Geriatric Research Education and Clinical Center (GRECC)

Little Rock GRECC

• Pathogenesis of Alzheimer’s dementia
• Neuropsychiatric symptoms of dementia
• Biology of aging outcomes in skeletal, muscle, central nervous and cardiovascular systems
• Exercise and nutrition interventions
• Advance care planning and palliative care

Dementia-mechanisms:

• Defining basic mechanisms of Alzheimer's disease and neurodegeneration including the role played by disruption of insulin and glucose regulation, similar to diabetes.
• Characterizing events and molecules involved in Alzheimer's disease and related disorders with an emphasis on genetics and inflammation in disease causation and progression.
• Dementia-noncognitive symptom management: Using drug and non-pharmacological treatments targeting neuropsychiatric symptoms of dementia or altering trajectory of neurodegeneration.
• Dementia-repurposing FDA approved meds for prevention of dementia: Ezetimibe, Statins.

Preventing frailty:

• Neuromodulation for enhancing exercise adherence in older adults.
• Increasing mobility for older adults through technology and technology-based exercise programs

Toxic exposures and infections as accelerated aging models:

• Open Burn Pit research study – Understanding the chronic health issues experienced by Veterans exposed to open burn pits by studying the DNA methylation biomarkers.
• COVID-19 impact on dementia and caregiving, on physical activity in older adults, and on biopsychosocial factors of loneliness and social isolation in older rural Veterans.

Caring for multi-morbid older adults:

• Meeting the supportive care needs of chronically and seriously ill Veterans and their caregivers
• Evaluating Staffing Methodology and Veteran Outcomes in the Community Living Centers

The CONFIRM Study:

• A cooperative study program for reduction in colon cancer mortality

• Retooled GRECC fellowship in Advanced Geriatrics
• End-of-Life Nursing Education Consortium (ELNEC) for Veterans
• Enduring education focused on engaging staff in geriatric topics with emphasis on cognitive impairment, dementia, delirium, depression and palliative care
• Monthly webinars focused on geriatric care in primary care and Community Living Centers
• Health Profession Training Program (HPTP) with monthly interdisciplinary geriatric education and training
• Host site for Geriatric Scholars virtual clinical practicum
• Monthly GRECC Journal Club
• Quarterly Geriatric Ethics Forum
• Interdisciplinary format of dementia education for medical students
• Year 4 medical student clinical rounds

Advance Care Planning

• ACP-Group Visits, a nationally disseminated project to improve advance care planning.
• HAVE (Helping Aging Veterans Everywhere)
• Preventing frailty among older Veterans
• Geriatric Walking Clinic (partnered with Gerofit for dissemination)
• DASH program (collaboration to promote early and progressive patient ambulation during hospitalization)
• Stay Home Stay Fit: program to enhance fitness in older Veterans.
• Tai Chi for Health and Recovery in Older Veterans – a multi-site Tai Chi virtual exercise program to help Veterans improve their strength and balance.
• Addressing national VA shortage in geriatric

Workforce

• National Ask the Expert-Geriatric Psychiatry: A national network of geriatric psychiatrists supporting clinicians in the field treating geriatric mental health issues.

Geriatric E-consults 

• TeleGeriatrics Consultation/Co-Management for Rural Older Veterans: a program to improve the care delivered to Veterans in their home through video telehealth.
• Enhancing delivery of Geriatric Care
• Virtual Geriatrics (formerly known as GRECC Connect): Supports Geriatric E-consult, Virtual Memory Clinic, and the Connections Plan initiatives.
• Memory clinic (clinically sustained with Mental Health and refining neuropsychology battery to predict function)
• Connection Plans for Social Isolation and Loneliness: a low-tech intervention based on cognitive behavioral therapy to help Veterans make Mind, Body, and Social connections.
• Supportive C-TRAC: a low cost, telephone-based case management program that fosters patient-centered care that aligns with Veteran patients’ goals and provides assistance with care transitions.

• Effect of Methylphenidate on Apathy in Patients With Alzheimer Disease: The ADMET 2 Randomized Clinical Trial JAMA Neurol https://pubmed.ncbi.nlm.nih.gov/34570180/
• Evaluating the Staffing Methodology Model in Veterans Health Administration’s Community Living Centers Geriatr Nurs https://pubmed.ncbi.nlm.nih.gov/35512508/
• A Review of Race and Ethnicity in Hospice and Palliative Medicine Research: Representation Matters J Pain Symptom Manage https://pubmed.ncbi.nlm.nih.gov/35905937/
• Veteran comfort and satisfaction with comprehensive geriatric assessment via video telehealth to home. J Am Geriatr Soc. https://pubmed.ncbi.nlm.nih.gov/39360482/
• Ezetimibe Lowers Risk of Alzheimer’s and Related Dementias over Sevenfold, Reducing Aggregation in Model Systems by Inhibiting 14-3-3G::Hexokinase Interaction. AgingBio, https://pubmed.ncbi.nlm.nih.gov/39263528/
• Evaluation of a Virtual Tai Chi Program for Older Veterans at Risk of Loneliness or Physical Deconditioning: A Quality Improvement Project. Geriatrics (Basel). https://pubmed.ncbi.nlm.nih.gov/39051255/

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