Growing the Next Generation
Miho Bautista, MD aging researcher, educa-
tor, clinician... the real deal, the"whole ball
of wax."She came to the US in 1988 from
Japan, a vibrant, ambitious young woman who spoke
little English but was able to communicate her passions
-- from a culture that holds the elderly in high esteem
and has great respect for their experience and wisdom.
Dr. Bautista received her undergraduate degree in
Nutrition from UF, but found she wanted to oversee and
supervise every aspect of care of older patients in an
interdisciplinary setting. She then went on to graduate
from Meharry Medical College in Nashville, completed
Miho Bautista, MD, teaching the geriatric clerkship
her residency in the Gainesville VA Geriatric Evaluation
and Management (GEM) Unit, entered the one-year UF
Geriatric Fellowship program, and was hired as assistant
In the 18 months since joining the faculty, Dr. Bautista
has accomplished so much: She won a Geriatric Aca-
demic Career Award from the US Department of Health
continued on page 3
VOL. 2 ISSUE 3 WINTER'07-'SPRING08
R member when our parents talked
about how fast
time passes? Well, .
they were right. Time has
passed, and with each
year, it has passed more
quickly. Suddenly in the
blink of an eye, we're 60, ,
70, 80, 90... but times have
changed since we were Marco Pahor, MD
young. We're not quite ready
to retire to the rocking chair, to allow our age
or our health to dictate our lives. Today, quality
of aging is determined as much by lifestyle as it
is by genetics.With the right medical care from
health-care providers specially trained in the
complex problems of older adults, we can live
longer, healthier, more independent lives. And isn't
this what we all want for ourselves and our loved
The University of Florida's Division of Geriatric
Medicine and Department of Aging and Geriatrics,
along with the Geriatrics Research, Education, and
Clinical Center (GRECC) at the Malcom Randall
Veterans Affairs Medical Center strive to provide
state-of-the-art, patient-centered health care
focused on the management of specific geriatric
health issues in an environment of caring, respect,
understanding and communication
We are committed to developing programs for
training the next generation of geriatricians,
educators and researchers programs that foster
an interdisciplinary system of integrated health
care for older adults -"one-stop" state-of-the-art
health care for frail and healthier older persons.
Institute on Aging VA GRECC
Growing the Next Generation...
Last May, Juliessa Pavon received her medical
degree. She was also one of the very first
students in the first required geriatrics
course for UF medical students -- the 4th Year
Geriatrics Clerkship. When asked what had steered
her toward geriatrics, Juliessa responded,"I went to
Duke University for undergrad... they have a very
good aging program, as well as a center for aging. My
major was psychology, and one of our projects was
late-life development, so I picked Alzheimer's Disease.
I noticed in a journal that one of the authors was
actually someone at Duke, so I sent an email and we
got in touch.That just opened
up a whole world for me"
She volunteered with Alzheim-
er's caregivers and became
aware of geriatrics through the
eyes of a social worker who
introduced her to the concept
of an interdisciplinary approach.
Her research projects further broadened her perspec-
tives about issues facing older adults, and she grew
fascinated with the population. Her research at Duke
then led to a year of research in the epidemiology of
aging at the National Institutes of Health (NIH).
Juliessa carried her enthusiasm and passion to medi-
cal school and found the one-on-one experience
with patients to be very rewarding and exciting. She
said it fascinates her to work with someone now"and
then see a picture of them when they were younger,
and just imagine all the things that have transpired
between then and now. In fact, when I go to the VA,
they'll have pictures in their soldier uniforms... it's re-
ally fascinating -- all of the stories they carry"
Her plan is to build a strong foundation in internal
medicine, to formulate and hone her diagnostic skills,
then follow up with a fellowship in geriatrics focusing
on its complexity and interdisciplinary nature. Her
end goal is to pursue an academic career in research
combined with clinical practice to address some of
the issues unique to geriatrics.
So, Juliessa is back at Duke, serving her residency
in internal medicine... last May Juliessa received her
medical degree -- now she's becoming a doctor.
r. Emanuele Marzetti MD/PhD is one of the
new Junior Scholars in our Pepper Center.
He first became interested in a career in
geriatrics because Italy, his home country, has the
oldest population in the western world and the
as a physi-
the challenge of treating older patients in whom many
disease conditions often coexist, thus complicating
the diagnosis and management of illnesses and mak-
ing the approach to the geriatric patient absolutely
unique. Most of the disease conditions affecting ge-
riatric patients are chronic/degenerative and by their
nature cannot be resolved. However, during his clinical
training he learned that even a small improvement in
the clinical-psychological status of a geriatric patient
can have a dramatic impact on his/her quality of life,
an enormous reward for a geriatrician.
During the course of his PhD in Preventive Medicine
in Geriatric Populations at the Catholic University of
the Sacred Heart in Rome, he started to investigate the
various epidemiological factors leading to disability
in old age. In 2005 he was offered the opportunity to
come to the US and join Dr. Christiaan Leeuwenburgh's
laboratory at the University of Florida Institute on Ag-
ing. In this dynamic scientific environment, he started
to focus his research on skeletal muscle loss and dis-
ability in advanced age.
Dr. Marzetti's goal as a geriatric researcher is to com-
bine his clinical experience with "bench knowledge"to
help bridge the gap between clinical practice and ba-
sic science. Although he is not sure when he will return
to Rome, he knows he will. However, Dr. Marzetti says
that"the knowledge, the scientific approach and the
technical skills that I have achieved during my stay in
the US will be a precious'souvenir'that will be instru-
mental for my career as an independent investigator"
Growing the Next Generation continued from page 1
Resources and Services Administration; joined the UF&Shands Senior Care at Tower Hill primary care practice;
co-developed, directs, and teaches the required 4th year medical student geriatric clerkship; collaborated on a
stroke research project and now is developing her own research based on the clerkship. And, in her"spare time,"
Dr. Bautista is also working on her master's degree in Public Health.
Dr. Bautista keeps certain beliefs close to her heart: Medical students must learn to communicate effectively
with older patients; patients need to be informed consumers and participate in their own health care; physicians
need to be taught to review journals critically and often, navigating through the myriad sources of information;
patients need to be taught how to reconcile their own preferences and lifestyles with their health care; there
needs to be a continuum of each generation training the next generation; aging research will assure both good
health and health care in the future.
Dr. Bautista says her first love is clinical, followed by education, then research. But, but she says, although "re-
search takes time away from the first two and it is difficult to balance all three, I cannot do just one thing --they
are all connected."
E manuele Marzetti GIFT
of our new IOA Pepper Scholars, are currently
working on a research project with Dr. Christiaan
Leeuwenburgh to study how muscle quality
declines with age.
One process that changes with age is muscle
fiber apoptosis, orprogrammedce//death, which
results in age-related skeletal muscle loss (known
as sarcopenia) and subsequent disability. Most of
this research has been based on animal studies;
however, evidence on the process of apoptosis in
older human subjects with normal aging is still
lacking. A deeper understanding of the cellular
and molecular process underlying muscle loss
represents a step forward in designing treatments
aimed at preventing, delaying or even reversing
muscle loss and disability.
In fact, Dr. Leeuwenburgh and his trainees are now
investigating these intriguing and potentially crucial
cellular processes in older human subjects. They do
this by taking a small sample of skeletal muscle from
older adults through a biopsy of the thigh and then
assessing the degree of muscle loss.
The ultimate goals are the discovery of new process-
es and the application of new interventions, such as
tailored physical training, hormonal replacement,
and calorie restriction, for the prevention and treat-
ment of muscle loss.
The Next Generation
Aging affects us all. In its indiscriminate
nature are the roots of many diseases
and obstacles to independent living.To
address this, the Institute on Aging is training
the next generation of scientists, educators,
and health-care providers who will meet the
complex physical and cognitive health needs of
Supporting this next wave of leaders is a
powerful way to invest in a healthier, more
independent future for us all. Fellowships
provide needed funds to rising scientists in their
academic pursuits. Gifts for research sustain
current projects and help fund new endeavors.
Philanthropy for mentoring and lecture series
programs exposes up-and-coming clinicians
and researchers to leaders in aging and cutting-
edge science and care.
If you are interested in exploring a meaningful
way to partner with the Institute on Aging to
help grow the next generation of leaders in
geriatric research and medicine, please contact
Troy Munn, director of development, at (352)
224-8537 or firstname.lastname@example.org.
Ginesville, FL 32610
Marco Pahor, IOA Director
IUF UNIVERSITY of
') University of Florida
Q: What makes a doctor a geriatrician?
A. The qualities of a geriatrician can be expressed by
the five Cs: Concern, Compassion, Continuity, Compre-
hensiveness, and Coordination.
Concern for the individual is the basis of a relationship
between the geriatrician and the patient. Concern by
the geriatrician is expressed through focused interest
and involvement in the patient and their care.
Compassion is awareness of discomfort and suffering
by another person coupled with the wish to relieve
it. It is the substance of empathy and sympathy. It is
the aim of geriatrics to relieve suffering and maintain
function in the older patient.
The relationship between the geriatrician and the
patient is a long-term, uninterrupted succession of
care. This Continuity allows patient and geriatrician
to know each other and understand each other bet-
ter. This results in more appropriate and better care.
Comprehensive care is holistic. The scope is broad
and involves understanding a large array of
problems including medical, psychological, and
social issues. The issues and stresses of the whole
person are addressed.
Since geriatrics does include a broad array of issues,
the geriatrician Coordinates care among many disci-
plines. Geriatrics is a team specialty. Each member
of the team must know what the other is doing to
assure a coordinated effort for the patient's benefit.
The geriatrician serves as the captain of the team.
Geriatricians are doctors who employ the five Cs and
apply them to the benefit of the patient. The
essence of geriatrics is Continuous, Coordinated,
Compassionate, and Comprehensive care for the
S itt' For more information about giving,
GIFT go online to www.aging.ufl.edu.