GEARed to Better Serve Baltimore’s LGBTQ+ Elders!

Imagine this: Chris, a 57-year-old with severe chest pain is taken by car to Johns Hopkins Bayview Medical Center’s Emergency Department; Pat, aged about 46 years, drives and waits in the Emergency Department. Chris is in severe pain, and Pat is palpably terrified. And Chris is thinking:

  • “Will this doctor believe my life isn’t worth saving because of whom I love?”
  • “Will I receive substandard care because I am who I am?”
  • “Can I trust these people to treat Pat and I with dignity and respect?”
  • “Will these strangers in white coats listen to my life partner of 21 years, whose judgement I trust over my estranged family’s, if I become incapable?” 

Sadly, the fears in this hypothetical scenario are all too real for most LGBTQ+ older adults. According to the AARP’s report, Maintaining Dignity, a sizeable sum of LGBTQ+ people do not trust medical professionals out of fear of prejudice, leaving them increasingly vulnerable for adverse health outcomes. They can’t tell at a glance if a doctor or nurse has prejudice against them.

By the same token, even culturally competent clinicians can’t tell if a person is LGBTQ+ just by looking at them. Frankly, clinicians don’t know if this particular patient had lost their job or housing due to their sexual orientation, or was forced to go through conversion therapy by another physician many years before, or experienced other appalling insults and harmful practices by past doctors.  Many LGBTQ+ elders have experienced such trauma, producing minority stress that erodes their health quality over time, and that has led to a large number of them avoiding healthcare when they need it.

You may be interested to know that LGBTQ+ people in the greater Baltimore metropolitan area on average live to be around 59 years old according to Chase Brexton Health Services. Per Trust Choice, the average life expectancy in Baltimore is 84 years, and the national average is 78.5 years. That is a 20 to 25 year difference.

To address this glaring disparity, Geriatricians Engaged and Ready (GEARed) for LGBTQ+ Aging, Health & Wellness is a new initiative resulting from a Johns Hopkins Diversity Innovation Grant aimed at improving the quality of compassionate, culturally aware care to Baltimore’s LGBTQIA+ community. GEARed’s leadership includes: Dr. Matthew McNabney, Chair, Mosaic Initiative Workgroup to Promote Diversity and Inclusion, Division of Geriatric Medicine and Gerontology; Dr. Panagis Galiatsatos, Co-Director, Medicine for the Greater Good, Division of Pulmonary and Critical Care Medicine; and me, Tony Teano—I work with several different teams as a Communications Specialist, and I serve on the Johns Hopkins University Diversity Leadership Council. Additionally, we are fortunate that Dr. Cynthia Boyd, Director of the Division of Geriatric Medicine and Gerontology, fully supported the idea to create GEARed and helped shape the winning grant proposal.

At this time, the Division of Geriatric Medicine and Gerontology invites Johns Hopkins Medicine clinicians—including MDs, RNs, PAs—who serve older people to participate in GEARed’s training program.  GEARed’s curriculum is currently being finalized; it will be a carefully curated selection from the National LGBTQIA+ Health Education Center, a program of Fenway Institute that offers free online training modules. A limited number of those who acquire the most CMEs in LGBTQ+ older adult care by the end of April will be eligible to receive a subsidized “Health Professional” membership with GLMA, an association of Health Professionals Advancing LGBTQ+ Equality.  To express an interest in GEARed, please email me at tony.teano@jhu.edu by the end of the day on Friday, March 18th for next steps.

image of Anthony TeanoI believe that GEARed for LGBTQ+ Aging, Health & Wellness will make a valuable contribution to meeting the healthcare needs of older adults in our communities. I hope that GEARed may serve as a pilot program, in a way—inspiring other areas of medicine to do something similar.  Ultimately, my dream is that GEARed will build trust between LGBTQ+ elders and their care team, and bring parity in outcomes for healthy aging.  I am grateful to work with such an amazing team of visionary people who make GEARed possible:

 

 

 

“I have been interested in the care of LGBTQ+ older adults for several years.  This has been inspired by an opening dialogue on the national scene as well as participation in the Mosaic Initiative in the Division of Geriatric Medicine and Gerontology since 2010.  The Mosaic Initiative explores all issues of diversity and inclusion including LGBTQ persons. There are many things that our Division can learn and grow as people and professionals.  We are grateful for this grant and the opportunities that will follow!”   

  —Dr. Matthew McNabney, Chair, Mosaic Initiative for Diversity & Inclusion

 

 

“We aim to assure the promise of medicine reaches all and every person. This initiative, this collaboration, reaffirms that promise. I’m thrilled to see this executed, and the great projects and engagements this will bring on in the future!” 

 

—Dr. Panagis Galiatsatos, Co-Director, Medicine for the Greater Good

 

 

 

“Congratulations to the team that has kicked off this exciting initiative!” 

 —Dr. Cynthia Boyd, Director, Division of Geriatric Medicine and Gerontology

 

 

 

 

 

By Anthony L. Teano, MLA
Communication Specialist

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Johns Hopkins ADRC’s “Memory & Aging” #BrainMatters Twitter Chat: February 24 at Noon ET

Are you interested in research about memory loss, dementia, and Alzheimer’s disease?

I am. I believe research is where the future is—treatments, interventions, discoveries—and, speaking as someone who was a caregiver to my mom who died from a type of frontotemporal dementia known as Pick’s Disease, I find hope and comfort in the promise of interventions for Alzheimer’s disease, dementia, and memory loss.  The #BrainMatters Twitter chats described below, facilitated by the Johns Hopkins Alzheimer’s Disease Research Center (JHADRC), are pivotal to sharing critical information among the masses.

Researchers and members of the broader community who want to learn more about research are invited to follow the JHADRC’s “Memory & Aging” Twitter handle on Thursday, February 24 starting at noon ET to catch their #BrainMatters Twitter chat on the “State of Research on Memory Loss, Dementia and Alzheimer’s Disease.” It is very easy to do—simply be on Twitter during the event, and follow @JH_Memory_Aging.  The chat will unfold in real time, and anyone may contribute to the conversation.

According to the Alzheimer’s Association’s website: “Recruiting and retaining research participants is now the greatest obstacle, other than funding, to developing the next generation of Alzheimer’s treatments. Individuals with dementia, caregivers and healthy volunteers are all needed to participate in clinical studies focused on Alzheimer’s and other dementias. Without clinical trials, there can be no better treatments, no prevention and no cure for Alzheimer’s disease.”

For the upcoming Twitter Chat, we look forward to hearing from Johns Hopkins researchers at the Agrawal Lab and the HEADS Center, and Drs. Rosenberg, Smith and Pettigrew, and from researchers with the George Washington University’s Institute for Brain Health and Dementia.  They will explore the following topics:

  • Ongoing research in this discipline
  • Research about dementia risk reduction
  • New research findings
  • Local studies seeking new research volunteers and how to get involved
  • Factors that motivate people to become research participants
  • How research influences treatment, care, and interventions; and
  • The importance of diversity in memory loss research

The live #BrainMatters Twitter Chats have been an excellent opportunity to engage with leading researchers and advocates on brain health at Johns Hopkins University, throughout the Mid-Atlantic, and across the nation. Here’s what collaborators and past participants are saying about it:

Volunteering gives voice to groups that can affect service, research and voting.”

-Jo Ann Scipio, RN, Delta Sigma Theta Annapolis Alumnae Chapter

“Alzheimer’s disease is a growing global health crisis.  Research is critical to address this crisis, in order to achieve breakthroughs in treatment and prevention. These Twitter chats provide a platform for information sharing and discussion of some of the more pressing issues in brain health, early detection, health disparities, and research.”

-Ilene Rosenthal, Alzheimer’s Association Greater Maryland Chapter

“The Brain Matters collaboration is helping to elevate discussions on the importance of brain health, raising awareness of critical issues including equity, and engaging new audiences through interactive and insightful conversations – all free and open to the public!” 

-David Parkes, AARP Global Council on Brain Health

“As geriatricians, we believe it is important to meet older adults and their families where they are, and for many, that is on Twitter! Our bodies have an incredible capacity to regenerate and heal. Supporting brain health helps us all thrive. Research helps us find a way forward.”

-Dr. Alicia Arbaje, Johns Hopkins JHAD-RCMAR

“The #BrainMatters chats have been a fun and innovative way to share emerging scientific findings on topics related to brain health, memory loss, and aging with members of the community.”

-Dr. Corinne Pettigrew, Johns Hopkins ADRC 

#BrainMatters is a regional collaboration that is dedicated to sharing science-based information about brain health, health disparities, memory loss & Alzheimer’s disease and related dementias. In addition to the JHADRC, collaborators include the Greater Maryland Chapter of the Alzheimer’s Association, the AARP’s Global Council on Brain Health, the Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research (JHAD-RCMAR), and Delta Sigma Theta Alumnae Chapters from Annapolis and from Columbia, Maryland.

If you cannot make the live chat, you can catch up with the content later simply by searching #BrainMatters on Twitter. Doing so will also show content from prior chats on “Brain Health” and “Achieving Brain Health Equity.”  You may also be interested in following #JHMemoryResearch over the coming months as the JHADRC will be sharing additional information about ongoing research studies, Research Team Spotlights, and Research Participant Testimonials. The entire @JH_Memory_Aging Twitter feed is chocked-full of golden nuggets!

Any questions? Email tony.teano@jhu.edu

 

By Anthony Teano, Communications Specialist

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Measurement and Structure of Cognition

Alden L. Gross, PhD, an Associate Professor in the Division of Epidemiology of Aging at the Johns Hopkins Bloomberg School of Public Health and a Core Faculty member at the Center on Aging and Health in the Division of Gerontology at the Johns Hopkins University School of Medicine will present Measurement and Structure of Cognition across the world: Statistical  harmonization of the HCAP studies” at the March 7th Scientific Seminar Series.  In person attendance is encouraged.  To attend via zoom, registration is required at https://bit.ly/3gGC2rb

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Social Isolation and Biomarkers

Hopkins Geriatricians Identify Biomarkers Linking Social Isolation & Mortality

Congratulations are in order to COAH champions Dr. Thomas Cudjoe, Shang-En Chung, Dr. David L. Roth, and Dr. Cynthia Boyd from the Division of Geriatric Medicine and Gerontology and Dr. Roland Thorpe, Jr., from the Bloomberg School of Public Health for their timely and significant research paper: “Getting under the skin: Social isolation and biological markers in the National Health and Aging Trends Study.”  The full journal issue with this article went live on Feb. 6, 2022 and can be found here.

Also, collaborators outside of COAH included Dr. Carl Latkin from the Bloomberg School of Public Health and Sruthi Selvakumar, who was a Summer Research Trainee through the Division of Geriatric Medicine and Gerontology’s MSTAR Program.

Importantly, they found that social isolation and extreme social isolation are associated with higher levels of IL-6 and CRP, biomarkers of aging associated with deleterious health consequences over time—including increased mortality and morbidity.

Until now, social isolation was considered a risk factor for morbidity and mortality comparable to smoking, hypertension, and a sedentary lifestyle, but the science behind that deleterious association was not understood. Consequently, the discovery that social isolation is clearly linked to IL-6 or CRP may be instrumental to interventions mitigating social isolation’s negative health outcomes.

What follows is a brief interview with Dr. Cudjoe about it.

Tony Teano: How will this discovery help shape interventions?

Dr. Cudjoe: I think about this work as one of the steps in understanding how biological markers might be used as an outcome measure for social isolation intervention studies.

Tony Teano:  What can older adults do to stay socially connected, especially now, given the COVID-19 pandemic?

Dr. Cudjoe: The last few years have been difficult for everyone. Due to a variety of factors the COVID-19 pandemic has been particularly burdensome for the health and well-being of older adults. My advice is to first stay safe practicing proper masking, physical distancing, and hand hygiene. Specifically, as it relates to staying socially connected, I believe its important for people to prioritize the practice of connecting with friends, families, and neighbors at regular and routine intervals. This could take the form of safe in-person interactions (masked, distanced, or outdoors), connecting using communication technologies (i.e. phone, Zoom, Facetime), or writing letters. At the core of this is nurturing our relationships.

Tony Teano: If people took away just one pearl of wisdom from your most recent research, what would you want that to be?

Dr. Cudjoe: Social isolation is not good for our bodies.

Tony Teano: What social isolation research is in the pipeline that you’re working on?

Dr. Cudjoe: I am actively working to understand what older adults think about social isolation and what they believe might be solutions to prevent or address this challenge.

 

By Anthony Teano, Communications Specialist