from Episode: Lei L, Levy H, Ankuda C, Hoffman GJ, Kim HM, Strominger J, Maust DT. Partner Plan Choices and Medicare Advantage Enrollment Decisions Among Older Adults. JAMA. 2024 Mar 20:e241773. doi: 10.1001/jama.2024.1773. Epub ahead of print. PMID: 38506841; PMCID: PMC10955388. 

The transcript for this episode can be found here.

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In this episode, Lauren and Matt talk with Leah Richmond-Rakerd, PhD who is an Assistant Professor in the Department of Psychology at the University of Michigan. Her research focuses on emotional and behavioral dysregulation across the life course. Here, Dr. Richmond-Rakerd will discuss her recent study on “The Associations of Hospital-Treated Infections with Subsequent Dementia: Nationwide 30-year Analysis” that was published in Nature Aging.  

Articles Discussed in Episode:  

Richmond-Rakerd LS, Iyer MT, D'Souza S, Khalifeh L, Caspi A, Moffitt TE, Milne BJ. Associations of hospital-treated infections with subsequent dementia: nationwide 30-year analysis. Nat Aging. 2024 Jun;4(6):783-790. doi: 10.1038/s43587-024-00621-3. Epub 2024 May 7. PMID: 38714911. 

Milne BJ, Atkinson J, Blakely T, Day H, Douwes J, Gibb S, Nicolson M, Shackleton N, Sporle A, Teng A. Data Resource Profile: The New Zealand Integrated Data Infrastructure (IDI). Int J Epidemiol. 2019 Jun 1;48(3):677-677e. doi: 10.1093/ije/dyz014. Erratum in: Int J Epidemiol. 2019 Jun 1;48(3):1027. doi: 10.1093/ije/dyz054. PMID: 30793742. 

NZ Integrated Data Infrastructure: https://www.stats.govt.nz/integrated-data/integrated-data-infrastructure/ 

Visit the Center to Accelerate Population Research in Alzheimer's (CAPRA) website to learn more.

The transcript for this episode can be found here.

You can subscribe to Minding Memory on Apple Podcasts, Spotify, or wherever you listen to podcasts.

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Welcome to Season 4 of Minding Memory, where we are welcoming a new co-host, Lauren Gerlach to the Minding Memory team. Lauren is a Geriatric Psychiatrist at the University of Michigan and a member of the CAPRA leadership team. In this episode, Lauren shares a little background on her research interests, what it’s like to be a geriatric psychiatrist, and some lessons learned about using “uncool” emoticons or emojis when texting.  

The transcript for this episode can be found here.

You can subscribe to Minding Memory on Apple Podcasts, Spotify, or wherever you listen to podcasts.

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