Halima Amjad

COAH Champion: Halima Amjad, MD, MPH, PhD

Halima Amjad, MD MPH PhD is a most valued core faculty member with the Center. She is an Assistant Professor with the School of Medicine in Division of Geriatric Medicine and Gerontology.  Her areas of clinical expertise include geriatric medicine and geriatric psychiatry, with a focus on individuals living with dementia. She is a provider at the Johns Hopkins Memory and Alzheimer’s Treatment Center, located at Bayview.  Dr. Amjad is known for being friendly, compassionate, and extraordinarily insightful in her research inquiries and findings. We are grateful for this opportunity to learn more about her personally and professionally, and share with you how truly wonderful Dr. Amjad is through this COAH Champion interview. Let’s start by recognizing a fabulous recent accomplishment! The PhD part of her credentials is new!

Congratulations on earning your PhD degree! This is in addition to your MD and MPH! What does that mean to you? What will you be able to do differently now?
Obtaining a PhD in Clinical Investigation highlights my commitment to a career in clinical aging research and acknowledges that formal training is important to ensuring that clinician researchers have the skills to plan, conduct, and disseminate high-quality research. Several geriatricians at Johns Hopkins followed a similar path to establish themselves as independent investigators, and I hope to do the same. The doctorate degree shows the world, particularly funders and collaborators, that I have a strong foundation in research methodology and a dedication to this career.

Tell us about your background, education, and path to COAH.

image of drawingAs a pre-schooler, I declared that I wanted to be “mommy and daddy’s doctor” and followed through! I was always drawn to a medical career, a career centered around caring for others. I made the commitment to medicine early, going to a joint BA/MD program for undergrad and medical school (Lehigh University and Drexel University in PA). During my internal medicine residency at Yale, I was drawn to geriatrics because I loved the emphasis on the whole person and family as well as the “less can be more” approach. I think I was subconsciously also led to geriatrics by my dad’s dementia diagnosis. I never envisioned a research career, but I got involved in my first research project related to advance care planning with Terri Fried at Yale. That first experience peeked my interest in research, and I came to Johns Hopkins for a clinical and research fellowship in geriatrics to image of Halima Amjad and Momget more training in aging research and see if I would enjoy research long-term (Hopkins was also closer to my parents, which was important to me). As a fellow, COAH Director Dr. David L. Roth was one of the first mentors I connected with. His mentorship helped me obtain my earliest grants using National Health and Aging Trends Study (NHATS) data to examine potentially unsafe activities among older adults with dementia and then extending that work to examine people living with undiagnosed dementia with NHATS-linked Medicare claims data. Many of my mentors are core or associate faculty of COAH, and I love the interdisciplinary connections and collaborations it brings.

 

 

Why did you choose to go into this field of work?

image of Halima Amjad and DadAs I carved out a career as a clinician investigator, I focused on dementia care and health services for people living with dementia due to my dad’s diagnosis. He was diagnosed with early-onset frontotemporal dementia just as I was graduating from medical school. Through our family’s experiences, and now also through experiences of my Memory Clinic patients, I have seen the many ways in which medical care and our health care systems fail people with dementia, from diagnosis until death. I know that there are policies, interventions, and clinical practice changes that can improve the care and support that individuals and families receive. My work, and the work of many others, is trying to bring those needed changes. Research can also be daunting when you see the work of senior or established researchers; because of my personal experience, I felt dementia care was one area where I had expertise even as an early career investigator.

What paper are you most known for or most proud of?
While my paper on continuity of care and healthcare utilization in older adults with dementia was published in my highest profile journal, I’m most proud of my paper characterizing people living undiagnosed or unaware of dementia in the Journal of General Internal Medicine (which you can find by clicking here). It is work that I envisioned and led. It’s often cited in research to improve diagnosis and disclosure of dementia, which is something that can be a long road for many patients and families, including mine.

Turning to the escapes you may have in your personal world, please share with us your favorite films or songs over the past year.
Two films that I loved happen to also hit home the importance of the work that COAH faculty do: The Father and CODA.

What is the top item on your bucket list?
Foreign travel! Between the pandemic and having triplets, it has been a long time since we’ve been able to explore new places, cultures, and most importantly, food.

Tell us about your hobbies… what renews you?
Time separating myself from work – focused time with my family, vacations (even short ones), exercise (Pamela Reif on YouTube is my go-to), and reading (mostly fiction). Hopefully I can report back with more hobbies and activities once my kids are older!

Favorite daytrip getaway destination?
Fort McHenry is a family favorite for a picnic, playing, and boat watching.

What’s your favorite city or state? Why?
Philadelphia – there’s no place like home.

We thank Dr. Halima Amjad for allowing us into her world through this very personal interview. Absolutely, her commitment to improving the lives of those living with memory loss and dementia comes from a place of sincere compassion, especially as it personally touches her immediate family; we were saddened to learn that her father, Dr. Muhammad Amjad, passed away on March 10, 2022. Diagnosed at age 59 and passing away of end-stage dementia at age 72, he lived 13 years with early-onset frontotemporal dementia at home under the loving care of his wife. Dr. Muhammad Amjad was known for his smile, laugh, generosity, and kindness—all wonderful attributes he clearly passed down to Dr. Halima Amjad.  The COAH family expresses our deepest heart-felt condolences on this great loss—may his memory be a blessing.

By Anthony L. Teano, MLA
Communication Specialist

 

image of COAH staff

COAH 2022 Spring Awards Luncheon

I am overjoyed that we could gather at the center’s offices on May 10th for the 2022 COAH Spring Awards Luncheon. The center has been around for almost 25 years, and this luncheon has been a favorite part of happenings since 2014.

The purpose of this luncheon is really to bring people together and celebrate our successes and our talented, growing team. At the event, we highlight new hires, appointments and promotions. We recognize accomplishments individuals have earned through their dedication and hard work. And we acknowledge the prolific new financial awards/funding our team of researchers have gained to further advance scientific data around healthy aging.

Since this was the first COHA Spring Awards Luncheon since the pandemic began, it encompassed such laurels over the past two years.  Here are a few examples of our reasons to come together and celebrate:

New Hires:
Tom Cidav  –  New hire: Biostatistician (April 2020)

Tony Teano –  New hire: Sr. Administrative Coordinator (April 2020)

Talan Zhang  –  New hire: Sr. Biostatistician (August 2020)

Tim Sanders  –  New hire: Software Engineer (September 2020)

Appointments:
Cynthia Boyd – Director, Division of Geriatrics (August 2021)

Jennifer SchrackNamed new Co-PI of NHATS (2021)

 

 

Promotions:
Ravi Varadhan – Promoted to full professor (2021)

Marcela Blinka – Promoted to Research Associate (2021)

Tony Teano – Promoted to Communications Specialist (July 2021)

Awards:
Marcela Blinka – MFL Staff Award of Excellence for Leadership (2019)

Tony Teano – SOM Pride Month Achievers Award (June 2021)

Tony Teano – MFL Award for Creativity & Innovation (June 2021)

Tony Teano – Wrote/won a Diversity Innovation Grant from APL/DLC for “Geriatricians Engaged and Ready for LGBTQ+ Aging, Health & Wellness” with Drs. Matt McNabney (Mosaic Initiative in Geriatrics) & Panagis Galiatsatos (Medicine for the Greater Good & Office of Diversity Inclusion & Health Equity) as co-leaders of this initiative, and with the support of Dr. Cynthia Boyd, Director of the Division of Geriatric Medicine & Gerontology (January, 2022)

Emma Nichols – Louis I. and Thomas D. Dublin Award (2022)

Elizabeth Linton – Delta Omega Scholarship – Applied Research Award (2022)

Erica Twardzik – ProQuest Distinguished Dissertation Award – (2022) Of the more than 800 dissertations submitted each year, only ten are selected. The ProQuest Distinguished Dissertation Awards recognize highly accomplished graduate students who have produced exceptional dissertations of outstanding scholarly quality in any field of study.

While the lists of new grant-funded research and prominent peer-reviewed articles are too long to enumerate here, suffice it to say that the center’s industrious team successfully gained the resources to advance research benefiting older adults and their caregivers nationally and globally with many interesting and innovative approaches and topics that promise to yield valuable findings.

As COAH’s director for more than a decade, I am proud of our team as individuals and as collaborators—both internally to Johns Hopkins as well as with prominent external researchers in the field of applied geriatrics. I congratulate you on your successes, and wish you many more!

 

By Dr. David L. Roth

The Elderly in Sub-Saharan Africa: the Case of Ghana

C. Charles Mate-Kole, PhD, Professor in the Department of Psychology, Consultant Clinical Neuropsychologist in the Department of Psychiatry and Founding Director of the Centre for Ageing Studies at the University of Ghana will present “The Elderly in Sub-Saharan Africa: the Case of Ghana” at the June 6, 2022 Center on Aging & Health Scientific Seminar  Series.  We invite you to attend in person.  Masks are required.  You may also view via Zoom by registering at https://bit.ly/3vTcnEi.  This event is sponsored by: The Matthew Tayback, Sc.D., Memorial Lecture Fund; Center on Aging and Health; Division of Geriatric Medicine and Gerontology; Johns Hopkins Older Americans Independence Center; Epidemiology and Biostatistics of Aging Training Program.

senior Latina couple

Family Caregivers Share Both Positive and Challenging Experiences in New Study

An old adage goes something like this: “Growing old is not for the faint of heart.” Perhaps there’s something else about the aging human condition at parity with this wisdom: caregiving is both challenging and rewarding. And perhaps listening to caregiver experiences individually and as an aggregate can help us prepare for a culture and society where aging and caregiving can be less challenging and more rewarding.

Now is the time to do so.

According to Aging Care’s Caregiver Statistics, in 2020, the AARP Public Policy Institute and the National Alliance for Caregiving reported that 53 million Americans are providing unpaid care to family and friends, and family caregivers provide an average of 23.7 hours of care each week—and if they cohabitate, the number of hours increases to 37.4 hours weekly.

Baby boomers are getting older and living longer, and the Population Reference Bureau projects the number of Americans over the age of 65 will practically double between 2018 to 2060, from 52 million to 95 million people. Additionally, given the fact that many older adults develop chronic conditions as they age, combined with the scarcity of affordable care, we can only expect the number of “informal” or “family caregivers” to grow over time, especially as older adults overwhelmingly desire to age in place, in their own homes.

participants characteristicsMany quantitative studies have examined the health impact of providing care on those who care for family and friends, but few qualitative studies looked into the nuances of how they think, feel, and perceive their experience as a caregiver. To better understand and support them, that’s precisely what Drs. Marcela Blinka, Orla Sheehan, and David L. Roth from JHU’s COAH investigated along with colleagues from the University of Vermont and the University of Alabama at Birmingham.  The results of the study, “Family caregivers emphasize patience and personal growth: a qualitative analysis from the Caregiving Transitions Study,” was published in Age and Ageing in February, 2022.

They examined 251 responses to an open-ended question on the Caregiving Transitions Study—an ancillary of the Reasons for Geographic and Racial Differences in Stroke study—that gathers data about family caregiving and its effect on family caregivers: “Is there any other information that you can think of about your experience in being a caregiver that we should know about or you think might be beneficial to the study?” Upon a thorough review of the answers, the team identified four themes:

  • Cultural/family expectations
  • Growth opportunities
  • Reciprocity
  • Stressors/challenges and recommendations

These caregivers provided about 50 hours of care per week, well above the national average. Most of the caregivers were White women in their 70s providing care to a spouse with dementia. For some, it was their second turn at caregiving, having already cared for a parent. Reflecting a few of the themes above, here is a sample of moving, heart-felt, and all-too-real responses from caregivers in their own words:

  • “I promised my father-in-law that I would do whatever it takes to not put [my mother-in-law] in a nursing home.”
  • “It is something you have to do from the heart, if your heart is not in it you will not be able to stick with it… remember that when things get tough, and your loved one says things that hurt you, you have to realize it’s not that person saying things to you, it is their disease.”
  • “I do not like the word ‘caregiver.’ We are married. I do not get paid. I do what I do out of love.”
  • “‘We have a faith-based view that places great importance on honoring your parents.”
  • “You treat them the way that you would want to be treated because… one of these days we will all need help.”
  • “[Even though] there are a lot of resources out there to help… programs are not available to everyone so we have to pay out of pocket which I am not capable of doing.”
  • “If there was a way to get a mental break from everything for just a little while it would help a lot.”
  • Very difficult emotionally [and] I also feel like a prisoner.”
  • “There is a time period where you have to come to the realization that this is the way it is and do the best you can.”
  • “He refuses to let me [help him], because he doesn’t want to be a burden to me… I have a feeling that many care-recipients feel the same way.”

Many individuals who have been caregivers may identify with these themes.  Essential to understanding the enormity of it all is the reality that the caregiving experience is in fact paradoxical. It isn’t all easy or fun, and it can be anguishing sacrifice. But sometimes, it has a silver lining, too, and encompasses “both/and.” Caregiving can push people to grow in ways previously unimagined and spur deep human growth and awareness. This realization can teach us to be aware of what we must do to anticipate and prepare for an aging society that relies upon their informal and family caregivers. What do they need right now?  How can interventions help people become better, healthier caregivers?  What resources need to be developed to support them?

The insights from this qualitative review are useful and impactful because “The projected need for informal caregiving for older adults is expected to outpace the number of available caregivers dramatically in the next decade.  As such, caregivers’ readiness and/or burden in their role are of great importance to an ever-increasing proportion of the population.”

The research team’s key takeaways from the study were:

  • Caregiving was viewed as an unquestioned obligation, repayment of benefits provided by the family member, acts of love, or the fulfilment of promises.
  • Opportunities for growth and reciprocity were the important aspects of the caregiving experience.
  • Caregivers experienced lifestyle changes, financial burdens, and desire for more support in their role.

Dr. Blinka, the first author, wrote: “Informal caregivers are essential to an aging society, especially as there is an increasing emphasis to allow older adults to age in place. Our findings show that caregivers can meet the challenges of caregiving by finding meaning, engaging in mutual support with the care recipient and identifying opportunities for growth. A more comprehensive understanding of the caregiving experience can help inform future interventions as well as provide guidance for how individuals and systems can most effectively support caregivers in fulfilling their roles.”

Dr. Blinka is available for interviews and comments.

By Anthony L. Teano, MLA
Communication Specialist