Jurivich awarded $3.75 million to study geriatrics education and health care transformation in Dakotas

Dr. Don Jurivich, chair of the Department of Geriatrics and the UND School of Medicine & Health Sciences (SMHS), was recently awarded a $3.75 million grant from the Health Resources & Services Administration. The federal grant will be used to advance geriatrics education and health care transformation in the Dakotas, with particular focus on the American Indian population.

According to Jurivich, the grant will be directed both to improve older adult health care through geriatric education for all learners ranging from caregivers and medical students to practicing providers, and make primary care in the state more “age-friendly.”

“Ultimately we want to create age-friendly health care systems and entire age-friendly communities,” said Jurivich. “The latter is focused on creating community awareness and committing to ‘successful’ aging as evidenced by strong cognitive, physical, and emotional functionality throughout the lifespan.”

Although boasting a population with a relatively low median age (35.4 in 2018), advanced age is a growing socioeconomic and health issue in North Dakota, whose population ranks fourth out of 50 American states and the District of Columbia for Alzheimer’s disease prevalence and “oldest–old” status (citizens age 85 and up). As the nation’s median age continues to increase, incidence of other conditions typically associated with older age—not only Alzheimer’s but things like Parkinson’s disease and dementia—are also likely to rise.

Partnering with the SMHS on the project are the North Dakota State Division on Aging Services and Health Promotion, UND Center for Rural Health, Good Samaritan Society, Alzheimer’s Association, Memory Café, North Dakota State University, and South Dakota State University, among other organizations.

Calling the collaborative “Dakota Geriatrics,” Jurivich says that the group’s mission will be to “engage multiple partners in academia, health care, and the community to strengthen health care of the older adult and the aging population through collaborative, interprofessional, and culturally attentive education.”

One of the challenges in applying geriatrics principles in patient care lies in the longitudinal nature of the discipline, added Rick Van Eck, Ph.D., associate dean for Teaching and Learning in the SMHS Office of Faculty Affairs. This challenge is one of the reasons that Van Eck, a partner on the grant, and Jurivich proposed the use of games.

“Like many people, I assumed that geriatric health care applies only to the elderly, so I was surprised when Don told me that it must be applied in patients as young as 40 or 50,” said Van Eck. “We are creating a game where clinicians prescribe treatment for a panel of patients whose age and health status reflect the general population. Physicians can see the impact of their decisions as patients ‘age’ over time, showing how early treatment leads to better health outcomes and lower costs.”

They accomplish this by using “turn-based” gaming, said Van Eck, where clinicians make decisions every five years in their patient panel, allowing them to see patterns in patient populations in minutes that would normally emerge over 40 years.