Cardiovascular & Frailty Initiative

Description

An increasing incidence and prevalence of cardiac disease along with the rapidly aging population calls for a need to establish evidence-based principles to manage cardiac disease in older adults.  The effects of multimorbidity and other physiological changes that occur during aging and how they interact with cardiovascular disease and treatment are largely unknown. Dr. Bell, a physician-scientist (with a dual clinical role as a cardiologist and geriatrician) has an overarching research aim to improve outcomes and strive towards patient-centered cardiac care in older adults with multimorbidity. Dr. Bell’s research portfolio ranges from clinical and translational research to large-scale implementation and outcome based health services research in the field cardiovascular aging and geriatrics:

• Frailty is an important geriatric syndrome that results in a decline across multiple interrelated systems that confer a loss of reserve in response to stressors, such as acute health care events. The frailty syndrome is highly associated with hospitalization, institutionalization, morbidity and mortality. One of Dr. Bell’s main research endeavors aims to identify underlying vascular mechanisms of physical frailty and cognitive impairment using magnetic resonance imaging (MRI) techniques to increase knowledge of the intricate pathways linking frailty to cardiovascular disease (CVD).
• Understanding patient factors (demographic, social, physiological, and psychological) that specifically impact patient-centered outcomes in older adults with CVD is critical to improving the high morbidity and mortality experienced by this population. Dr. Bell’s secondary research goals have been to identify gaps in this knowledge and to highlight the impact of geriatric principles and disease processes in the management of older adults with CVD.
• Geriatric syndromes are prevalent among older adults and independently associated with a risk for adverse outcomes such as functional decline, the acquisition of additional syndromes, hospital admissions and mortality, even when controlling for illness severity and age. One of Dr. Bell’s additional research goals has been to explore prevalence, identification and interventions of these syndromes in relation to adverse outcomes.

(Bell et al., 2014, J Am Heart Assoc)

Collaborators

• Angela Jefferson, PhD (Career development primary mentor) / Professor of Neurology, Vanderbilt University / Director, Vanderbilt Memory & Alzheimer’s Center

• Bruce M. Damon, PhD / Associate Professor of Radiology and Radiological Sciences / Associate Professor of Biomedical Engineering / Associate Professor of Molecular Physiology and Biophysics

• Mark Lawson, MD / Assistant Professor of Medicine / Vanderbilt University Medical Center

• Sunil Kripalani, MD, MSCI / Associate Professor of Medicine / Section of Hospital Medicine, Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University / Center for Clinical Quality and Implementation Research, Vanderbilt University Medical Center / Center for Health Services Research, Vanderbilt University Medical Center

• John F. Schnelle, PhD / Professor of MedicineHamilton Chair in Geriatrics, Division of Geriatrics, Vanderbilt University Medical Center / Director, Center for Quality Aging, Vanderbilt University Medical Center / VA Geriatric Research, Education and Clinical Center (GRECC)

• Sandra F. Simmons, PhD / Associate Professor of Medicine / Division of Geriatrics, Vanderbilt University Medical Center / Center for Quality Aging, Vanderbilt University Medical Center / Institute for Medicine and Public Health, Vanderbilt University Medical Center / VA Geriatric Research Education and Clinical Center (GRECC)

• Quinn Wells, MD, PharmD, MSCI / Assistant Professor of Medicine / Assistant Professor of Pharmacology / Division of Cardiovascular Medicine, Vanderbilt University Medical Center

• John Jeffery Carr, MD / Cornelius Vanderbilt Professor of Radiology and Radiological Sciences  / Professor of Biomedical Informatics and Cardiovascular Medicine / Vanderbilt University Medical Center

• Daniel F. Forman, MD / Chair, Geriatric Cardiology Section, UPMC / Director, Cardiac Rehabilitation, VAPHS / Physician Scientist, Pittsburgh GRECC, VAPHS / Immediate Past Chair, Geriatric Cardiology Section, ACC

• Mathew S. Maurer, MD / Professor of Clinical Medicine, Department of Medicine, Division of Cardiology / Medical Director, Clinical Cardiovascular Research Laboratory for the Elderly (CCRLE) / Columbia University College of Physicians and Surgeons

• Avantika A. Saraf, MPH / Research Analyst III / Division of Cardiovascular Medicine, Vanderbilt University Medical Center / Center for Quality Aging, Vanderbilt University Medical Center

Relevant Publications