Mentoring and Research to Help Patients with Alzheimer’s Disease and Related Dementias Experiencing Elder Mistreatment - The overarching aim and long-term goal of my research is to: improve identification, intervention, and prevention of elder mistreatment among persons living with Alzheimer’s disease and related dementias (ADRD) by: (1) mentoring and supporting the next generation of researchers and (2) advancing patient-oriented research in this field. Elder mistreatment (EM) is common, with older adults with ADRD at much higher risk, and is associated with adverse health outcomes. Unfortunately, EM is dramatically under-recognized and underreported. An assessment by a healthcare provider may represent the only contact outside the family for many older adults experiencing EM, particularly older adults with ADRD. Therefore, clinicians have a unique opportunity to identify suspected EM and initiate intervention, and an urgent priority exists to improve EM detection and response in healthcare settings. My research and that of collaborators and mentees addresses this pressing need. My colleagues and I have already used innovative approaches to identify injury patterns and forensic biomarkers specific to physical EM. We have also successfully linked EM cases to Medicare claims data, describing patterns of healthcare utilization among these older adults. I have also led the development and implementation of the Vulnerable Elder Protection Team (VEPT), a first-of-its-kind ED/hospital-based multi-disciplinary consult service to assess and provide care to potential EM victims. Much more research is needed, though, and few junior researchers are currently focused in this area. Recruiting, mentoring, and supporting the next generation of elder mistreatment researchers is critical. Also, as victims are particularly likely to receive care in an Emergency Department (ED), research focused on improving identification of and intervention for elder mistreatment is essential to optimize geriatric ED care. I will leverage my expertise, experience, datasets, clinical programs, and collaborative relationships to mentor promising researchers in elder mistreatment and geriatric emergency medicine. Through protected time and training in this K24, I will mentor the next generation of researchers in these areas. My research aims are to: (1) identify differences in electronic health record information between older adults with ADRD experiencing EM presenting to the ED in comparison with non-exposed older adults with ADRD, including developing and validating a machine learning algorithm to predict EM exposure, (2) describe rates and patterns of health care utilization of older adults with ADRD experiencing EM identified using Medicare claims data before and after initial EM diagnosis in comparison to controls, and (3) use focus groups with primary care clinic leaders and team members to explore how to optimally integrate a novel screening tool for neglect in older adults with ADRD into workflow in a primary care setting. These projects complement NIA-funded research in my patient-oriented research lab. Each will advance EM research and improve detection and response in healthcare while also offering many opportunities for mentees to contribute and to take a leadership role in related work.
