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Featured Researcher: Cathleen Colon-Emeric, MD

cathleen-colon-emericAs a geriatric medicine fellow working in the hospital and nursing home, I was alarmed by the large number of older adults I encountered with a recent hip fracture.  Despite good medical care and rehabilitation, a majority of these individuals never fully recovered their prior level of walking and independence.  Even more concerning, a substantial number experienced multiple complications, additional fractures, continued decline and death within the next 1-2 years. My research has focused on finding ways to prevent or interrupt the terrible consequences of fractures in older adults.

With outstanding mentorship from Aging Center Faculty including Kenneth Lyles and Kenneth Schmader, and training from the Duke Clinical Research Training Program, I have conducted a number of studies focused on fall and fracture prevention, particularly in the nursing home setting.  I co-wrote the study which showed that a once-a-year medication, zoledronic acid, prevents additional fractures and reduces death by 28% after a hip fracture.  I developed and tested health service interventions to improve osteoporosis care in skilled nursing facilities following a fracture.  I led the development of a regional service to identify older Veterans at high risk of fracture, and ensure that they are appropriately tested and treated for osteoporosis.

I currently have 2 large funded projects focused on fall and fracture prevention.  The first is a NIH-funded intervention study in nursing homes, testing 2 different approaches to training staff to implement fall prevention programs.  This is important because nursing homes have the highest rates of falls and fractures in older adults.  While prior studies have shown that fall prevention programs work when implemented by study staff, it has not been shown that such programs reduce falls when the nursing home staff themselves try to use them.

The second is a Department of Defense funded study which has allowed us to assemble a large database of over 5 million men over age 50 years, including their Medicare, VA, and pharmacy records.  This database will allow us to determine the benefits, costs, and harms of osteoporosis screening in men.  There is no current consensus across professional societies about whether men should be screened for osteoporosis, and if so how to select those at highest risk; this will be the largest study of screening in men ever conducted.  If we can identify and treat osteoporosis in men, we can prevent many fractures from ever occurring.

I am currently an Associate Professor of Medicine with Tenure, a Senior Fellow for the Duke Center for Aging and Human Development, and the Assistant Director of the Geriatric Research Education and Clinical Center at the Durham VA Medical Center.  I completed undergraduate work in Biology at Cornell University, and received my medical degree from the Johns Hopkins School of Medicine in 1994.   I have been at Duke ever since, completing a residency in internal medicine, a chief residency, a Masters of Health Science in clinical research, and a fellowship in geriatric medicine.  I am excited to have just received a K24 mid-career mentoring award from the National Institute on Aging, which will allow me to mentor early investigators who like me are passionate about preventing falls and fractures in older adults.