VOL. 2 ISSUE 2 SPRING '07
New leadership at the Geriatric Research, Education and Clinical Center
onald Shorr, M.D., arrived in Gainesville in early January
to lead the Institute on Aging's clinical programs.
A board-certified geriatrician and internist, Shorr will
assume three roles in his new position -director of the Veterans
..r U Affairs Geriatric Research, Education and Clinical Center
earh (GRECC), associate director of the IOA and professor and chief
Rs. of the division of geriatric medicine in the department of aging
Education and geriatrics.
ini In his new position, Shorr will help unite the shared mission of
the VA and UF -providing full-service geriatrics care to seniors.
Center Shorr, who comes to Gainesville from the department of
preventive medicine at the University of Tennessee Health Science
Sei Center in Memphis, will use all his skills as he begins his work in his
d.P-.,. "I moonlight as a jazz musician," Shorr said. "I have learned
that you must listen to what the band is already playing in order to
make music. So as I approach this position, I'm going to go on a
Dr. Ronald Shorr, the new director of the VA GRECC, will have listening tour of the IOA and GRECC."
an active leadership role overseeing the UF Institute on Aging's The Veterans Health Administration initiated a strategy in the
clinical programs. New leadership, continued on page 3
Welcome from IOA Director Marco Pahor
On this issue we focus on the importance of providing
specialized geriatric care in our community.
Shands at the University of Florida in conjunction
with the North Florida/South GeorgiaVeterans Health System
has had a long-standing reputation for excellence in providing
geriatric care to veterans and community members.
This partnership, started in the 1970s, continues to grow
under the aegis of the Institute on Aging. To develop a "one-
stop shopping" opportunity for the delivery of geriatric health
care, UF's department of aging and geriatrics incorporated
UF's geriatrics division, which was formerly housed in UF's
department of medicine. This effectively brought together
UF and VA students, faculty and clinicians who specialize in
providing senior care.
We envision a continuity of this mission through the
training of the next generation of geriatric
physicians through our fellowship program AI .
and clerkships in geriatrics through a
partnership with UF and the Geriatric
Research, Education and Clinical Center
at the VA.
This integration of services addresses
one of the fundamental goals of the Marco Pahor, M.D.
UF Institute on Aging -to foster the
development of a cross-campus system of integrated health
care for older people -and will ensure the best quality of care
for elders in our community by developing health-care delivery
in the context of state-of-the-art research and education in
A physical therapist assists a patient at the VA's Gait and Balance Clinic.
Clinical Care the third GRECC mission
he third component of GRECC's mission is clinical care. G
clinicians fulfill their clinical effort through service on thi
Geriatric Evaluation and Management Unit
Palliative Care Unit
The Gait and Balance Clinic
The Geriatric Evaluation and Management Unit, or GEM, a
Palliative Care Unit, or PCU, are located on the third floor of the 1\
Home Care Unit Building. Each of these units has an interdisciplinar
dedicated to working with frail elders to help them achieve their gc
The 16-bed GEM selects patients with functional impairmei
rehabilitative needs. Over an average four-week stay, patient nee
comprehensively assessed and addressed, with the goal of dischargini
back to their home.
The Gait and Balance Clinic uses an interdisciplinary team of a p
therapist, physician, nurse and pharmacist to evaluate and treat older p
at high risk for falls.
The eight-bed PCU selects patients who are in the terminal pf
illness and addresses physical, emotional and family needs. Average let
stay is one or two weeks.
A geriatric fellow, attending physician and two medical residents r
knowledgeable and compassionate medical care on the GEM and PC
Miho K. Bautista, M.D., a clinical assistant professor and co-director of the
geriatric clerkship, recently passed the American Board of Internal Medicine
Specialty Board in Geriatric Medicine to become a board-certified geriatrician.
This spring we welcome a number people to the department of aging
Jameson DuPree, laboratory technician, Hazel Lees, M.S., laboratory tech-
nician, and Maria Seabra, M.S., senior laboratory technician, havejoined the
division of biology and aging.
Silvia Giovannini, M.D., is welcomed to the department as a postdoctoral
research associate from the Universita Cattolica del sacro Cuore in Rome, where
she is currently a geriatric fellow
Predictors of Adherence in LIFE
O here is national evidence of a decline in
physical activity with age and an association
between inactivity and increased risk for
physical disability. The Lifestyle Interventions and
Independence for Elders (LIFE) Pilot is a randomized
controlled trial that was designed to examine the
feasibility of conducting a large multi-center trial on
the effects of increasing physical activity in sedentary,
functionally compromised older adults to delay or
prevent the onset of mobility disability. One of the
objectives was to examine predictors of adherence to
The community setting for the pilot
included institution-based and home-based physical
activity for 213 men (31.1%) and women (68.9%)
with an average age of 76.5 years who were at risk for
disability. Adherence to physical activity interventions
was not related to differences in demographic profiles.
Similarly, there was not strong, consistent evidence that
adherence is related to comorbidities, level of physical
functioning, physical symptoms, or even cognitive
processes related to functioning and physical activity
that exist prior to the onset of an intervention.
The results were heartening in that the physical
activity intervention appears to have been well tolerated
by diverse groups of older adults. The role of prior
behavior in predicting later adherence to the program
underscores the importance of anticipating it and
developing advance interventions for its treat. T
Bhaskar Malayappan, Ph.D., comes to the department as a postdoctoral
research associate from Virginia Commonwealth University, Richmond, Va.,
wherehe was a postdoctoral associate.
Todd Manini, Ph.D., joins the department as a research assistant professor. He
will study energy expenditure in late life and design interventions to prevent the
onset of age-related disabling conditions.
Keri Merchant hasjoined the department of aging and geriatrics, division of
geriatric medicine, where she serves as division manager and coordinator of the
Jinze Xu, Ph.D., will join the department as a postdoctoral research associate.
She is currently a research fellow with the Mayo Clinic researching lipid metabo-
lism and insulin resistance.
New leadership, continued from page 1
mid-1970s to focus attention on the aging veteran population,
to increase the basic knowledge of aging, to transfer that
knowledge to health-care providers and to improve the quality
of senior care. A cornerstone of this strategy has been the
development of GRECCs. Gainesville has one of 21 such
centers of excellence currently operating in the nation.
The Institute on Aging's three-part mission also involves
patient care, education and research. One of the key components
for enacting this mission comes from its relationship with the
The work of the IOA naturally lends itself to the mission
of the GRECC and vice versa, Shorr said. He said his goal
for GRECC is to help translate some of the more mechanistic
research findings that come out of the Institute on Aging so they
VA GRECC educational activities
So clinicians can better care for their patients and seniors
can better understand the aging process, the Geriatric
Research, Education and Clinical Center at the VA
joins with the University of Florida's College of Medicine and
the Institute on Aging to provide various educational activities.
The courses, lectures and other educational offerings target
different audiences in three general areas: career development
of younger clinicians and researchers, training of health-care
providers and outreach activities in the community.
To enhance development of research, clinical and leadership
skills among students, trainees and fellows, UF and the GRECC
provide a variety of interdisciplinary learning experiences,
including weekly seminars, workshops on writing grants and
manuscripts, journal clubs, distance learning experiences, online
activities, informal networking events and a two-week geriatric
clerkship for fourth-year medical students.
The GRECC's efforts to improve the knowledge and
skills of faculty and staff at UF and the VA include two weekly
interdisciplinary aging seminar series that focus on research and
clinical topics. Special education events such as the Whittington
Lecture series, educational workshops and regional/national
conferences on geriatrics take place throughout the year.
Another aim is to improve the knowledge of older adults
and to enhance understanding of the aging population by
health professionals and consumers in the community. To do
this, GRECC initiated a campaign to educate the public about
health strategies to reduce the risk of stroke, produced a video to
empower patients with congestive heart failure to manage their
disease, and is currently developing educational materials to
help older adults readjust after returning from the wars in Iraq
and Afghanistan. t
can be applied to patients.
'A guy like me can take that research and translate it to apply
to the care of our patients with problems like frailty, which is
one problem we deal with that is linked to aging," Shorr said.
Shorr will also oversee the IOAs clinical operations, including
the geriatricians at the University of Florida Physicians Senior
Care of Tower Hill clinic.
Shorr holds a master's degree in epidemiology and
completed a postdoctoral fellowship in pharmacoepidemiology.
His research interests include the appropriate use of and
adverse effects of medications in older adults. He is currently
the principal investigator of an NIH grant to test whether
proximity alarms reduce fall risk in acute care.
The geriatric imperative -
Training a new generation of geriatricians
O n 2002, the University of Florida declared in its newly
adopted strategic plan that addressing the social and
medical problems associated with aging was one of its
seven top priorities. This significant commitment cleared the
way for the Institute on A. -_i under the leadership of Marco
Pahor, M.D., to make some new educational initiatives.
Today the UF College of Medicine's Department of Aging
and Geriatrics and the VAs Geriatric Research, Education
and Clinical Center combine resources to provide an intensive
interdisciplinary learning experience for medical students
through a fourth-year clerkship and for postdoctoral physicians
through a geriatric fellowship.
The geriatric clerkship provides fourth-year medical
students a two-week rotation at one of four unique locations:
the North Florida/South Georgia VA in Gainesville, the Shands
at UF Rehab Hospital, the Transitional Care Unit of Shands
Jacksonville and the River Garden Hebrew Home. During their
rotations, students are responsible for up to six patients in their
facility and are required to work as part of an interdisciplinary
team. Communication is a key element of the learning
The geriatric fellowship is administered through the VA
GRECC and is designed to train physicians in clinical care
of older adults through a core curriculum that provides basic
knowledge of the biological and psychological aspects of aging.
Firsthand experience is gained in clinical care, research, teaching
John Meuleman, M.D., directs both programs. For more
info, please visit http://www.aging.ufl.edu and click on either
Geriatric Fellowship or Fourth-Year Geriatric Clerkship. T
Institute on Aging
Marco Pahor, M.D.
Elena Andresen, Ph.D.
Henry V. Baker, Ph.D.
Kenneth I. Berns, M.D., Ph.D.
Rebecca J. Beyth, M.D., M.Sc
Christy S. Carter, Ph.D.
Lauren E. Crump, M.P.H.
Michael J. Daniels, Sc.D.
Paul Hoffman, M.D.
Ann L. Horgas, R.N., Ph.D.
Steven A. Kautz, Ph.D.
Christiaan Leeuwenburgh, Ph.D.
Michael Marsiske, Ph.D.
John Meuleman, M.D.
Troy Munn, M.P.A.
Michael G. Perri, Ph.D.
Scott K. Powers, Ph.D.
Beverly Roberts, Ph.D.
Philip J. Scarpace, Ph.D.
Elizabeth A. Shenkman, Ph.D.
Ronald Shorr, M.D., M.S.
Constance Uphold, Ph.D.
Marco Pahor, IOA Director
Christy Carter, UF IOA, VA GRECC
Louise Perras, UF IOA
Peggy Smith, UF IOA
Denise Trunk, UF IOA
Connie Uphold, UF IOA, VA GRECC
Mickey Cuthbertson, Design
A Institute on
UNIVERSITY OF FLORIDA
Giving for a healthier, more
Good health and independence make for quality living, especially
as we age. The University of Florida is committed to leading in
research, education and patient care through the Institute on Aging.
You can invest in a healthier and more independent future for
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support educates future geriatricians and health-care providers for
older persons, generates critical resources for our world-class faculty
to conduct cutting-edge research and creates a legacy for UF to
remain a leader in providing a healthier and more fulfilling tomorrow
for us all.
Please contact Troy Munn, director of development for the
Institute on A.1_ at 352-265-7227 or toll free at 888-374-2867 or
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