Improving medical care for the minds of older adults
Innovator and geriatrician Malaz Boustani is in a hurry.
Each day, he races against time to improve medical care of the mind for older adults—especially those with dementia, depression, or delirium—and expand support for their families. He does this by inventing new tools that help clinicians understand more about the aging brain and improve how health care systems serve an ever-growing population of older adults.
"I look at a problem and persevere until I can put pieces together to invent a solution, making sure that it's implemented and doesn't stay on the bookshelf," Boustani said.
"If we want to live forever, as I do, or more realistically for eight or nine decades or more, we need to redesign health care systems so we enjoy a great quality of life, and our later years will be the best time of our lives."
Boustani is constantly in motion. As a vocal and internationally visible advocate for older adults, research into age-related issues, and scientific innovation, he can be likened to a conductor leading an orchestra. Through his inventions, he empowers caregivers, clinicians, industrial and human-factors engineers, computer scientists, biostatisticians, graphic artists, and others to improve the lives of seniors. Much of his work builds upon the IU Center for Aging Research's Aging Brain Care, or ABC, model, which provides individualized and integrated care both in the clinic and in patients' homes.
Among Boustani's innovations is the user-friendly Healthy Aging Brain Care Monitor, with both self-reporting and caregiver versions. It measures 27 items that assess a patient's cognitive, functional, and psychological symptoms. With the monitor, health care teams collect data on the patient's cognitive status and note declines or improvements by tracking scores over time.
Another tool is known as Enhanced Electronic Medical Record Aging Brain Care Software, or eMR-ABC. This clinical decision-support system gives clinicians the ability to assess and meet the complex biopsychosocial needs of older adults, as well as those of their family members and other informal caregivers. Boustani also invented the Anticholinergic Burden Scale. It allows clinicians, patients, and caregivers to anticipate potentially adverse effects that many prescription and over-the-counter medications have on the brains of older adults.
I look at a problem and persevere until I can put pieces together to invent a solution, making sure that it's implemented and doesn't stay on the bookshelf.
Boustani's favorite invention is his most recent, the ABC Simulator. This software program enables health care administrators to input data specific to their health care system to learn the impact of applying or modifying the Aging Brain Care model over time and provide answers to various "what if" scenarios.
The unifying theme of Boustani's inventions: transforming the medical care of older adults; supporting caregivers; and developing adaptive health care systems to serve patients, families, and communities. As a mentor to many junior faculty, he passes his enthusiasm for disruptive innovation to a new generation of researchers as well.
Boustani has been an innovator since his childhood days in Syria, when he set up a lab in the basement of his family home. There he attempted to make plants grow faster or change color using potions he devised from expired medicines and other products scrounged from around the house.
Despite an early interest in physics, he ultimately chose medicine as a career because he saw it as a way to engineer meaningful change. From cartoons and Hollywood films, he deduced that "real" scientists were from the United States. So after earning an M.D. degree from Damascus University, he relocated to Cleveland for a residency in internal medicine.
Afterward, he earned a master's degree in public health care and prevention from the University of North Carolina, where he also completed a fellowship in geriatric medicine. In 2002, Boustani joined IU and the Regenstrief Institute. A decade later, he founded the Center for Health Innovation and Implementation Science.