loader from loading.io

Inflammaging: Brian Andonian, Sara LaHue, Joe Hippensteel

GeriPal - A Geriatrics and Palliative Medicine Podcast

Release Date: 12/04/2025

Longevity Treatments - Snake Oil or Breakthrough? John Newman & Mahtab Jafari show art Longevity Treatments - Snake Oil or Breakthrough? John Newman & Mahtab Jafari

GeriPal - A Geriatrics and Palliative Medicine Podcast

The longevity industry is booming. Influencers are promoting this and that as promoting healthy aging, longevity, and healthspan, and it’s hard for us, much less our patients, to make sense of it.  To be sure, we should always start by recommending exercise, nutritious foods, good sleep habits, and meaningful social interaction.  We wanted to go beyond that to talk about the promise and potential and risks/harms of “biohacks.” Today we talk with Mahtab Jafari, PharmD, and John Newman, MD, PhD, and to discuss: How we clinicians should think about this movement, knowing many of...

info_outline
Who Should Deliver Palliative Care in Liver Disease? Chris Woodrell, Manisha Verma, Marie Bakitas show art Who Should Deliver Palliative Care in Liver Disease? Chris Woodrell, Manisha Verma, Marie Bakitas

GeriPal - A Geriatrics and Palliative Medicine Podcast

Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training?  That’s the question we take a deep dive into on this week's podcast by breaking down the We’ve invited three of the trial's authors, , , and , to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We’ll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative...

info_outline
Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer show art Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer

GeriPal - A Geriatrics and Palliative Medicine Podcast

Emergency Podcast! Our guests Sean Morrison, Ken Covinsky, and Stacy Fischer believe that you should care deeply about the proposed shakeup at the National Institutes of Health.  Major at the would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes of Health (NIH), the subject of today’s podcast. You dear listeners should all care.  You should care because you care for older adults, or you’re a researcher who studies palliative care, or you're a chaplain who visited with the family of...

info_outline
How We Limit Non-beneficial Life Sustaining Treatments: Jason Batten, Liz Dzeng, Teva Brender show art How We Limit Non-beneficial Life Sustaining Treatments: Jason Batten, Liz Dzeng, Teva Brender

GeriPal - A Geriatrics and Palliative Medicine Podcast

Today’s podcast is a natural follow up to our podcasts on and .Today we talk about a new study about how clinicians , published in JAMA Network Open. Do they adhere to society guidelines, which allow as permissible approaches only shared decision-making and following institutional policy.  Or do they take alternative approaches, like not offering interventions, not mentioning interventions, or simply stating a plan to limit interventions? Turns out doctors are using these alternative approaches frequently. Our guests are Jason Batten, Liz Dzeng, and Teva Brender, all clinicians, all of...

info_outline
Elder Mistreatment Prevention and Solutions: Carrie Rubenstein, Julia Hiner, & Tony Rosen show art Elder Mistreatment Prevention and Solutions: Carrie Rubenstein, Julia Hiner, & Tony Rosen

GeriPal - A Geriatrics and Palliative Medicine Podcast

Today we revisit a topic we last discussed in a : elder mistreatment.  Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment, including: Terminology: elder mistreatment vs. abuse and neglect The need to incorporate prevention and solutions into how we talk about mistreatment This is not rocket science. Studying elder mistreatment is much harder than rocket science. Highlighting the reasons they focus on elder mistreatment, including inspiring words for...

info_outline
CCRCs, ALFs, and Private Equity: John Burton, Bill Applegate, & Melissa Aldridge show art CCRCs, ALFs, and Private Equity: John Burton, Bill Applegate, & Melissa Aldridge

GeriPal - A Geriatrics and Palliative Medicine Podcast

Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid.  You can read about John’s early experiences in his JAGS commentary titled,   The tone is bleak.  John’s experience since Covid, as you’ll hear, is very positive.  Many of the concerns he raised about isolation have been addressed. Second, we hear from Bill Applegate,...

info_outline
Search for Geriatrician Identity: Mary Tinetti, Helen Fernandez, Jerry Gurwitz, Ken Covinsky show art Search for Geriatrician Identity: Mary Tinetti, Helen Fernandez, Jerry Gurwitz, Ken Covinsky

GeriPal - A Geriatrics and Palliative Medicine Podcast

Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the .  Today’s conversation is prompted by multiple articles in JAGS: (1) an article with a title the same as this podcast; (2) an article by Helen Fernandez on “”, a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, “?”  Of note, Mary’s article is a follow up to her 2017 in which she wrote: Those outside the field have difficulty understanding what geriatrics is and...

info_outline
The Interior Experience of Prescribing Medical Aid in Dying: Carly Zapata and Dani Chammas show art The Interior Experience of Prescribing Medical Aid in Dying: Carly Zapata and Dani Chammas

GeriPal - A Geriatrics and Palliative Medicine Podcast

I had the privilege of learning from fellow Lisa Harris about a term she termed, “.”  As an ob/gyn and abortion provider, Lisa found the debate around the legality of abortion so polarizing that it created a false dichotomy: you’re either for or against.  Any talk about misgivings, uncertainty, ambiguity, or ambivalence was silenced.  Talking about these issues in the face of polarization was deemed dangerous and undermining to one side or another. “How could you?” For Lisa’s work in finding common ground and embracing nuance she was awarded the for forging...

info_outline
Navigating Organ Donation Discussions: Toby Campbell, Nikole Neidlinger, Samantha Taylor show art Navigating Organ Donation Discussions: Toby Campbell, Nikole Neidlinger, Samantha Taylor

GeriPal - A Geriatrics and Palliative Medicine Podcast

While we have previously discussed t, we have yet to explore the complex landscape families face regarding organ donation. In this episode, we dive into the nuances of Donation after Brain Death (DBD) and Donation after Circulatory Death (DCD), and clarify the essential role of healthcare providers who are not part of an organ procurement organization. In this episode of the GeriPal Podcast, we step into a space in serious illness care that is often misunderstood, overlooked, or reduced to a simple "call the organ donation network" checklist item. Joining us are three experts to help us...

info_outline
Dermatology in Older Adults (GeriDerm): Daniel Butler and Eleni Linos show art Dermatology in Older Adults (GeriDerm): Daniel Butler and Eleni Linos

GeriPal - A Geriatrics and Palliative Medicine Podcast

In this episode of the GeriPal podcast, we dive into the fascinating world of geriatric dermatology, or “GeriDerm,” with two exceptional guests: and .  First, we tackle the big question: how do we keep our skin healthy as we age? I see this on a daily basis with my own skin, but I’m unsure what to do about it, including whether we all need to use sun protection and moisturizers, and if so, which ones?   Then we explore the lag time to benefit in dermatology by examining whether we need to treat every actinic keratosis and basal cell carcinoma aggressively, or whether...

info_outline
 
More Episodes

Six years ago we had John Newman on GeriPal to talk about Geroscience (Song choice Who Wants to Live Forever by Queen, perfect selection).  John explained the basics of geroscience, what is it, what are the key theories in geroscience, what is senescence, why people who provide clinical care for older adults should care about geroscience, and potential therapeutics like metformin and rapamycin.

Today we bring on three rising stars in Geroscience, Brian Andonian, Sara LaHue, Joe Hippensteel, to talk about one of the key pillars of Geroscience: inflammaging.  We use this terrific paper they published in Geroscience as a springboard.  We discuss:

  • What is inflammaging? Chronic progressive low grade inflammation with aging.

  • I try to get one of them to stake a claim that inflammaging should be the organizing principle of geroscience

  • How does inflammaging operate in rheumatologic conditions like rheumatoid arthritis (Brian), neurologic conditions like traumatic brain injury  (Sara), and critical illness (Joe).  We talk about Post-ICU Syndrome (PICS) and relate inflammaging to our prior podcast with Wes Ely about his book Every Deep Drawn Breath.  We also talk about how inflammaging is not just a factor in chronic conditions like diabetes or inflammatory bowel disease, which make intuitive sense, but also in acute conditions, like sepsis or traumatic brain injury in older adults.

  • The state of the science on clinical and research tests for inflammaging - ready for prime time?  What is the state of the science for therapeutics? Why should some anti-inflammatory therapeutics make us nervous in frail older adults? Inflammation developed evolutionarily for a reason. E.g. tthink of drugs that wipe out the immune system.

  • The outsized discrepancy between non-FDA products marketed to consumers as anti-inflammaging and the state of academic Geroscience.  We announce GeriPal’s new lineup of skin care anti-inflammaging products!

  • We discuss lifestyle interventions such as exercise, meditation, caloric restriction and intermittent fasting, and strength/resistance training.

  • \We recognize the efforts of Clin-STAR in bringing together multidisciplinary aging researchers to advance aging research, including our guests.

And what a joy to sing Billy Joel!  Here’s a link to the documentary I mentioned, which is on my list to see.

-Alex Smith