Gerotech: technology in aging interview with Dr. Peter Abadir

Introduction: 00:03

Welcome to Ask Dr. Mia. Episode Conversation on Aging Well, this podcast is for educational and informational purposes only and solely as an educational tool for your own use. Dr. Mia is not providing medical, psychological, or nutritional advice. You should not use this information to diagnose or treat any health problems or illnesses without consulting your own medical practitioner. For more information, including transcription, please go to miayangmd.com. That's miayyangmd.com. And now our host, Dr. Mia.

Dr. Mia 00:36

Thanks for joining the Ask Dr. Mia Podcast. I am Dr. Mia, and today we have a special guest, Dr. Peter Abadir, and I'm going to let Dr. Abadir introduce himself.

Dr. Abadir 00:48

Dr. Mia, thank you for having me. I'm honored to be with you and excited to share a little bit about my journey into medicine and engineering. So my name is Peter Abadir. I'm a geriatrician. I'm a specialist in taking care of older adults. I'm an associate professor of geriatrics medicine at Johns Hopkins, and I also have a second appointment in the School of Engineering, which I think your audience will find interesting. I am an associate professor of electrical and computer engineering, not because I have any training or credential that supports affiliation, but because I work with engineers in this Hopkins Artificial Intelligence and Technology Collaboratory for aging research. And I'll tell you a little bit about this as we go through the session.

Dr. Mia 1:36

Absolutely, yeah. For those listening, if you haven't figured it out, today is going to be an aging and technology episode, talking with someone who's working in this space like Dr. Apadir. And I think you mentioned, Peter, that you're a geriatrician. Just tell us a little bit about kind of what drew you to this field.

Dr. Abadir  1:53

So, geriatrics. I did my residency training and edit program that projections were in the VA system, VA nursing home, VA hospital and I got to tell you, the moment I walked into the rooms of those veterans, saw the pictures on the walls, there are pictures from World War II, World War I. One of my patient's airplane was shot as he was flying over Libya. So kind of like you get your own History Channel show. And I felt like my heart just were drawn to this population. I felt that if I don't do anything for the rest of my life, that would be the best thing I would choose for myself. So that was my first interaction and love for geriatrics.

Dr. Abadir 2:37

And I decided that I had a background in basic research, and I wanted to combine the love for taking care of older adults with research. So this is how I came to Hopkins, like yourself Mia, and did my clinical and research training at Hopkins. And fast forward here now for a little bit over 15 years.

Dr. Mia 2:56

Wow, that's a long time because you said that you don't have an engineering background, what kind of drew you to this particular intersection in working with technology and engineers?

Dr. Abadir 3:06

So I want to use a metaphor, and I use that always to explain why it is important for us to work together. So I don't know if you guys have seen redwood trees. Redwood trees are huge trees that basically are the tallest trees on Earth. They go as high as 35 stories high, which is interesting because since I play an engineer, if you have a building that's 35 stories high, then you need at least one-third in foundation. You need to go deep one-third of that to maintain and to support the building so that it doesn't fall. Interestingly, even though that the redwood trees are 35 stories high, they have only five to 6ft of roots. So how do they stay standing? That is the magical question. They stay standing by intertwined roots.

Dr. Abadir 3:54

So you will never find a redwood street living alone. They always live in colonies. They provide strength and support and encouragement for each other. And this is exactly how we thought about that alliance with the School of Engineering, the School of Nursing, and Carey Business School. That we don't have to have all the engineering expertise and the business expertise within jury athletes, but our strength comes from working together, from bringing those heavyweight champions in engineering and business and nursing and put them all in one place. And then when you put everything in one place, magic happens. And this is exactly how it started. A few years ago, I was invited by the Department of Medicine, our Department of Medicine chair at that time, Dr. Mark Anderson, to chair the Department of Medicine research retreats.

Dr. Abadir 4:41

And it was an annual research conference that brings all the amazing research that happens within the Department of Medicine at Hopkins. Because I think in a little bit interesting way, I thought that's, why don't we try to fight it up, bring other people that can make it interesting for us? And I went to Dr. Anderson and we opened up and thought about engineering school, and we invited the School of Engineering, and we started to know that, oh my gosh, there are amazing things that happen when we put engineers and clinicians to work together. Ideas come with problems, they come with solutions. So this was the start of everything, basically. Let's bring other players into the equation. Let's bring the engineering school, let's bring Carey Business School, let's bring the nursing school and put them together.

Dr. Abadir 5:28

Let's do something that is good for our older adults. So the products of that conference that now became one of the largest conferences at Hopkins that brings the School of Engineering and Department of Medicine was the establishment and the foundation of what we call the Gerotech Incubators program and Gero comes from Geriatrics, Tech from Technology, and this is a student-led incubators that bring trainees from the School of Engineering to work with our medicine residents or medical students, with Carey Business School students and with nursing students. So in one incubator. You bring all the formulas in a way that promotes innovation, promotes development of a technology for older adults. The second child of this that came out of just knowing that there are amazing engineers that we can work with, was the Artificial Intelligence and Technology Collaboratory.

Dr. Abadir 6:21

And that is one of three centers nationwide that focus on developing new technologies for older adults. The difference between the Gerotech and the AITC. Gerotech is basically Hopkins students. The AITC is a nationwide center that puts requests for proposals and startups academia companies will come and put applications to work on developing technologies for older adults.

Dr. Mia 6:46

Got you. And what would you say is the goal of these incubators or collaborations? Is it to create a certain type of technology or just in general, technology that can help aging and those who are older navigate their daily lives better?

Dr. Abadir 7:02

So our theme is engineering innovation to change aging, and our focus is how to increase independence and quality of life for older adults. So we're not focused on certain technologies. There are certain areas that we think we can better at just because of the presence of expertise. But in general, we are open to any technology that will help older adults to live independent and enjoy quality of life.

Dr. Mia 7:27

Got you. Yeah, I really love that analogy you gave about redwood trees. I think as human beings, we're all interconnected. It's just sometimes we think that we are in an island by ourselves, but we actually get more done and have more fun when we work with other people. So I'm so glad that the incubator has draws from a diverse group of disciplines and everyone working together. What's an example of a project within the A two collective or the AITC that gets you excited?

Dr. Abadir 7:57

I'll give you an example of a technology that actually was born of the Gerotech incubators program and then made it to the AITC. So this product was developed by the group of engineering students that worked with a resident and a Carey Business School units of business students to give you just a brief overview how they come to pick their innovation or technology that they want to work on. When we put the first foundation for the Gerotech Incubators. Program, the Dean of the School of Engineering said clearly and explicitly, “I want my students to go in unpolluted and unrestrained hunt for problems and solutions.” Unpolluted. I don't want you to tell them what to work on.

Dr. Abadir 8:39

I want them to go to the hospital, figure it out for themselves, find a problem that really matters, meet the patients, meet the physicians, meet key stakeholders, and based on all those meetings and interviews, come up with a problem they would like to work on. Unrestrained: don't tell them how to solve it. And he said, “quite frankly, if you guys knew how to solve problems, you wouldn't have that problem to start with,” which was eye opening to me. Because it really made a huge difference. I always come with a list of things that I want them to work on and I always try to remember the guidance is to say let them go in unpolluted and unrestrained hunt for problems and solutions.

Dr. Abadir 8:19

So the group of students basically went and shadowed, observed, met with different stations, key stakeholders and the clinic that stuck in their mind very clearly was the memory clinic. Just because of the impact of dementia on older adults. And interestingly, they found that one common thread that unified a lot of the patients that they thought was the fragmented sleep, that our older adults that have issues with memory always also complain about some form of pragmatic sleep. And as a geriatrician, you know that sleep is one of the most important and critical functions for everyone, not only for older adults. And that lack of sleep or fragmented sleep will affect your memory, will affect your physical function, will affect pretty much everything, your mood, everything. So they looked into solutions in the market and they found that most of the approaches are focused on medications.

Dr. Abadir 10:16

And although there is a need for using medications, in some cases they wanted to approach it from a different aspect. And what they found is that there are technologies that uses what they call pink noise Mia. And pink noise is our sound waves that can put that patient, when they enter into deep sleep, into even deeper sleep for longer time. So it wasn't that simple because what they had to go to develop this technology was basically to talk with the patent holders to keep building a way to pick the brain waves so that they can figure out when the patient enters into deep sleep.

Dr. Abadir 10:50

And then those waves and fast forward, they develop this headband that older adults can wear when they get to sleep and when they enter into deep sleep and the brain wave starts to show that the headband starts to net those sound waves that keeps the older adults longer and deep sleep. So I want to just highlight a couple of things. First is that I was super excited about how they came to identify the problem and to work on the solution and to think a clinician would definitely the first thing you will think about is maybe I can think about new medications that would be without side effects or that I will reorganize their sleep pattern behaviors, whatever it is. Right.

Dr. Abadir 11:33

But those engineers came with feels like something they built out of their garage and put it together and chips and wires and stuff like that and you get really their level of excitement is extremely contagious and you get to feel like, man, I love working with engineers. They can do different things. The amazing thing is wasn't just them building it, but working with care business students to do market analysis, finances, to figure out what's in the market, to speak with the Hopkins Technology Transfer Office and think about patenting commercialization. The future is always going to be for working together, Mia. And if we can harness the power of the School of Engineering and a business school and the School of Nursing and put them all together to serve our older adults, I think that would be the most noble goal for our center.

Dr. Mia 12:22

That's amazing. Yeah. Speaking of pink noise, my husband actually listens to pink noise. There's YouTube channels for pink noise, brown noise, white noise. I had no idea there were so many different color noises, but I guess it's different frequencies that kind of help you have deeper sleep. He wears, like, wireless earbuds in his sleep because I'm apparently a very loud snorer and I wake him up. So wow. I had no idea this was going to go into my own sleep habits during this conversation. But yeah, that's amazing. I think it's not just building an idea for a particular solution, but it's incorporating the people who are really affected by it and the front line clinicians and hopefully family caregivers. And sleep is so important.

Dr. Mia 13:12

I really try to ask about sleep questions in my own memory clinic and home visits as well because if the person with dementia is not sleeping, then no one else in the family is sleeping. It's like having a young infant at home. It really affects everything and affects the next day. So I was going to say that the business school and working with the engineers can really help not build just a prototype, but kind of take it all the way into potential market and patent. And there's so much, I think, when it comes to technology, there seems to be from an outsider like me, there seems to be so much proprietary information where some company makes something and you have no idea how it works.

Dr. Mia 13:55

It's kind of a black box of things and people don't want to share that information because it's their own proprietary information. But it makes it hard to know as a consumer or clinician what to recommend because you can't possibly test every single thing. Do you have any recommendations for kind of just the general public in terms of selecting and figuring out which technology that's focused specifically on the example of sleep or maybe sound machine or something related to that? How do people even find what would work for them?

Dr. Abadir  14:31

So I will touch this bullet Mia, and I will tell you that one of the reasons that we established the Artificial Intelligence and Technology Collaboratory, that is one of three nationwide centers. The second is in U Penn, and the third is, UMass, University of Massachusetts. And each center has eight cores. Our center at hockey is codirected. Each of those courses are co directed by an engineer and a Geriatrician, which is amazing because any technology that is basically proposed, vetted, tested will be weighed on by a Geriatrician and by an engineer at the same time. And we have actually also mentoring a business score that's directed by Dr. Philpan from Carry Business School to also weigh in on the business aspects of the technology.

Dr. Abadir 15:20

So why am I saying because the process of building our request for proposal, we list things that we want companies to work on, starts with the key stakeholders engagements core directed by Dr. Nancy Schoenborn, Dr. Thomas Cudjoe and the purpose of the core is to put a list of things that matter most to older adults. So we start with geriatricians, coming up with things that are really important for older adults and this core is important along the way and weighing in the different milestones of the project, the testing of the project, selection of the population to be tested on and so on from there. So that's the first core, second core, it goes to technology identification and training. So now we know what are the list of important things to work on.

Dr. Abadir 16:06

And this is a little bit different approach than the Gerotech, which I told you unpolluted, unrestrained. This is more directed request for things that we want to be developed for older adults. Technology identification will come. And that's directed by Dr. Alicia Arbaje and Dr. Craig Hager from the School of Engineering. And basically the idea is that they will match the list of needs with available technologies and then we write a request for proposal saying those areas that we are interested in. It's pretty broad in the way that it focuses on resilience independence and older adults, will focus on the physical independence and also cognitive independence and special emphasis on caregivers.

Dr. Abadir 16:47

Then the first year that we put the request for proposal and this is really exciting to me, we got 130 applications from companies and startups and academicians that are wanting to develop new technology for older adults. This is amazing that we can get that much interest, energy expertise from AI companies, AI experts, engineers that want to develop new technologies for older adults. Our way of making sure that the products are going to be relevant for older adults is infiltrating every level of the development of the technology with a Geriatrician, with a clinician that takes care of older adults and will be able to use their clinical training, their insight, what they know about the disease, to make recommendations, to modify it, so you don't end up with a technology that has absolutely no relevance to older adults.

Dr. Abadir 17:38

One of the examples I use when I talk about the Gerotech Incubators. Program is an example of a technology that was presented to us long time ago, not related to the AITC or older adults, but it was a thermometer that can measure temperature to the 7th Circuit. And even though that this is a scientific breakthrough, I mean, I got to say that is really hard to do. But for me, it wasn't something that I would be able to use in any way in my patients. So that is why I think the way to get more input and more insight and that we develop relevant technologies for older adults is always that we are going to be part of the development of the technology. When we get new products into the market, we will be part of that development effort.

Dr. Abadir 18:16

And you will see that with using engineering, you're not talking about 20 years to get medicine or a drug out. You're talking about two to three years, which is

Dr. Mia 18:35

Fast

Dr. Abadir 18:36

very amazing.

Dr. Mia 18:37

Can you talk a little bit about the contributions from the nursing students and the School of Nursing as well into this collaborative?

Dr. Abadir 18:44

Of course. So the Gerotech Incubators program is co directed by myself and three other directors from the School of Nursing, the School of Engineering, and Carey Business School. And our role is to integrate the students. And it's hard to make something work for one school, but when you bring four different schools together, even that we are one university, it's a little bit harder. And so it was important to bring directors from each school to work together and say, this is my part of the incubator, and I'll make sure that my students are engaged, involved, and that they are part of the effort. But the role of the School of Nursing has two doctorate programs, PhD program, a regular PhD program of nursing, and then doctorate of nurse practitioner. And I just step a little bit back and tell you.

Dr. Abadir 19:29

So the technology development of the project starts with the engineering students first identifying a problem. Once they identify a problem and make a decision that they want to work on this, then comes the care Business school. And care business schools will do the market analysis, finances, and give a thorough assessment of the potential of that technology. They end up with development of a prototype. This is where the nursing students start, because now you have a prototype to test on a population PhD students from nursing school or doctorate, nurse practitioners are looking for a project that they can do as part of their thesis. So it's a win situation where they can take that and develop the IRB, develop all the protocols, procedures in order to take that to the bedside.

Dr. Mia 20:16

That's really exciting. Man, I think if I were a student, I would love to be involved in a project like this as well. And while we have just a few minutes left, any other questions or any other comments you wanted to add? I think one of the questions I was hoping you can maybe touch on is what do you wish everyone could know about kind of this intersection of aging and technology?

Dr. Abadir 20:41

When I interview students for the Geriatric Incubators program, I always make sure to ask them, why do they want to do that? Because it's an investment from their side. This is not part of mandatory courses. This is basically elective. They sign up for it. It's that scholarly activity. Very interestingly. You know how Geriatrics fellows, when they come to do training. There are two reasons usually to do Geriatric fellowship. Either that you have seen a role model in Geriatrics that you want to be like that Geriatrician or your parents grandparents. The interesting thing that I saw in my engineering students is that almost all of them, when I asked that question, they brought pictures of their grandparents and parents that said I'm doing this for that person, I want to develop the technology for that person.

Dr. Abadir 21:24

I want to be part of this incubator to develop technology for that person. And with that I felt that there is a hope in the future when we see that level of passion, commitment, genuine interest in developing technologies for our older adults. I think that we have amazing future and I think that there is nothing more noble than taking care of older adults. So that's all to say that I am excited about the future. I want everybody to send us problems, stuff that they want us to work on. We have an amazing group of engineering students that are lining up to work on technology for older adults and it is always helpful to send them a real feedback from people in the real world saying that this is a problem. I wish that we have a smart engineering student that can work on it.

Dr. Mia 22:13

That's great. And where can people send real problems? I feel like there's a lot of real problems that can be sent in.

Dr. Abadir 22:20

So the Human Aging Project is where the Gerotech Incubators program website is hosted and I can see we'll put it.

Dr. Mia 22:27

In the show notes. Yeah, great. Well, that's very exciting. Thank you so much. Peter. Thanks for joining me today.

Dr. Abadir 22:34

Thanks, Mia.

Outro 22:36

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