EP53: Integrative Medicine and Healthy Aging

Integrative Medicine and Healthy Aging "People can stay healthy when their head, heart, and spirit are aligned."-Melissa Batchelor, PhD, RN, FNP-BC, FGSA, FAAN Polypharmacy is a significant concern in geriatric treatment, presenting a chance of adverse effects and medication reactions. Although older adults under the age of 60 take 2–3 prescription medicines every day, those above 80 consume over 4–5 prescriptions per day. With that, many older adults in the United States are shifting to integrative medicine to boost their Quality of Life (QOL) significantly. The shift is a result of health issues and as a support for their beliefs and underlying theories about health and lifestyle. However, despite its increasing popularity, integrative medicine's impact on an older adult's quality of life and preventive medicine is too well understood. To fill in the gap, I am joined today by two guests, Dr. Leigh Frame and Dr. Mikhail Kogan, both from the George Washington University's Center for Integrative Medicine. We will be having meaningful discussions about The role of Integrative Medicine in Healthy Aging. Part One of 'Integrative Medicine and Healthy Aging.' What is Integrative Medicine? Integrative medicine is a pyramid of treatment that starts with non-invasive, non-surgical, non-pharmacological methods, especially for chronic conditions that often don't have a curative pharmacologic approach.  Moreover, integrative medicine focuses on the whole person and their entire lifestyle. It looks at all aspects of their life, support system, mind, body, and soul. It's an all-inclusive systems approach to health and wellness that uses any evidence-based therapeutic available. "Among people over 65 years old, prescriptions are the third cause of death, killing approximately a quarter of millions of Americans every year."  -Mikhail Kogan, MD, AM How is Integrative Medicine Similar or Different to Traditional Primary Care? Integrative medicine is known in other terms as alternative medicine, traditional medicine, complementary and integrative medicine (CAM), or non-mainstream medicine. Furthermore, as described by the National Institutes of Health, integrative medicine is a non-mainstream treatment used outside traditional primary care. As a result, integrative medicine is by far uncommon in the United States.  On the other hand, traditional primary care is what the majority of people are familiar with. Primary care has been described in a variety of ways. Basically, it includes healthcare professionals' treatment— Primary care areas of expertise include general internal medicine,  family medicine, general pediatrics, and obstetrics and gynecology.  Moreover, its scope extends to health care activities that characterize the range of primary care, including treating or relieving common diseases and disabilities. Traditional primary care can also be defined as a level of treatment or  program that integrates secondary care (provided by community hospitals) and tertiary care  (by medical centers ) Examples of integrative medicine approaches are;  Acupuncture Hypnotherapy Massage Meditation Psychotherapy Holistic Primary Care Reiki Yoga Part Two of 'Integrative Medicine and Healthy Aging.' The Role of Integrative Medicine in Aging Well There is this famous thing in geriatrics, "Don't look for zebras. Look for cows that look like zebras" because the common conditions that are often present in older age are extremely unusual, but they're still prevalent.  So if you don't think in that framework and if you don't ask, "Could this be that it just looks like this kind of zebra, but it's not actually a zebra?" It means that specific to primary care and to integrative, most healthcare professionals are looking for zebras because they're kind of cool. They always look for some more fascinating diagnosis—but in geriatrics, that's not the case.  "Look at the bigger picture rather than just the symptoms."  -Leigh A. Frame, PhD, MHS    To understand some of the older age's illnesses and chronicity, you need to understand how it occurs in the younger age. Most of the diseases can be traced to middle age or even younger age. It is understanding how to advocate for specific steps and care and, more importantly, what questions to ask when somebody comes to you regarding their chronicity. Furthermore, with integrative medicine, the physician role stops being a physician role. You're becoming a mirror for a patient, and you're suddenly becoming a reflection to help them to see what they're doing right and wrong, and then select the choices to move forward. A lot of what's done in integrative medicine is not rocket science: eating well, sleeping well, exercising,  staying positive, and staying balanced in terms of the nervous system - it's not all that complicated, but achieving these can be quite challenging at times. About Mikhail (Misha) Kogan, MD, ABIOM, RCST Dr. Kogan received his medical degree from Drexel University, College of Medicine.  He completed the Social Internal Medicine Resident program at Montefiore, Albert Einstein School of Medicine and Geriatric Fellowship at George Washington University.  Currently he serves as medical director of the GW Center for Integrative Medicine, associate stant professor of medicine in division of Geriatrics and Palliative Care, associate director of the Geriatrics Fellowship Program and director of Integrative Medicine Track program at the George Washington University School of Medicine.    Dr. Kogan is founder and executive director of AIM Health Institute, a 501(c)(3) non-profit organization in the Washington, D.C. metropolitan area that provides integrative medicine services to low-income and terminally ill patients regardless of their ability to pay.  About Leigh A. Frame, PhD, MHS Dr. Leigh Frame brings nutrition and immunity together through clinical, translational research. Dr. Frame's T-shaped expertise in health, wellness, science, and medicine were developed through her wide-ranging experience in biomedical research (from wet bench to clinical research) and overseeing research and education programs. Dr. Frame is working to build a GW Integrative Medicine research program while directing the graduate education programs and the Office of Integrative Medicine and Health. Her interests include the role of the microbiome and nutrition in health, the consequences of malnutrition in obesity, vitamin D as an immune modulatory hormone, research ethics, and social media. While working at the Johns Hopkins Center for Bariatric Surgery, Dr. Frame earned her PhD in Human Nutrition from the Johns Hopkins Bloomberg School of Public Health and also received a Master of Health Science in Molecular Microbiology and Immunology from the same school. About Melissa Batchelor, PhD, RN, FNP-BC, FGSA, FAAN: I earned my Bachelor of Science in Nursing ('96) and Master of Science in Nursing ('00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I genuinely enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home, and office visits), then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer. I obtained my Ph.D. in Nursing and a post-master's Certificate in Nursing Education from the Medical University of South Carolina College of Nursing ('11). I then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the George Washington University (GW) School of Nursing faculty in 2018 as a (tenured) Associate Professor. I am also the Director of the GW Center for Aging, Health, and Humanities. Please find out more about her work at https://melissabphd.com/.