Geriatric Research Education and Clinical Center (GRECC)

San Antonio GRECC

• Geroscience approach to accelerate new findings in basic aging biology from the bench to the patient’s bedside
• Lifestyle interventions, including exercise, to improve physical and metabolic health in older adults
• Trials of age-modulating agents in older adults to improve physical function, frailty, biologic resilience, sarcopenic obesity, immune function, cardiovascular health and cognition
• Mechanistic trials of thermoregulatory sequelae of chronic spinal cord injury with emphasis on altered vasomotor control mechanisms
• Molecular mechanisms underlying the role of nutrient sensors in obesity and diabetes
• The metabolic aspects and molecular pathogenesis of alcoholic liver disease and identifying novel therapeutic targets for its treatment
• Hepatokine regulation of nutrient metabolism, energy homeostasis and fatty liver disease related to aging
• Advancing Age-Friendly initiatives to diverse clinical arenas including innovative clinics in preoperative care of frail older Veterans and interprofessional post-ICU care.
• Training aging-experts of the future as investigators, subspecialty-geriatricians, geriatrics and palliative care, and interprofessional fields.

• Innovative health care models to ameliorate frailty and optimize quality of life.
• Promotion of successful weight management in older adults with overweight/obesity.
• Mechanisms of microbiome-mediated healthy aging.
• Effects of Tirzepatide on Muscle and Vascular Function in Obese Older Hispanic Adults.
• Effects of mTOR inhibition and rapamycin on physical function, immune function, cardiovascular function, cognition, malignancy and COVID-19.
• Functional role of mTOR in hepatic insulin resistance.
• Efficacy and safety of rapamycin in early Alzheimer’s disease.
• FGF21 as a novel modulator of metabolism in age-related metabolic disease.
• Role of SIRT1 and AMP-activated protein kinase in liver aging and age-related Non-Alcoholic Steatohepatitis (NASH) and metabolic disease.
• Role of TLR4 on insulin resistance in humans.
• Prospective Health Impacts of Chronic Binge Eating Disorder in Hispanic Older Women Living with Food Insecurity (PROSPERA).
• RESTOR [Rapamycin and Everolimus Study Towards Older Rejuvenation]: An exploratory PK/PD study of mTOR inhibition in older human subjects.
• Modifying Adiposity Through Behavioral Strategies to Improve COVID-19 Rehabilitation.
• Stay in the Fight: Optimizing the Performance and Retention of High-Performance Military and Civilian Specialized Units.
• 3D force sensing insoles for wearable, AI empowered, high-fidelity gait monitoring.
• The molecular transducers of physical activity consortium (MoTrPAC).
• COVID Convalescence Program Repository.
• Pragmatic Evaluation of Events and Benefits of Lipid-Lowering in Older Adults (PREVENTABLE).
• Diabetes Prevention Program Outcomes Study (DPPOS).
• Cellular resilience as a predictor of healthy aging.
• Determination of the relationship of oral health with general health during aging.
• Cardiometabolic Dysregulation as a Driver of Changes in Hemodynamic resilience and Accelerated Aging Among Hispanic Adult

• Interprofessional training focused on the 5Ms of geriatrics and palliative care in academic and clinical settings
• Development of our future leaders in medical education and aging research
• Dissemination of existing knowledge and new developments in the fields of aging and palliative care to local and national trainees
• Serve as a local and national resource for interprofessional staff development in the areas of aging and palliative care
• Partnering collaboratively with local GEC Service for education of clinicians and Veterans covering dementia caregiver support and educational programs.

• “Age-Friendly Health Systems – implementing system changes to ensure all older Veterans receive care consistent with the 4Ms of geriatrics.”
• Post-ICU clinic. “Development of interprofessional care of older Veterans post-ICU care.”
• VIONE- “Vital, Important, Optional, Not indicated (VIONE) program for deprescribing of potentially inappropriate medications.”
• Virtual Geriatrics - consultation for frail Veterans, focusing on rural Veterans, to increase access to care via telehealth modalities.
• Life sustaining treatment decisions Initiative.
• Implementation of patient priorities care in geriatrics services, which helps patients and providers focus decision making and health care on what matters most to patients.
• Former Prisoner of War (FPOW) Clinic - Implemented innovative telemedicine-based assessment of FPOWs by an interdisciplinary team to identify previously unrecognized presumptive service-connected and other disabilities

• Powers BB, Van Zuilen RM, Schwartz AW, Dang S, McLaren JE, Hoang-Gia D, Moo LR. Competencies for video telemedicine with older adult patients. J Am Geriatr Soc. 2023 Apr;71(4):1283-1290. doi: 10.1111/jgs.18246. Epub 2023 Mar 23. PMID: 36951209.
• Harrison DE, Strong R, Reifsnyder P, Rosenthal N, Korstanje R, Fernandez E, Flurkey K, Ginsburg BC,Murrell MD, Javors MA, Lopez-Cruzan M, Nelson JF, Willcox BJ, Allsopp R, Watumull DM, Watumull DG, Cortopassi G, Kirkland JL, Tchkonia T, Choi YG, Yousefzadeh MJ, Robbins PD, Mitchell JR, Acar M, Sarnoski EA, Bene MR, Salmon A, Kumar N, Miller RA. Astaxanthin and meclizine extend lifespan in UM-HET3 male mice; fisetin, SG1002 (hydrogen sulfide donor), dimethyl fumarate,  mycophenolic acid, and 4-phenylbutyrate do not significantly affect lifespan in either sex at the doses and schedules used. Geroscience. 2024 Feb;46(1):795-816. doi: 10.1007/s11357-023-01011-0. Epub 2023 Dec 2. PMID: 38041783.
• Cortes TM, Vasquez L, Serra MC, Robbins R, Stepanenko A, Brown K, Barrus H, Campos A, Espinoza SE, Musi N. Effect of Semaglutide on Physical Function, Body Composition, and Biomarkers of Aging  in Older Adults with Overweight and Insulin Resistance: Protocol for an Open-Labeled Randomized Controlled Trial. 2024 Sep 13;13:e62667. doi: 10.2196/62667. PMID: 39269759.
• Ocrospoma S, Restrepo MI. Severe aspiration pneumonia in the elderly. J Intensive Med. 2024 Apr 10;4(3):307-317. doi: 10.1016/j.jointm.2023.12.009. eCollection 2024 Jul. PMID: 39035624.
• Kilpela, L. S., Hooper, S., Straud, C., Marshall, V., Verzijl, C., Stewart, T., Loera, T., & Becker, C. The Longitudinal Associations of Body Dissatisfaction with Health and Wellness Behaviors in Midlife and Older Women. 2023 Dec 5;20(24):7143. doi: 10.3390/ijerph20247143. PMID: 38693125.

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