Geriatric Research Education and Clinical Center (GRECC)
The Madison GRECC has been serving older Veterans in the Madison area since 1975.
Research Focus Areas
Alzheimer's Disease and Related Disorders
Dysphagia and Disorders of Swallowing
Metabolism of Aging
Insulin Resistance and Diabetes Mellitus
ResearchThe Madison GRECC sponsors a large nationally renown research program with the primary mission of improving care of older frail Veterans with multiple comorbidities and cognitive and physical frailty. The program sponsors multiple cutting-edge studies that span across the full spectrum of aging research and have direct relevance to patient care. One of the largest GRECC-supported research program focuses on Alzheimer's disease (AD) and related disorders. Comprised of numerous laboratory-based, clinical and health services studies, the major objective of this program is to identify pre-clinical biomarkers of AD and better understand the molecular causes of the disease. Among the ongoing clinical studies, include those focused on neuro-imaging, cerebrospinal fluid (CSF) and cognitive biomarkers of AD. Additional dementia-related studies target innovative models of care, vascular dementia, clinical trials and health disparity and equity research. Under the leadership of Amy Kind, MD, PhD, the Madison GRECC endorses a large clinical intervention and health system innovative program in care transitions. The mission of this research program is to improve hospital-to-home and hospital-to-skilled nursing facility transitions for older frail Veterans and to reduce multiple adverse health outcomes associated with transitions. For over 25 years, the Madison GRECC has sponsored a widely acknowledged research program in dysphagia. The primary objective of this multi-disciplinary program is to characterize age-associated changes in swallow mechanisms and evaluate beneficial effects of innovative interventions on dysphagia and associated pneumonia. The GRECC sponsored laboratory-based research programs focus on metabolism of aging and insulin resistance and diabetes mellitus. The mission of ongoing studies in these research areas is to examine metabolic pathways underlying salutary effects of caloric restriction in non-human primates and various molecular mechanisms underlying diabetes mellitus, respectively. The long-term goal of these studies is to determine the potential efficacy of caloric restriction to prolong human life span, and innovative ways to treat and prevent diabetes.
Education and Evaluation
The Madison GRECC offers an array of interprofessional, competency-based educational experiences developed and managed by our active interdisciplinary education committee and supported by a number of local and national programs (Department of Medicine, University of Wisconsin School of Medicine & Public Health, Health Resources & Services Administration-Funded Geriatric Workforce Enhancement Project , VA Geriatric Scholars Program (GSP), John Hartford Foundation, National Institute of Health supported Alzheimer's Disease Research Center). These experiences include Fellowship programs, clinical rotations, practica, didactic conferences, simulation experiences and community outreach education. It serves as a primary site for geriatric education for most of the University of Wisconsin professional school (medicine, public health, pharmacy, social work, nursing, psychology). There are 6 ongoing conferences supported through our GRECC including geriatric grand rounds, geriatrics core lecture series, journal club, geropsychiatry colloquium, Aging Disability Resource Center research seminar and visiting speakers series. Our Accreditation Council for Graduate Medical Education accredited Fellowship programs (geriatric medicine, geriatric psychiatry) have been in existence since 1978 and have trained a number of national geriatric leaders since inception. Our academic fellowships (women's health, advanced geriatrics, dementia, National Institute for Aging-supported T32) equip developing scientists and leaders with 1-4 years of focused mentoring and skills to succeed in the academic milieu. Our team of clinician-educators and education researchers are engaged in a number of scholarly efforts to create competency based curriculum linked to national milestones and evaluated by direct observation tools and products. We use Objective Structured Clinical Examinations and mini-CEX products and are in the process of developing several virtual patient game simulations to ensure that learners and practicing providers demonstrate evidence based practice and behaviors aligned with the key tenets of geriatric care. Our VA GRECC-based Alzheimer's Disease Research Center and dementia clinician scientists are actively involved with dementia education and community outreach that impact Veterans, their caregivers, the local hospital, our Veterans Integrated Service Network, Veterans Health Administration and the University community. Our faculty also invest considerable time in training the primary care workforce to deliver high-quality geriatric care including local Patient Aligned Care Team(PACT) clinicians, regional PACT sites and non-VA primary care team members through the infrastructure of Geri PACT, VA Rural Interdisciplinary Team Training and GRECC-Connect.
The clinical care component of the Madison VA GRECC focuses on the development and evaluation of novel innovations and demonstration projects in geriatric care designed for dissemination to other VA Health systems thoughout the United States. One such example of clinical innovation is the Coordinated-Transitional Care (C-TraC) program - a program specifically designed for disadvantaged regions/populations to support high-risk older Veterans as they transition between hospital and community. C-TraC decreases care costs and re-hospitalization risk, and is now disseminated widely within and outside of the VA system. Addititonally, the Madison VA GRECC has a long history of housing and supporting established, gold-standard interdisciplinary models of geriatric care to better support the care of older Veterans as well as the geriatric-focused training needs of our multi-disciplinary learners. These include top-performing Geri-PACT clinics, Memory Assessment and Dementia Care clinics, Sleep and Falls clinics, Older Women Health clinics, GRECC_CONNECT outreach telemedicine clinics and Geriatric Evaluation and Management clinics. GRECC Clinical faculty and staff represent a wide-array of disciplines including physician-geriatricians, neuropsychology, nursing, social work and pharmacy. The GRECC-based clinical activities include: (1) GEM clinics; (2) Specialty clinics; (3) Primary Care clinics; and (4) Inpatient Consultation program.