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Volume 7, Issue 1
June 2012

Sponsored by: The National Institute on Aging, MetLife Foundation, the John A. Hartford Foundation, the Lillian R. Gleitsman Foundation, and several individual donors.  

Administered by: The American Federation for Aging Research (AFAR) and the National Institute on Aging (NIA).

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This online newsletter provides news and information about the Medical Student Research Training in Aging (MSTAR) Program to current and former student scholars, program directors, mentors, and others involved in the program.

PLEASE HELP US DISSEMINATE THIS NEWSLETTER to medical students and others in your institution. It is one of the best ways to promote this valuable program to potential applicants. Thank you!

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In This Issue

1. 2012 AGS Annual Scientific Meeting
2. 2012 MSTAR Awardees Chosen
3. Spotlight on a Former MSTAR Scholar: Tony Rosen, MD
4. MSTAR Scholar Success Story: Rahul Desikan, MD, PhD
5. AGS Student Special Interest Group
6. NIA Tip Sheet
7.Helpful Links / Geriatrics Recruitment and Student Opportunities

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2012 AGS Annual Scientific Meeting

This year’s American Geriatrics Society (AGS) Annual Scientific Meeting took place May 3 to 5 in Seattle, Washington. Nearly 2,700 geriatrics health care professionals attended. The meeting’s theme was “Patient Safety and Quality: What Geriatrics Has to Offer.” One-hundred and eighty-seven students presented their research at the student poster session, 80 of whom were MSTAR students.  The poster session and luncheon was supported by AGS, AFAR, Metlife Foundation, and the John A. Hartford Foundation.  In addition, AGS provided travel stipends to the 50 students who submitted the best abstracts, and MSTAR students comprised 27 of the award winners.

 

The 2013 annual meeting is set to take place in Grapevine, Texas.

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2012 MSTAR Awardees Chosen

A total of 146 medical students have been selected as this year’s MSTAR Scholars – the largest cohort since the program started. Ninety-six of the awardees are participating in the program at NIA-funded National Training Centers. The other 50 are being supported by private funding and will conduct their scholarships at their home institutions.

AFAR would like to thank all of the members of the MSTAR Review Committee for their hard work and careful review of each and every application.

For a list of the 2012 MSTAR Scholars, visit www.afar.org/grantees/years/2012-grantees. Congratulations to all of this year’s awardees!

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Spotlight on a Former MSTAR Scholar: Tony Rosen, MD

When we first spoke with Tony Rosen in 2007, he was a second-year medical student at Weill Cornell Medical College who had just completed his MSTAR project, studying resident-to-resident aggressive behaviors in nursing homes. He was bursting with enthusiasm for the project and the MSTAR program.

Five years later, that enthusiasm remains—along with a healthy dose of humility. During our recent conversation with Rosen—now Dr. Rosen—he kept reminding us that he is “only a second-year resident.” But his research and accomplishments are certainly worthy of recognition.

Dr. Rosen is now an emergency medicine resident at New York-Presbyterian Hospital. He specializes in geriatric emergency medicine, a field in which he says more people need to be interested. While emergency physicians are very good at treating younger patients with pains or injuries, he says, “We’re not as good with an older adult with multiple chronic illnesses for whom the diagnosis might not be as obvious, and for whom management might take a lot longer and involve a lot more subtlety.”

At the same time, Dr. Rosen says, “More and more older adults are coming in to the emergency department for their care. So whether or not we’re good at taking care of them, it’s going to be an important responsibility for us and an important part of improving emergency care.”

To help attract future physicians to geriatric emergency medicine, Dr. Rosen has gotten involved with MSTAR again this summer—this time as a mentor. Along with Dr. Mark Lachs of Weill Cornell Medical College—a member of AFAR’s Board of Directors and Dr. Rosen’s own MSTAR mentor—he is mentoring two students working on geriatric emergency medicine projects at Cornell. One student will help develop and implement a protocol for the diagnosis and management of delirium in older adults in the emergency department. The other will research alcohol withdrawal in older adults and help to identify and manage alcohol withdrawal in the emergency department. Dr. Rosen was already assisting with both of these projects.

At the same time, he has continued his MSTAR research. Dr. Rosen and his team published two papers based on his initial MSTAR work. After that, they researched sexual aggression in nursing homes—research Dr. Rosen presented at the AGS annual meeting two years ago. He and Dr. Lachs just completed another paper on resident-staff aggression in nursing homes. They’re now working on a paper on staff response to resident aggression. Dr. Rosen presented that research as a poster at this year’s AGS annual meeting.

But even while juggling all of this research, seeing patients, and caring for his infant daughter, Dr. Rosen is excited to be mentoring the MSTAR students this summer. “I really enjoyed the MSTAR program,” he says. “It gave me a lot of direction on the kinds of things I wanted to do.”

He is most keen on teaching the students a valuable lesson he learned from the MSTAR program—how to collaborate. “Collaboration between the emergency department and the geriatrics division is going to be the key to moving this type of research forward,” he says. “And understanding the importance of collaboration, and how to collaborate, was something I learned during the MSTAR program.”

After residency, Dr. Rosen says he may do additional training in geriatric emergency medicine. He hopes to then go into academic medicine, teaching emergency medicine with a focus in geriatrics. Perhaps we’ll check in with him again in five years!

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MSTAR Scholar Success Story: Rahul Desikan, MD, PhD

 

As a 2008 MSTAR Scholar, Dr. Rahul Desikan helped determine a biomarker for Alzheimer’s disease. He completed his MSTAR project at Boston University School of Medicine, from which he graduated in 2009. Since then, Dr. Desikan has remained dedicated to studying the disease. Now a clinical radiology resident at UC San Diego School of Medicine, he is also continuing his MSTAR work as the recipient of a 2011 AFAR-GE Healthcare Junior Investigator Award. Dr. Desikan spoke with AFAR about his important Alzheimer’s disease research and how the MSTAR program helped shape his career.

 

Tell me about your MSTAR project. 
Part of my work as a PhD student was developing a new way to automatically label brain regions based on MRI scans, and then to calculate how thin those regions were and what their volume would be. My MSTAR project built upon that work. We studied more than 300 subjects to see if we could differentiate older people who are not demented but have a very high risk of progressing to dementia from those with no memory problems. We looked at about 35 regions in the brain and narrowed in on three that we found to be very highly discriminative in one cohort. Then we took those same regions and applied them to a second cohort. We found that we essentially had a new biomarker for Alzheimer’s disease. Our work came out at the same time as work from my current mentor, Dr. Anders Dale, of UC San Diego’s Department of Radiology. He found the same thing, suggesting that automated measures of the human brain can be used as a biomarker to discriminate those people who will develop Alzheimer’s disease from those who will not.

Why was this project so important?
There was a real need to develop a new way to automatically look at different regions in the brain in living people rather than to wait for them to die and then do neuropathology. There was a need to quantify and validate in vivo biomarkers.

How can identifying a biomarker for Alzheimer’s disease change the way physicians treat patients?
We can use tools like the ones I’ve developed to do clinical testing to determine whether a patient’s memory problems are caused by something reversible, like a thiamine defect or a thyroid abnormality. If they’re not, then we want to know if there’s something happening in the hippocampus, the part of the brain involved in memory processing. If the volume of the hippocampus is lower than that of hundreds of other people in the same age range, we know there’s something structural going on, and the patient most likely has dementia of some sort. And that knowledge can help guide clinical care.

In terms of treatment, certainly there is nothing out there right now that’s going to change the patient’s disease trajectory. But we can give the patient a diagnosis and help the family come to terms with it and figure out long-term plans.

What did you find most helpful about the MSTAR program?
I was able to see geriatric patients at Boston Medical Center. It was very helpful to see clinically what was going on with these people, then go back to the lab and see what their brains really looked like, and then tie together the translational aspect to come up with ways to develop new tools that we can apply from the bench to the bedside. MSTAR provided me that unique opportunity to do translational research, which I think is very important and needed in the world of Alzheimer’s disease. A lot of people either do clinical work or do mouse-model research. But you really have to know and do both. The MSTAR program is a great place for young people to get to understand how to translate the things they develop to really help the lives of individual patients.

How is MSTAR beneficial for students who don’t plan to specialize in geriatric medicine?
As more and more baby boomers get older, taking care of the elderly is going to be one of the biggest weights on our society. So aging research extends far beyond geriatric medicine. It extends into neurology, radiology, genetics, and basic molecular/cellular genetic research. MSTAR applies to a whole slew of people who are interested in what is happening in normal aging.

Tell me about some of the work you’ve been doing as an AFAR-GE Healthcare Junior Investigator.
I am a research fellow in Dr. Dale’s Multimodal Imaging Laboratory at UC San Diego. We’ve been able to show that when we combine brain imaging with other markers, like cerebral spinal fluid (CSF) and genetic markers, we can identify those people who are cognitively normal but may have something going on in their brains. So, it is likely the case that Alzheimer’s disease begins decades before the onset of clinical symptoms. Using a combination of tools, we can possibly tell you what your likelihood is going to be of having Alzheimer’s disease even before you have the cognitive symptoms.

How did you become so interested in Alzheimer’s disease?

As a college student, I was a classics major interested in consciousness. In 1997 I attended a lecture by the person who became my undergraduate mentor, Dr. Andrew Budson at Brigham and Women’s Hospital. The lecture was on patients with Alzheimer’s disease having false memory, or false consciousness. I thought it was a fascinating concept. I talked to Dr. Budson after his lecture, and he convinced me to consider medical school and doing research with him.

I’ve been heavily invested in aging and Alzheimer’s research since then. I think it’s a really fascinating field. It’s a tragic thing to watch patients suffer through this disease, and even more tragic to watch their families go through it. I feel a very strong personal call to be able to do something about it. My grandfather, who died last year, may have been demented in the later years of his life. It was very tough for my grandmother and me to watch him lose his memory.

 

Do you plan to continue to do Alzheimer’s research?

Absolutely. I’m 110 percent committed to aging-related diseases—specifically Alzheimer’s disease and various dementias—for the rest of my life. 

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AGS Student Special Interest Group

The new American Geriatrics Society Student Special Interest Group is looking for students to get involved! The group aims to become a student-driven central resource for geriatrics-related news, scholarship opportunities, and mentorship and networking events.


The Student Special Interest Group’s new Facebook page will be updated regularly with interesting articles and useful resources. The group urges students to join the page and share things they come across with fellow geriatrics-minded students. The more people who share, the more comprehensive the resource will be. To join the page, search for "American Geriatrics Society Student Special Interest Group" on Facebook, or follow this link once you are logged in to Facebook: www.facebook.com/groups/364244326956402/

The group is also working on a quarterly listserv that will send out useful and relevant news. Please email group organizer Li-Wen Huang at lh83@duke.edu if you would like to be added to the list. Thank you for your interest!

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NIA Tip Sheet

The National Institute on Aging (NIA) offers numerous funding opportunities for new investigators conducting aging research. The NIA has put together a tip sheet to help these early-career researchers find the best resources and opportunities for them. To view and download the tip sheet, visit www.nia.nih.gov/sites/default/files/resources_for_early_career_researchers.pdf.

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Helpful Links / Geriatrics Recruitment and Student Opportunities

MSTAR information and online application:
www.afar.org/research/funding/mstar

MSTAR Toolkit:
http://www.afar.org/mstar-toolkit/

Diary of an MSTAR Student:
www.afar.org/mstarblog/posts

AGS Mentoring Programs:
www.americangeriatrics.org/health_care_professionals/trainees/find_a_mentor/  

Profiles of careers in geriatrics:
www.americangeriatrics.org/health_care_professionals/profiles_in_geriatrics/

AGS student chapters and other information for medical students: www.americangeriatrics.org/health_care_professionals/trainees/student_resident_chapters/ 

American Medical Student Association (AMSA) Geriatrics Interest Group:
www.amsa.org/AMSA/Homepage/About/Committees/Geriatrics.aspx

Association of American Medical Colleges (AAMC) Organization of Student Representatives: https://www.aamc.org/members/osr/  

AAMC Careers in Medicine program, which helps students select a specialty and apply to residency: https://www.aamc.org/students/medstudents/cim/

MSTAR information and online application: www.afar.org/research/funding/mstar

AFAR 's Twitter account: https://twitter.com/afarorg

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