Research
The primary focus of the Geriatric Center of Excellence's Center for Aging Research is to build networks and collaborate on projects that improve geriatric care. The Center’s success depends on close collaboration with northern New England’s universities and state agencies, as well as with home health agencies, hospitals, nursing homes, policymakers, and community-based organizations.
During fiscal year 2022/2023, the Geriatric Center of Excellence collaborated with and supported 8 research grants, contributing approximately $51 million to Dartmouth Hitchcock Medical Center.
Study of healthcare inequity in Alzheimer's disease
A team of researchers, led by Amber Barnato, MD, MPH, MS, at Dartmouth’s Geisel School of Medicine, has been awarded a $16.2 million grant from the National Institute on Aging (NIA) to study inequity in health and social care for adults with Alzheimer’s disease and related dementias (ADRD). The 5-year renewal grant will include major research hubs at the University of Indiana Medical School and Harvard Medical School.
Guided by three Cores—providing expertise in administration, research coordination, and planning; data management; and methods—the new grant will be organized around 3 main aims and several interrelated projects:
- Aim 1: Study the biases that people living with ADRD are subject to—particularly those embedded in policies and systems that shape the perceptions and behaviors of those who care for them.
- Aim 2: Look at how major shifts in the U.S. healthcare system—towards increased consolidation of providers and alternative payment models that encourage coordinated care and more home-based services—impact ADRD patients.
- Aim 3: Investigate the bias that people living with ADRD face in clinical decision making at the point of care. The study teams will explore bias in HCBS referral patterns, as well as in provider diagnostic test ordering in the acute-care setting, while also looking at the impact of diagnosis on the functional trajectory of patients with ADRD.
Publications
2023
Flaherty, E., & Fulmer, T. (2023). Using geriatric interprofessional team transformation for primary care to improve the care of older adults in a rural setting. Journal of the American Geriatrics Society, 10.1111/jgs.18669. Advance online publication. https://doi.org/10.1111/jgs.18669
Flaherty, E., O'Connor, S., Steltenpohl, C. N., Preiss, M., Volckaert, A., & Pepin, R. L. (2023). Geriatric Interprofessional Team Transformation for Primary Care overview. Journal of the American Geriatrics Society, 10.1111/jgs.18637. Advance online publication.
Garbarino, J. T., O'Connor, S., Pepin, R. L., Aitken, M. S., & Flaherty, E. (2023). Age-friendly health care and the 4Ms in RN-led annual wellness visits. Journal of the American Geriatrics Society, 10.1111/jgs.18671. Advance online publication.
Seifert, B., Volckaert, A. E., O'Connor, S., Flaherty, E., & Pepin, R. L. (2023). Bridging the gap between primary care and community-based organizations to address complex care needs of older adults. Journal of the American Geriatrics Society, 10.1111/jgs.18670. Advance online publication.
2022
Coll, PP, Batsis, JA, Friedman, SM, Flaherty, E. Medicare's annual wellness visit: 10 years of opportunities gained and lost. J Am Geriatr Soc. 2022; 70( 10): 2786- 2792. doi:10.1111/jgs.18007
Flaherty E, Biese K. The Implementation of Geriatric Emergency Department Accreditation (GEDA) in Rural Critical Access Hospitals. Innov Aging. 2022 Dec 20;6(Suppl 1):338. doi: 10.1093/geroni/igac059.1334. PMCID: PMC9766001.
Donnelly KZ, Jeffreys C, MacKenzie T, McDonnell L, Black H, Bruce ML, Smith AD. A crossover pilot trial of the feasibility, acceptability, and effectiveness of LoveYourBrain Yoga for community-dwelling adults with multiple sclerosis. Complement Ther Clin Pract. 2022 Nov;49:101607. doi:10.1016/j.ctcp.2022.101607. Epub 2022 Jun 30. PMID: 35780542.
Alexopoulos GS, Bruce ML, Silbersweig D, Kalayam B, Stern E. Vascular depression: a new view of late-onset depression. Dialogues Clin Neurosci. 1999 Sep;1(2):68-80. doi:10.31887/DCNS.1999.1.2/galexopoulos. PMID: 22033775; PMCID: PMC3181568.
Bruce ML, Pearson JL. Designing an intervention to prevent suicide: PROSPECT (Prevention of Suicide in Primary Care Elderly: Collaborative Trial). Dialogues Clin Neurosci. 1999 Sep;1(2):100-12. doi:10.31887/DCNS.1999.1.2/mbruce. PMID: 22033641; PMCID: PMC3181574.
Lim C, Moak G, Fortuna KL, Bianco CL, Shakhau A, Bruce ML, Bartels S. Attitudes and Beliefs on Aging Among Middle-Aged and Older Adults With Serious Mental Illness. Am J Geriatr Psychiatry. 2022 Mar;30(3):419-423. doi:10.1016/j.jagp.2021.07.005. Epub 2021 Jul 24. PMID: 34400046.
Fortuna KL, Myers AL, Ferron J, Kadakia A, Bianco C, Bruce ML, Bartels SJ. Assessing a digital peer support self-management intervention for adults with serious mental illness: feasibility, acceptability, and preliminary effectiveness. J Ment Health. 2022 Dec;31(6):833-841. doi:10.1080/09638237.2021.2022619. Epub 2022 Jan 28. PMID: 35088619; PMCID: PMC9329481.
2021
Pepin, R., Stevens, C. J., Choi, N. G., Feeney, S. M., & Bruce, M. L. (2021). Modifying Behavioral Activation to Reduce Social Isolation and Loneliness Among Older Adults. American Journal of Geriatric Psychiatry. 29(8) 761-770. doi:10.1016/j.jagp.2020.09.004.
Bruce, M. L., Pepin, R., Marti, C. N., Stevens, C. J., & Choi, N. G. (2021). One Year Impact on Social Connectedness for Homebound Older Adults: Randomized Controlled Trial of Tele-delivered Behavioral Activation Versus Tele-delivered Friendly Visits. American Journal of Geriatric Psychiatry, 29(8), 771-776. doi:10.1016/j.jagp.2021.05.005.
Ganoe CH, Wu W, Barr PJ, Haslett W, Dannenberg MD, Bonasia KL, Finora JC, Schoonmaker JA, Onsando WM, Ryan J, Elwyn G, Bruce ML, Das AK, Hassanpour S. Natural language processing for automated annotation of medication mentions in primary care visit conversations. JAMIA Open. 2021 Aug 19;4(3):ooab071. doi:10.1093/jamiaopen/ooab071. PMID: 34423262; PMCID: PMC8374372.
Lim C, Moak G, Fortuna KL, Bianco CL, Shakhau A, Bruce ML, Bartels S. Attitudes and Beliefs on Aging Among Middle-Aged and Older Adults With Serious Mental Illness. Am J Geriatr Psychiatry. 2021 Jul 24:S1064-7481(21)00391-2. doi:10.1016/j.jagp.2021.07.005. Epub ahead of print. PMID: 34400046.
Brady R, Hegel MT, Curran GM, Asmundson GJG, Xie H, Bruce ML. Evaluation of a brief psychosocial intervention for health anxiety delivered by medical assistants in primary care: study protocol for a pilot hybrid trial. Contemporary Clinical Trials. (2021) Dec;111:106574. doi:10.1016/j.cct.2021.106574. Epub 2021 Oct 7. PMID: 34628077; PMCID: PMC8678311.
Gould, CE, Carlson C, Alfaro AJ, Chick CF, Bruce ML, Forman-Hoffman VL (2021, accepted). Changes in Quality of Life and Loneliness Among Middle-Aged and Older Adults Participating in Therapist-Guided Digital Mental Health Intervention. Frontiers in Public Health. 2021 Dec 9;9:746904. doi:10.3389/fpubh.2021.746904. PMID: 34957011; PMCID: PMC8695684.
Barr PJ, Haslett W, Dannenberg MD, Oh L, Elwyn G, Hassanpour S, Bonasia KL, Finora JC, Schoonmaker JA, Onsando WM, Ryan J, Bruce ML, Das AK, Arend R, Piper S, Ganoe CH. An Audio Personal Health Library of Clinic Visit Recordings for Patients and Their Caregivers (HealthPAL): User-Centered Design Approach. J Med Internet Res. 2021 Oct 22;23(10):e25512. doi:10.2196/25512. PMID: 34677131.
Kennedy MA, Pepin R, Stevens CJ, Bartels SJ, Batsis JA, Beyea A, Bruce ML, Eckhaus JM, Korsen N, Pidgeon DM, Powell KE, Reynolds CF 3rd, LaMantia MA. Mind, Mood, Mobility: Supporting Independence Among Rural Older Adults at Risk for Functional Decline. Am J Health Promot. 2020 2021 Feb;35(2):295-298. PMCID: PMC7752854.
Choi NG, Marti CN, Wilson NL, Chen GJ, Sirrianni L, Hegel MT, Bruce ML, Kunik ME. Effect of Telehealth Treatment by Lay Counselors vs by Clinicians on Depressive Symptoms Among Older Adults Who Are Homebound: A Randomized Clinical Trial. JAMA Netw Open, 2020; Aug 3, 3(8):e2015648.
Lutz J, Van Orden KA, Bruce ML, Conwell Y; Members of the NIMH Workshop on Social Disconnection in Late Life Suicide. Social Disconnection in Late Life Suicide: An NIMH Workshop on State of the Research in Identifying Mechanisms, Treatment Targets, and Interventions. Am J Geriatric Psychiatry, 2021 Feb 5:S1064-7481(21)00167-6. Epub ahead of print. PMID: 33622593.
Grigoroglou C, van der Feltz-Cornelis C, Hodkinson A, Coventry PA, Zghebi SS, Kontopantelis E, Bower P, Lovell K, Gilbody S, Waheed W, Dickens C, Archer J, Blakemore A, Adler DA, Aragones E, Björkelund C, Bruce M, Buszewicz M, Carney RM, Cole MG, Davidson KW, Gensichen J, Grote NK, Joan Russo J, Huijbregts K, Huffman JC, Menchetti M, Patel V, Richards DA, Rollman B, Smit A, Zijlstra-Vlasveld MC, Wells KB, Zimmermann T, Unützer J, Panagioti M. Effectiveness of collaborative care in reducing suicidal ideation: An Individual Participant Data Meta-Analysis. General Hospital Psychiatry Journal, in press.
2020
Choi, N. G., Pepin, R., Marti, C. N., Stevens, C. J., & Bruce, M. L. (2020). Improving Social Connectedness for Homebound Older Adults: Randomized Controlled Trial of Tele-Delivered Behavioral Activation Versus Tele-Delivered Friendly Visits. American Journal of Geriatric Psychiatry, 28(7), 698-708. doi:10.1016/j.jagp.2020.02.008.
Kennedy, M.A., Pepin, R., Stevens, C.J., Bartels, S.J., Batsis, J.A., Beyea, A, Bruce, M.L., Eckhaus, J.M., Korsen, N., Pidgeon, D.M., Powell, K.E., Reynolds, C.F., & LaMantia, M.A. (2020). Mind, Mood, Mobility: Supporting Independence Among Rural Older Adults at Risk for Functional Decline. American Journal of Health Promotion. doi.org/10.1177/0890117120934622 [doi.org].
Sonnega, A., Leggett, A., Pepin, R., & Assari, S. (2020). Physical Activity and Insomnia Symptoms Over 10 Years in a US National Sample of Late-Middle-Age and Older Adults: Age Matters. Journal of Aging and Physical Activity, 1, 1-10. doi:https://doi.org/10.1123/japa.2018-0337 [doi.org].
2019
Flaherty E, Bartels SJ. Addressing the Community-Based Geriatric Healthcare Workforce Shortage by Leveraging the Potential of Interprofessional Teams. J Am Geriatr Soc. 2019 May;67(S2):S400-S408. doi:10.1111/jgs.15924. PMID: 31074849.
Flaherty, E., (2019) Try-This: Assessing Pain in Older Adults (PDF). Issue Number 7, Hartford Institute for Geriatric Nursing, College of Nursing, New York University.
Stadler, D., Oliver, B., Raymond, J., Routzhan, G., Flaherty, E., Stahl, J., Batsis, J., Bartels, S. (2019). Reducing Avoidable Facility Transfers (RAFT): Outcomes of a Team Model to Minimize Unwarrented Emergency Care at Skilled Nursing Facilities. Journal of American Medical Directors Association. 20(8).
Flaherty, E., Busby-Whitehead, J., Potter, J., Lundebjerg, N. (2019). The Geriatric Workforce Enhancement Program: Review of the Coordinating Center and Examples of the GWEP in Practice. Journal of Geriatric Psychiatry. 27(7)