Published November 19, 2019
Bruce R. Troen, MD, professor of medicine and chief of the Division of Geriatrics and Palliative Medicine, received a rare, perfect score from the National Institutes of Health (NIH) on his grant application for expansion of a center designed to enhance care for older adults throughout Western New York.
The grant will allow Troen to focus his time on building the UB Center for Successful Aging (UBCSA) and developing research and training programs in geriatrics.
“My mission since I came here in 2013 has been to help develop and foster a scholarly environment to enhance discovery in aging-related fields and optimize clinical care for older adults,” Troen says.
Troen’s proposal was deemed “exceptional” by the NIH reviewers, resulting in an impact score of 10, the highest score possible.
Reviewers cited Troen’s strong leadership and clear vision to expand the geriatrics focus at UB, as well as his commitment to mentoring junior faculty and the support he has secured from UB.
The award focuses on the relatively new field of geroscience, which is the study of the biological mechanisms of aging that result in disease and disability.
Troen is among the few geriatrician physician-scientists in the U.S. with a background that spans from benchtop science on the basic molecular biology of aging to delivering clinical care to older adults at the bedside and in the community.
One of his most significant research projects exemplifies that translational focus. After a lab animal study he and his colleague, Kenneth L. Seldeen, PhD, published in 2017 demonstrated for the first time that a novel, short-session regimen of high-intensity interval training can be safe and effective in older populations, he sought funding to determine if the finding could be replicated in humans.
Last fall, Troen and his research team secured funding from the U.S. Department of Veterans Affairs to do just that, with preliminary results anticipated by early 2020.
“With an increasing percentage of older adults, we are facing an aging, cognitive and frailty tsunami that is already crashing on our shores,” Troen says. “But unbelievably, the number of geriatricians in this country is declining.”
In part, that’s because many medical students and residents receive minimal exposure to geriatrics.
“Geriatricians typically treat patients with multiple and complex interacting comorbidities that require extensive routine follow-up care and often necessitate the involvement of family members,” Troen says.
The most important factor, however, is that geriatricians earn comparatively less than other subspecialties, Troen notes.
While medical students may enter medical school intending to focus on a primary care field, by the time they graduate the reality of medical school debt forces many to pursue more lucrative specialties instead.
“Society has this challenge, but there’s an inability to meet the need,” Troen says.
Western New York, in particular, has a more significant need than some other regions.
According to Troen, while the percentage of the national population that is 65 and older is 15 percent, in Erie County it’s almost 18 percent.
And he notes that by 2030, that population will make up 20 percent nationally, whereas some estimates have predicted that the figure will be reached by 2025 in Erie County.
“My goal is to do something new for Western New York — create a discovery environment for geroscience and a new curriculum that cuts across boundaries,” he says.
Thus far, the UBCSA has awarded its first round of pilot projects, all of which exhibit the transformative and collaborative potential that Troen says is critical to improving care of older adults.
They include a deprescribing network aimed at reducing the prescribing of unnecessary and sometimes harmful medications in the elderly; a novel way to accurately assess muscle mass and, potentially, frailty through a simple urine test; and the use of voice-command devices to combat life loneliness and depression among socially isolated adults.
These and future projects, Troen says, should draw on the full breadth of the university’s expertise, not just in fields like medicine, public health, nursing and pharmacy, but in engineering, architecture, law, business, humanities and the social sciences.
The grant specifically funds efforts to develop a new geroscience curriculum, recruit and mentor diverse trainees and junior faculty in the field and establish teams comprised of researchers in the UBCSA and those within the UB Clinical and Translational Science Institute in order to fully realize the grant’s translational potential.
“We need to bring together all elements that help create effective interdisciplinary teams to deliver the best care for older adults,” Troen says.
“UB should be a national leader. We have a great opportunity, distinctive demographics in this community, and we are older than other areas with a diverse confluence of both racial and ethnic parts of the population,” he adds. “An explicit component of the grant is that we need to engage with the community, because we need to assess its needs and respond.”
“The ultimate goal is to serve the members of this community to enhance quality of life and increase lifespan, not just the years in our life, but the life in our years.”
In addition to his UB and UBMD appointments, Troen is a physician-investigator with the VA Western New York Healthcare System and director of geriatrics services at Erie County Medical Center.
He is also the director of UB’s Center of Excellence for Alzheimer’s Disease in Western New York and an investigator on SNAP, the SUNY Network Aging Partnership: Investigating Frailty and Enhancing Lifespan Across the Health Spectrum, both funded by New York State.