Minding Memory

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.