REACT! Study, Round 2, comes to a close

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The University of Pennsylvania’s Institute on Aging wrapped up their second round of the Rhythm Experience and Africana Culture Trial (REACT!) on Monday, October 9, 2017.

The trial concluded with a celebratory award ceremony which included readings, art presentations, and a dance performance by the study participants. Dara Meekins, REACT! Study Coordinator, kicked off the ceremony with a welcome speech describing the importance and impact of this clinical trial. “This study was developed to investigate a culturally important form of physical activity that could enhance the neurocognitive health and physical and emotional well-being of older African Americans,” explained Dara. “Prior studies have shown promising effects of physical activity, but REACT! specifically seeks to provide a fun, engaging, and broadly translatable platform for reducing the health disparities that currently exist for older African Americans.”

Not all clinical trials are as pleasant and many require a variety of unfavorable medical procedures or testing. “I think this study shows you that if you don’t want to be probed or prodded with needles, we can still use your help,” says Dara.

REACT!Group2_endingceremony

Lewis Reddick, REACT! education group participant, is a perfect example of the many ways this study is bettering the lives of older African Americans. “This program has let me know about things that I still can do that I thought I couldn’t, such as my reading and writing,” he explained. “I couldn’t write the way I used to, I couldn’t read the way I used to… and [this study] got me started again and it has inspired me to maybe even go back to school!”

Mr. Reddick also expressed his praise and appreciation for Dara and the rest of the REACT! team, including Samuel Gorka, study coordinator, as well as several student interns. “Everyone was kind and we had a great time!” he said. “I looked forward to everyday that I came!”

Below are some highlights from the REACT! Dance Group’s wonderful performance led by African Dance Instructor, Yattah Jones! Their performance is set to the sounds of African Conga drums and tells a story of celebration, life, vitality, harvest & rebirth through a fusion of Afro-Caribbean dance styles.

REACT! is an Alzheimer’s Association-funded research study being conducted at the University of Pennsylvania and the University of Pittsburgh (Pittsburgh).

Learn more about the REACT! Study here.

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Penn Medicine’s 6th Annual 5K for the IOA & Memory Mile Walk

It was a warm Fall morning on Sunday, September 24, 2017 as 371 runners and walkers and 70 volunteers gathered for Penn Medicine’s 6th Annual 5K for the IOA and Memory Mile Walk.

The fundraiser, which takes place throughout Penn Park and the University of Pennsylvania campus, raised a total of $49,260 this year for Alzheimer’s and aging-related disease research efforts at Penn’s Institute on Aging.

In addition to its usual run and walk, the event also included pre and post-race yoga sessions, entertainment provided by DeeJay007, and photobooth fun for the whole family. This year’s overall male winner, Alexis Tingan (pictured below, left), finished the race in 17 minutes and 35 seconds, with the overall female winner, Sara McCuaig (pictured below, right), not far behind him with a time of 19 minutes and 24 seconds.

To view the full list of race results, click here.

Last week, CBS Philly interviewed PJ Brennan, MD, Chief Medical Officer at Penn Medicine who created the event in memory of his father who lost his battle with Alzheimer’s disease. “I thought it would be a fun way to get my community here together and bring some attention to the work that the Institute on Aging does and raise some money for this novel research,” said Brennan during the interview.

To view more photos of the event, click here.

The 14th Annual Jane Wright Symposium on Parkinson’s Disease for Patients and Caregivers

Published by Benjamin Deck, Udall Coordinator 

The 14th annual Jane Wright conference was held on June 15th at the Sheraton Hotel on City Line Avenue in Philadelphia, PA. The Jane Wright conference is an annual symposium that brings together the local Parkinson’s community to hear presentations around a central theme and to make people with Parkinson’s (PwP) and their loved ones aware of available resources. The theme this year was, “Hot Topics in Parkinson’s Disease” and the attendance reached an all-time high of over 200 people.

Professor Emeritus of Neurology, Dr. Matthew Stern, MD opened the conference with his lecture on Parkinson’s history and discussed updates to James Parkinson’s original definition of Parkinson’s disease (PD). Some of the issues Dr. Stern outlined were disparate pathologies in PD, PD subtypes, and the idea that current diagnostic criteria do not allow for early diagnosis in PD. One precluding factor of early diagnosis is that motor symptoms are typically not present until later stages of the disease.

The second speaker was the newly appointed Director of Medicine at the Penn Neurological Institute, Dr. Andrew Siderowf, MD. Dr. Siderowf presented new therapeutics in PD such as Safinamide, Rytary, Droxidopa, and Primavanserin. Dr. Siderowf’s presentation also touched on newer surgical interventions for PD such as Focused Ultrasound and Duopa. The presentation then focused on disease modifying procedures and medications that are currently under development, i.e. gene therapy, alpha synuclein anti-body trials, and treatments specialized for specific genetic mutations in PD. View his presentation here.

Assistant Professor of Neurology, Dr. Lama Chahine, MD, spoke of biomarkers and the crucial role that they will play in the diagnosis, prognostication, and treatment of PD. Dr. Chahine made the compelling case for further research on biomarkers in PD by showing the subjectivity of in-clinic motor exams, which are currently the gold standard for a PD diagnosis in movement disorder clinics. Dr. Chahine emphasized that biomarker discovery in cerebral spinal fluid (CSF), blood, and tissue sampling (collected most recently for this trial), could one day diagnose patients earlier and/or better treat the disease.

The final speaker at this year’s Jane Wright Conference was Movement Disorders Fellow, Dr. Michelle Fullard, MD. Dr. Fullard’s presentation outlined the recent technological advances that are helping to deliver better and more accessible treatments. Telemedicine has been implemented in many clinics and decreases travel burden for PD patients who often find this to be a barrier to quality care. Telemedicine allows physicians to remotely diagnose and treat individuals through the use of telecommunications technology. Dr. Fullard also discussed wearable devices that can track a PD patient’s movements through the use of accelerometers and other such technology. The hope its that these devices would allow movement disorder specialists to better understand the motor complications of their patients.

JW Symposium 2017 picture

Lastly, Dr. Stern was awarded an Proclamation signed by Mayor Jim Kenney that decrees April as Parkinson’s Awareness Month in Philadelphia. The proclamation was presented by Ms. Lori Katz and a represenative from Mayor Kenney’s office (pictured above).

View all presentation slides here.

 

Genetics of Aging-Related Neurodegeneration: The Sylvan M. Cohen Annual Retreat & Poster Session 2017

077On Tuesday, May 23, 2017, the Institute on Aging (IOA) hosted their annual Sylvan M. Cohen Retreat and Poster Session in collaboration with co-sponsors, the Penn Neurodegeneration Genomics Center (PNGC).

The 2017 retreat focused on the ‘Genetics of Aging-related Neurodegeneration’ and for the second year in a row, it began with opening remarks from the Dean of the Perelman School of Medicine, J. Larry Jameson, MD, PhD. “I’m mainly here to thank you for your scientific collaboration,” said Dean Jameson. He used this time to express the importance and impact of these contributions in the field of genetics and aging, especially in trying to solve the puzzle of very complex conditions such as neurodegeneration.

Lectures were presented by Penn’s Gerard (Jerry) D. Schellenberg, PhD, Director of the PNGC, Adam Naj, PhD, Assistant professor of Epidemiology in Biostatistics and Epidemiology, and Nancy Zhang, PhD, Assistant professor of Statistics, as well as this year’s keynote speaker, Philip De Jager, MD, PhD, Associate Neurologist at Brigham and Women’s Hospital and Associate Professor of Neurology at Harvard Medical School.

Lectures:

  • “Alzheimer’s Disease Genetics; Progress in Gene Therapy” – Jerry Schellenberg, PhD
  • “Genetic Risk Factors Associated with Coincident Alzheimer’s and Parkinson Disease in Neuropathologically Confirmed Cases” – Adam Naj, PhD
  • “Structural Variant Profiling in Alzheimer’s Disease Genetics” – Nancy Zhang, PhD
  • “The molecular network map of the aging cortex: v1.0: an integrative approach targets the epigenomic and inflammatory components of Tau pathology” – Philip De Jager, MD, PhD

As usual, the event concluded with the annual poster session on aging. Prizes were awarded to the top posters in each of the following categories: Basic Science and Clinical Research/Education & Community.

Poster Winners:

BASIC SCIENCE:

1st Place:

172Title: “Integrative analysis identifies immune-related enhancers and IncRNAs perturbed by genetic variants associated with Alzheimer’s disease”
Presenter: Alexandre Amlie-Wolf
Authors: Alexandre Amlie-Wolf, Mitchell Tang, Jessica King, Beth Dombroski, Elizabeth Mlynarski,Yi-Fan Chou, Gerard D. Schellenberg, Li-San Wang
Affiliation(s): University of Pennsylvania, Genomics and Computational Biology Graduate Group

2nd Place:

173Title: “Differential Vulnerability to a-synuclein Pathology Among Neuronal Subpopulations”
Presenter: Luna Esteban
Authors: Luna Esteban, Dawn M. Riddle, Virginia M.Y. Lee, Kelvin C. Luk
Affiliation(s): Center for Neurodegenerative Disease Research

 


Clinical Research/Education & Community

1st Place:

175Title: “Correlates of Sleep Indices Among Community Dwelling Older Adults Enrolled in a Collaborative Care Management Program”
Presenter: Ashik Ansar
Authors: Ashik Ansar, MD, PhD, Shahrzad Mavandadi, PhD, Kristin Foust, Suzanne DiFilippo, RN, Joel E.. Streim, MD, David W. Oslin, MD
Affiliation(s): Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania

2nd Place:

176Title: “The Impact of Cognitive Reserve and Brain Atrophy on Survival in Neurodegenerative Diseases”
Presenter: Carrie Caswell
Authors: Carrie Caswell, MS (1), Sharon X. Xie, PhD (1), Murray Grossman, MD, EdD (1), Corey T. McMillan, PhD (1), Lauren M. Massimo, PhD, CRNP (1,2)
Affiliation(s): (1) University of Pennsylvania, (2) Penn State University

To view the full lectures from the 2017 Sylvan M. Cohen Annual Retreat, click here.

To view more photos from the 2017 Sylvan M. Cohen Annual Retreat, click here.

 

“Through the Eyes of the Caregiver: Frontotemporal Degeneration (FTD) and the Penn FTD Center” premieres at the Penn FTD Center Caregiver Conference 2017

On Friday, May 12, 2017, the Penn Frontotemporal Degeneration (FTD) Center hosted its 9th annual Penn FTD Caregivers Conference at the University of Pennsylvania. The day-long conference held at the Smilow Center for Translational Research welcomed 150 attendees and consisted of a series of lectures that covered information around the latest scientific advances in research on FTD and its related disorders, such as Amyotrophic lateral sclerosis (ALS) also known as Lou Gehrig’s Disease and Corticobasal degeneration (CBD), as well as practical caregiving issues such as strategies for symptom management, understanding the genetics of FTD and genetic testing options, respite and supportive resources for caregivers, and legal and long-term care planning.

One of the highlights of this year’s conference was the premiere of “Through the Eyes of the Caregiver: Frontotemporal Degeneration (FTD) and the Penn FTD Center,” a short film sharing the stories of three caregivers whose loved ones are patients at the Penn FTD Center.

“The brunt of this disease falls solely on those closest to the individual with the disease unfortunately and it is very difficult to navigate the healthcare system and obtain the types of resources that give structure to a patient’s day-to-day life and to help a caregiver keep a patient safe and cognitively stimulated,” said David Irwin, MD, assistant professor and Cognitive Neurologist in the Penn FTD Center. The goal of this video is to show caregivers and family members of those with FTD that they are not alone in this life-altering process and that there are many support groups and community and medical resources available to them – including many at the Penn FTD Center – to help them every step of the way.

Watch “Through the Eyes of the Caregiver: Frontotemporal Degeneration (FTD) and the Penn FTD Center”*:

Two Penn FTD Caregivers Conference sponsors, the Alzheimer’s Association Delaware Valley Chapter and the Association for Frontotemporal Degeneration (AFTD), were also in attendance to answer questions and present information on the many advocacy and community resources that they offer for patients with FTD or related disorders and their families and caregivers.

Learn more about the Penn FTD Center at: https://ftd.med.upenn.edu

* Learn more about each individual caregiver by watching their full story! Click the “i” icon bubble in the top right hand corner of the video for a drop down menu with links to each caregivers story! If you are watching on a mobile phone, click the title of the video which will open a drop down menu containing the links to each caregiver’s story as well as a link to the Virtual Tour of Penn’s FTD PPG and Penn FTD Center to learn more about the FTD research and care taking place at Penn.

Unlocking the Mysteries of Delirium

What is delirium and how should we handle it?

EdwardMarcantonio_FlyerLast month, Edward Marcantonio, MD, MS, the IOA’s most recent visiting scholar and professor of Medicine at Harvard Medical School*, offered some answers to these questions during his lecture at the University of Pennsylvania.

In the 1980’s, as he was just beginning his career in the medical field, Dr. Marcantonio was taught that it was essentially “normal” for older people to go a little crazy – or “bonkers” as he calls it – during their hospital stay. The belief was that there really was not much that could be done about it, but if the symptoms became overly bothersome, prescription medications such as haloperidol or diazepam — drugs commonly used for mental or psychiatric disorders — would “take care of it.”

Today, while we are much better at recognizing what delirium actually is – and understanding that it is not “normal” – there is still some confusion across disciplines in the terminology used to identify this condition. Delirium is often referred to as acute confusional state, altered mental status, subacute befuddlement, or postoperative psychosis.

Regardless of what term is used, the diagnosis of delirium, or any of the other aforementioned names, is characterized by confusion, restlessness, and a disturbance in attention and awareness that develops acutely and tends to fluctuate. Delirium is typically referred to as one of two types—prevalent delirium or incident delirium. Prevalent delirium is when the condition is present and observed at the time of hospital admission and incident delirium develops during the hospital stay.

Delirium is even more common than most people realize. According to Dr. Marcantonio, it is experienced in 30-40% of medical inpatients over 70 years old, 15-50% of surgery patients over 70 years old, and at least 75-80% of intensive care unit patients over 18 years old.

In his line of research, Dr. Marcantonio focuses on two main aims: 1) improving delirium identification at the bedside and 2) understanding the pathophysiology of delirium and its association with dementia.

Improving delirium identification at the bedside

Because symptoms of delirium can come and go and vary in severity, identifying it can be quite a challenge. “When I got started in the field there were a number of studies that sent research teams out doing gold standard delirium assessments and then compared that to what was diagnosed in clinical care and it turned out that less than 50% of cases were recognized,” said Dr. Marcantonio.

In the 1990’s, the Confusion Assessment Method (CAM) was developed to help detect delirium in patients. The CAM looks at four key features: 1) acute change/fluctuating course, 2) inattention, 3) disorganized thinking, and 4) altered level of consciousness. In order to officially diagnose delirium according to the CAM diagnostic algorithm, the patient must be experiencing both features 1 and 2, in addition to either 3 or 4. While recognizing these features as signs of delirium can produce a successful diagnosis, there still needed to be a standardized way to identify these features in the patients. With this in mind, Dr. Marcantonio developed a series of methods and assessments for detecting delirium – some taking as little as 30 seconds to administer.

Learn more about these assessments in Dr. Marcantonio’s full lecture starting at 0:20:28:
Full lecture

Understanding the pathophysiology of delirium and its association with dementia

Although a variety of situations, such as dehydration, visual or hearing impairment, immobility, and sleep deprivation, can increase the chances of developing delirium, current research suggests that one of the strongest risk factors – aside from aging – is dementia.

One emerging hypothesis is that delirium may represent a state of neuroinflammation. It is believed that this neuroinflammation could be the link between delirium and dementia and if this theory is confirmed, it could have some very important therapeutic effects for both conditions.

Learn more about the link between dementia and delirium in Dr. Marcantonio’s full lecture starting at 0:40:05:
Full lecture

Although we have come a long way over the years to better understand delirium, there is still much work left to do. The ultimate goals are to establish effective and efficient assessments of delirium as a part of daily hospital vital sign checks and to develop pathophysiologically-based treatments to improve the short and long-term outcomes of this condition.

To view the full lecture, click here.

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* Dr. Marcantonio is also the Section Chief for Research in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center (BIDMC).

 

The Assumptions of Aging: Addressing the Myths and Stereotypes Associated with Getting Older

On Thursday, April 13, 2017, the Philadelphia Corporation for Aging (PCA)* held a daylong training course titled “Assumptions of Aging,” led by Kathy Jedrziewski, PhD, Deputy Director of the Institute on Aging (IOA) at the University of Pennsylvania.

The purpose of this training was to address and debunk some of the common myths and stereotypes that are often associated with the aging population. Participants in the course ranged from social work coordinators and senior counselors to service coordinators from PCA and other local senior service centers. While this goes for the general public as well, it is especially important for individuals in these lines of work to understand and differentiate between the truths of aging and the negative labels that often overshadow in the elderly community so that they can provide the level of service — and respect — that seniors need and deserve.

After an ice-breaker introductory exercise, the group took turns sharing some of the common aging-related stereotypes that they have heard or experienced themselves. Some of the most frequently mentioned ideas were:

  • Older people are not good with technology
  • Romance is only for the young
  • All older people are weak and sickly
  • Older people cannot maintain the same hobbies, activities, or social life that they had when they were younger
  • Older people with disabilities are helpless and useless

Debunking Some of the Myths:

  • Older people are not good with technology:
    One of the most common misconceptions about the aging community is that they do not know — or cannot learn — how to use technology. While it may take older individuals a bit longer than the younger generation (a generation who has grown up using, and often depending on, technology) to pick up on the latest devices, they are not incompetent or unable to do so. Many older adults actually enjoy learning the latest technology and internet trends as it provides a way to stay engaged and in touch with the ever evolving means for communicating and consuming information (i.e. social media). In fact, according to Pew Research Center, 56% of U.S. online users ages 65 and up use Facebook.
  • Older people cannot maintain the same hobbies, activities, or social life that they had when they were younger
    As people age, they often feel pressure from their peers, relatives, and even from themselves to re-evaluate and restrict their idea of what is “appropriate” for them. Whether it is a choice in clothing, a physical hobby such as sports or exercise, or even something as personal as dating or physical intimacy, older adults often think or hear that they are “too old for that.” However, if an individual is still physically and mentally capable, their age alone should never determine what they can or cannot do.
  • Older people with disabilities are helpless and useless
    One of the most important things to understand about an individual with a disability is that it does not define them as a person. It is a common myth that individuals, particularly seniors, with disabilities need to be completely catered to and treated as children, which in turn can strip them entirely of their sense of independence, and in some cases, their self-worth. It is important for family members, caregivers, and others to understand that as long as the individual is still cognitively and/or physically capable of doing something — whether it is making their own decisions or taking part in normal day-to-day activities — they should be given the opportunity, and respect, to do so.

Instead of addressing these ideas through a lecture or notes, the participants were put into groups and asked to act out a series of scenarios that were based on many of these common myths and stereotypes of aging. Each scenario was followed by an open discussion among all of the participants to share their thoughts and feelings on how each character handled, or mishandled, each situation. This method of role-playing put the participants into the scenarios in a more hands-on way — showing them the effects of these stereotypes in a much more personal and relatable manner.

“I love doing this training at PCA twice a year,” said Dr. Jedrziewski, leader of the training session. “It gives me a chance to meet staff from across the aging network who are doing such important work, impacting lives every day and hopefully I give them some tools to work with.”


* PCA is a private nonprofit organization serving the Philadelphia area with a broad range of services to help older Philadelphians live as independently as possible. In addition to providing training programs to individuals working in aging-related fields, they also offer serves such as advocacy programs, coordinating in-home care, legal assistance, and home-delivered meals. It is the largest of 52 Area Agencies on Aging in Pennsylvania and assists more than 134,000 individuals through its PCA Helpline each year. 

For more information on PCA and their services, visit: www.pcacares.org