# Ann Arbor GRECC

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| VA Medical Center               | **Affiliation:**                   |
|                                 |                                    |
| GRECC (11G)                     | University of Michigan Medical     |
|                                 | School                             |
| Ann Arbor, MI 48105             |                                    |
|                                 |                                    |
| Phone: (734) 761-7686           |                                    |
|                                 |                                    |
| Fax: (734) 761-7489             |                                    |
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| **GRECC Director:**             | **Associate Director for           |
|                                 | Research:**                        |
| Mark A. Supiano, MD             |                                    |
|                                 | Neil B. Alexander, MD              |
+---------------------------------+------------------------------------+
| **Associate Director for        | **Associate Director for Clinical  |
| Education/Evaluation:**         | Programs:**                        |
|                                 |                                    |
| Thomas Fitzgerald, Ph.D.        | Margaret S. Terpenning, MD         |
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**Research Focus:**

**Basic Biomedical: Neurosciences and Metabolism/Nutrition**

Exploring the role of striatal metabolic glutamate receptors in movement
disorders such as Parkinson's Disease. Assessing effects of targeted
intervention to improve the mobility of frail, individuals. Defining the
genes responsible for paroxysmal choreoathetosis and heredity spastic
paraplegia. Role of amyloid precursor protein processing by accumulation
of amyloid in the brain of defining the molecular mechanisms diabetic
neuropathy. Defining age-related response and mapping genes that
influence free life span.

# Applied Clinical: Autonomic Function, Diabetics Mellitus, Hypertension

Quantifying abnormalities of insulin secretion in older individuals with
normal and impaired glucose tolerance. Determine that older
hypertensives are characterized by higher levels of a-adrenergic
receptor responsiveness for their level of sympathetic nervous system
activity and that older hypertensive individuals who are sodium
resistant are characterized by metabolic insulin resistance. Define that
periodontal disease is an independent risk factor for stroke and
coronary artery disease.

# Health Services: Cost and Quality of Health Care

Development of the National Resident Assessment Instrument (RAI) for
nursing home residents, home care and psychiatric care. Development of
quality indicators utilizing information from the RAI. Defining
characteristics of nursing home and home care patients predict their
utilization of medical services. Determining of patients treated for
depression, dementia or depression dementia. Determining racial and
ethnic differences psychiatric diagnosis and health services utilization
among the elderly.

**Education Focus:**

Provides continuing education programs in local and VISN settings, well
as regularly scheduled clinical geriatric teaching conferences. As the
primary site for education and training of physicians allied health
professionals in geriatrics, including an integrated Geriatric
fellowship program for geriatric medicine, neurology, psychiatry and
dentistry.

**Clinical Focus:**

Developed a model of care program which has successfully reduced
incidence of aspiration pneumonia. Clinical care sites include an
evaluation and management unit, a geriatric outpatient clinic, and
geriatric inpatient consultative service.