minding memory Articles

In this episode, Lauren Gerlach and Matt Davis speak with Theresa Shireman, PhD, Director of the Center for Gerontology and Healthcare Research and a Professor of Health Services, Policy and Practice and Epidemiology at the Brown University School of Public Health. Dr. Shireman’s research focuses on pharmaceutical policy, pharmacoepidemiology, health services research, and medication use among vulnerable populations. Dr. Shireman discusses her recent study, "Impact of Federal Antipsychotic Use Policy in Nursing Homes on New Diagnoses for Approved Indications in Dementia Residents," published in the Journal of the American Geriatrics Society. The study examines whether federal policies designed to reduce antipsychotic use in nursing homes were associated with increases in new diagnoses of conditions, such as schizophrenia, that exclude residents from publicly report antipsychotic quality measures. Using an interrupted time-series design, the researchers examined changes following the 2012 National Partnership to Improve Dementia Care and the 2015 addition of antipsychotic use to the Nursing home Five-Star Quality Rating System. They found that neither policy was associated with an increase in new exclusionary diagnossees, challenging concerns that nursing homes were increasingly assigning these diagnoses to circumvent restrictions on antipsychotic use. The conversation also explores the benefits and risks of antipsychotic medications for people living with dementia, including the potential for serious adverse effects such as sedation, falls, stroke, and increased mortality. Dr. Shireman discusses how public reporting and financial incentives can influence prescribing practices,the limitations of using a single quality measure to evaluate nursing home care, and the importance of balancing medication safety and residents’ individual needs. The discussion highlights the need for shared decision-making among clinicians, nursing home staff, residents, and families, as well as greater investment in staffing, resources, and nonpharmacological approaches to improve quality of life for people living with dementia. The transcript for this episode can be found here.

In this episode, Lauren & Matt speak with Neguine Rezaii, MD, an Assistant Professor of Neurology at Harvard Medical School and a Board-Certified Neuropsychiatrist at Mass General Hospital. Dr. Rezaii’s research focuses on using natural language processing and artificial intelligence to improve the detection and classification of neurodegenerative disorders. Dr. Rezaii talks about her recent study, “Voiceprints of Cognitive Impairment: Analyzing Digital Voice for Early Detection of Alzheimer’s and Related Dementias,” which explores how artificial intelligence can analyze short speech samples to identify subtle signs of cognitive impairment. The study used speech recordings from 120 individuals and found that features such as pauses, word choice and the specificity of language can help distinguish cognitive impairment and Alzheimer’s disease. The conversation also explores how a simple 30-second speech test could potentially be used in clinical settings to support earlier detection and monitoring of cognitive impairment, as well as the challenges and ethical considerations that come with using AI to analyze something as personal as a person’s voice.

In this episode, Lauren & Matt speak with Neil Mehta, PhD who is the associate dean for research and a professor in the Department of Epidemiology at the University of Texas Medical Branch in Galveston. Dr. Mehta’s research focuses on US life expectancy trends, the effects of obesity on disability and mortality, the sources of socioeconomic status disparities in mortality, and patterns of health in the United States and Europe. Dr. Mehta talks about a recent manuscript from the NIA-funded TRENDS study called “Trends in Memory Function and Memory Impairment Among Older Adults in the United States and Europe, 1996 to 2018.”, which looks at data from several sources to compare trends in memory function across 13 different countries.

Welcome back to Season 6 of Minding Memory! In this episode, Lauren & Matt speak with Dr. Katherine (Kate) Possin, who holds the John Douglas French Alzheimer’s Foundation Professorship at the University of California, San Francisco Fein Memory & Aging Center. Dr. Possin talks about the Care Ecosystem, a telephone and web-based model that provides ongoing education, support, care planning, and coordination for people living with dementia and their care partners. They’ll dig into how the Care Ecosystem was developed, and what studies have shown about its impact on people living with dementia.

In this episode, Matt & Lauren build off their previous conversation with Ashwin Kotwal about social isolation by speaking with Eve Lefkowitz, the Executive Director of the non-profit organization, A Conversation to Remember, which connects older adults – including those who live with cognitive decline – with young adult college students to combat the epidemic of social isolation and loneliness. Lauren & Matt learn about the populations this non-profit serve as well as perspectives on how to address social isolation with older adults.

In this episode we're going to discuss a topic that's increasingly recognized as central to cognitive health and social connection. We'll define what it is and what happens when it's missing. Social isolation and loneliness are now widely discussed as public health concerns, and evidence has really mounted that social disconnection has profound effects on health, including cognitive decline and dementia risk. To help us think through this, we're joined by Dr. Ashwin Kotwal, a geriatrician and health services researcher at UCSF and the director of the Social Connections and Aging Lab. His work examines how social relationships shape aging related outcomes, including cognitive health, disability, and mortality.

In this episode, Matt & Lauren speak with Kristine Ajrouch, PhD - a new member of our CAPRA leadership team. Kristine is a Research Professor at the Institute for Social Research whose work focuses on aging, health, immigration and family in the United Statues and the Middle East; social networks over the life course; and Arab American identity and well-being. Kristine discusses a recent article that examined an intervention to improve outcomes among Arab American caregivers who provide care to a family member living with dementia. She also shares what this work teaches us about caregiving as a family system rather than the responsibility of a single individual.

Welcome back to Minding Memory! In today’s episode, Lauren & Matt speak with Dr. Laura Zahodne – a professor of psychology at the University of Michigan and an affiliate of the Institute for Social Research. She's a clinical neuropsychologist by training and studies how psychosocial experiences shape late life, cognitive health, and risk of neurodegenerative disease. Also, a new member of our CAPRA leadership team! In this episode, we’ll get to know Laura a little better and talk with her about one of her research studies, the Neighborhood Racial Income Inequality in Cognitive Health, which looks at the association between racial income differences and a variety of cognitive measures.

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. 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.

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.

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.

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.

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.

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!

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.