iiinova — where your digital self keeps evolving

Art Walaszek, MD @walaszek.art · 23/09/2026

Great science communication by my @uwmadison.bsky.social colleague Dr. Hasmeena Kathuria, Director of the University of Wisconsin Center for Tobacco Research and Intervention, disputing purported health benefits of #nicotine products. www.washingtonpost.com/health/2026/... #medsky

washingtonpost.com

Guest Column | I’m a pulmonologist. Here’s why new wellness claims about nicotine worry me.

Some wellness influencers are saying nicotine promotes cognition and longevity. Scientific studies, however, paint a more complicated picture.

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And closing out our day of learning about #Alzheimers disease and related #dementias, Dr. Jessica Caldwell, PI of the WRAP study at @wai-alzheimers.bsky.social, is presenting on "Healthy Cognitive Aging & Lifestyle Intervention." wai.wisc.edu/staff/caldwe...

Dr. Joe Gaugler (University of Minnesota School of Public Health) is now discussing the State Alzheimer's Research Support (StARS) Center, a partnership among U Minnesota, Emory, and Hopkins supported by a cooperative grant from the National Institute on Aging. directory.sph.umn.edu/bio/sph-a-z/...

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Great summary of the finding that monoclonal antibody treatment of Alzheimer's disease can result in whole brain volume loss ("pseudo-atrophy"), though no change in hippocampal volume. The magnitude of volume loss correlates with the incidence of ARIA.

Structural MRI - the paradox of drug-induced volume loss in three key messages:
1. Region-specific atrophy: no change in hippocampal volume despite decreased whole brain volume and ventricular enlargement
2. Correlation with ARIA: magnitude of volume loss correlates with incidence of ARIA
3. What remains to be explored: mechanism of volume loss, long-term consequences, and predisposing factors are unclear

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Next, we are delighted to welcome Dr. Laura Eisenmenger (Dept of Radiology, @uwmadison.bsky.social School of Medicine & Public Health) to discuss "Neuroimaging in Alzheimer's disease & related dementias." www.radiology.wisc.edu/profile/laur...

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For example ... the interaction between SES and parental history in predicting cognitive trajectories ...

Adult SES (education, income, net wealth, occupational status) as potential buffer of the effect of parental dementia status on cognitive trajectory.

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We're truly honored to have Dr. Jennifer Manly (@manlyepic.bsky.social) join us to present on "Contributions of Intergenerational Research to Understanding Mechanisms of Disparities in #Alzheimers Disease & Cognitive Aging." #dementia #medsky www.neurology.columbia.edu/profile/jenn...

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She described the Ultra-Brief Confusion Assessment Method to screen for delirium in hospitalized patients - average completion time of 75 seconds, with 60% completed within 40 seconds. deliriumnetwork.org/measurement/... pmc.ncbi.nlm.nih.gov/articles/PMC...

deliriumnetwork.org

Dr. Fick shared this terrific fishbone diagram listing causes of undetected #delirium in healthcare settings. She also noted @amaclullich.bsky.social's seminal work in delirium, including the development of 4AT. #medsky

Next: "Detecting and Managing #Delirium in Persons with #Dementia: Integrating Technology & Human Intelligence" by Donna Fick, PhD, RN, GCNS-BC, FAAN, @pennstateuniv.bsky.social. www.nursing.psu.edu/directory/fi...

Portrait of Donna M. Fick, PhD, RN, GCNS-BC, FGSA, FAAN

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Very important point by Henrik Zetterberg: amyloid and tau aren't the only relevant biomarkers in neurodegenerative disorders. Many more discoveries and clinical applications ahead. #medsky #dementia #alzheimers

Biomarkers in addition to ATN:
Astrocytic activation
Microglial activation
Synaptic degeneration
α-Synuclein aggregation
TDP-43 aggregation
Cerebrovascular disease

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Up first is a world-class leader in #dementia biomarkers, my @uwmadison.bsky.social & @wisconsinadrc.bsky.social colleague, Dr. Henrik Zetterberg, who is presenting a masterful update on biofluid-based biomarkers in #Alzheimers disease.

Update on Biofluid-Based Bioamarkers for Alzheimer's Disease - Henrik Zetterberg, MD, PhD

Available biofluid-based biomarkers for neurodegenerative disease in 2026

Art Walaszek, MD @walaszek.art · 16/09/2026

And here's their publication of an RCT (N=40, 8 weeks) comparing "active CBT" and "calm CBT" in terms of behavioral activation and depressive symptoms: pmc.ncbi.nlm.nih.gov/articles/PMC...

Estimated expected change in behavioral activation for depression scale (BADS) total from week 1 with 95% confidence intervals by condition across all eight sessions.

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Art Walaszek, MD @walaszek.art · 16/09/2026

Terrific work by @uwmadison.bsky.social colleagues, Drs. Jacob Meyer and Simon Goldberg, suggesting that exercising before psychotherapy could augment its antidepressant effects. #medsky

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Reposted by Art Walaszek, MD

Sahib Khalsa @skhalsa.bsky.social · 08/09/2026

Postdoc job alert! I’m looking for someone with a PhD in neuroscience/psychology, psychiatry, computational modeling or a related field to join my NIH-funded team at UCLA studying the neural & computational mechanisms of #interoception in anorexia nervosa 1/2

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Art Walaszek, MD @walaszek.art · 08/09/2026

It's amazing to have Dr. Henrik Zetterberg on our team at @wisconsinadrc.bsky.social as a world-class leader in biomarkers in #dementia. Check him out on @nathanielchinmd.bsky.social's Dementia Matters podcast.

UW–Madison @uwmadison.bsky.social · 03/09/2026

Reposted by Art Walaszek, MD

New classrooms, new faculty members, new friends. September 2nd was the buzzing start of a new academic year at UW–Madison. Check out scenes from a first day full of forward motion: news.wisc.edu/a-first-day-...

news.wisc.edu

A first day of classes, full of motion

The start of the fall semester was marked by new places and faces.

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Art Walaszek, MD @walaszek.art · 01/09/2026

I agree. I'm impressed with the high quality compact cars in the $25-30k range, including the Civic, Prius, Jetta, and Mazda 3.

Howard Liu, MD, MBA @drhowardliu.bsky.social · 01/09/2026

Reposted by Art Walaszek, MD

Thrilled to join an outstanding panel of social media experts at the #AAMC26! From finding your voice to advocating for science to engaging the public about healthcare, social media can be a powerful tool at any career stage. If you are attending LSL, I would love to meet up!

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Art Walaszek, MD @walaszek.art · 28/08/2026

It was Larry David's fault.

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Art Walaszek, MD @walaszek.art · 26/08/2026

Join us on 10/9/26 for the 14th Annual Updates & Advances in Psychiatry Conference to learn about: - behavioral mgmt of patients with #dementia - #ADHD comprehensive mgmt in clinical practice - tx of mental illness before/during/after pregnancy and more ce.icep.wisc.edu/14th-annual-... #medsky

The University of Wisconsin School of Medicine & Public Health in autumn

Wisconsin Alzheimer's Disease Research Center @wisconsinadrc.bsky.social · 25/08/2026

Reposted by Art Walaszek, MD

Interest in brain health has increased over the last few years, so how are Americans understanding and incorporating this information into their lives? Dr. Heather Snyder joins #DementiaMatters to share the @alzassociation.bsky.social's new special report on the topic. Listen 🎧 go.wisc.edu/k4mxw4

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Art Walaszek, MD @walaszek.art · 25/08/2026

Incredible research investment at @uwmadison.bsky.social , including investigating the use of psychoactive medicines to treat mental health conditions.

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Yes! Those 215 days of Duolingo allowed me to understand this joke.

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4- The author of this piece argues for an empathetic and nonjudgmental approach for physicians whose patients report after death communication, helping them "understand and process these experiences," resulting in "increased sense of meaning in life, and decreased anxiety toward death."

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3- In "Paradiso," Dante encounters Beatrice, a woman he loved who had died. This contact transforms him: "There is a continuing bond - his eyes intent on quenching 10 years of thirst at last - yet he has formed a new relationship with her; he is seeing her as he has never seen her before."

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2- Reports of after death communications are common in older adults: 73% report feeling as though a dead loved one was looking over 49% as though a dead loved one was in the same room 24% hearing the voice of a dead loved one 21% seeing a dead loved one

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1- What does Dante's "Divine Comedy" have to do with people reporting the experience of after death communications (ADC)? Read on and find out! www.alphaomegaalpha.org/wp-content/u... (PDF) #medsky

Dante et Béatrice (detail), Odilon Redon, circa 1914. Uehara Museum of Modern Art, Japan. Public domain, via Wikimedia Commons

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4- Regarding the relationship between physicians and patients, Grubb argues for a restoration of "restores what reductionism has squeezed out: the recognition that healer and patient meet not merely as technician and mechanism, but as two expressions of the same underlying reality."

3- He cites #POTS as an example: "Treating POTS requires addressing the whole system. You are not fixing a broken part. You are helping a dysregulated system find new equilibrium."

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2- Since "complex biological systems display emergent properties that reductionism cannot predict or explain," a reductionist paradigm of breaking the body into parts & fixing what is broken is incomplete.

1- U of Toledo cardiologist & #POTS expert Dr. Blair Grubb argues that medicine should shift from its reductionist approach to a "field-based paradigm," analogous to the shift from classical to quantum physics. www.alphaomegaalpha.org/wp-content/u... (PDF) #medsky

Title of manuscript: "The day the universe changed: Toward a quantum paradigm in medicine." Abstract image of equations and curves.

Addressing loneliness in older adults is a critical public health concern. This editorial summarizes evidence-based interventions for loneliness, with modifications for people at end-of-life. agsjournals.onlinelibrary.wiley.com/doi/full/10.... @agsjournal.bsky.social #medsky

Loneliness interventions categorized as groups (e.g., circle of friends), activities (e.g., choose to move), companions (e.g., peer support programs), therapeutic support (e.g., online ACT), pets, and family relationships.

I appreciate recs from American Geriatrics Society regarding care of LGBTQI+ older adults: - educate clinicians & healthcare staff - promote inclusive & affirming policies - further delineate research priorities agsjournals.onlinelibrary.wiley.com/doi/full/10.... #medsky @agsjournal.bsky.social

Definition of lesbian, gay, bisexual, transgender, queer, intersex, and plus.

2- It is good news that the proportion of older veterans, with & without dementia, who receive any anticholinergics has been decreasing over time. Progress!

Temporal trends in anticholinergic medication use by drug class across fiscal years among veterans in long-term care. Percentages reflect the proportion of all participants (users and non-users) within each fiscal year who received at least one medication from the specified anticholinergic drug class. Counts represent the total number of individuals prescribed medications in that class during each 2-year cycle. Drug classes are not mutually exclusive; therefore, individuals may appear in multiple categories if prescribed medications from more than one anticholinergic class. Results are presented for the full cohort and stratified by dementia status.

AAMC @aamc.org · 20/08/2026

1- Many older U.S. veterans, especially those with #dementia, are exposed to #anticholinergic medications, which can worsen cognition & cause other side effects. Opportunities for #deprescribing abound. agsjournals.onlinelibrary.wiley.com/doi/full/10.... #medsky

Prevalence of anticholinergic medication classes by dementia status among veterans in long-term care. Bar plots display the proportion of participants with and without dementia who were prescribed at least one medication from each anticholinergic class. Among residents with dementia (n = 6638), first-generation antihistamines (29.5%), second-generation antipsychotics (30.6%), and bladder antimuscarinics (20.2%) were the most commonly used classes. Among residents without dementia (n = 8436), first-generation antihistamines (34.4%), bladder antimuscarinics (23.7%), antidepressants (17.7%), and antiemetic/antivertigo agents (11.9%) were most prevalent. Percentages were calculated using the total number within each dementia stratum. Class-specific totals exceed 100% because individuals may receive medications from multiple anticholinergic classes.

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Reposted by Art Walaszek, MD

NIH funding equates to $138 per American per year. And the return on investment is millions of lives saved. Read more about the extraordinary medical progress NIH funding supports: bit.ly/4i1ewX9

usatoday.com

How Biomedical Research Moves From a Lab Into Patient Care

Physicians work on both the research side and at the patient bedside, translating questions raised in clinical practice into rigorous scientific investigations and bringing those discoveries back to p...

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Reposted by Art Walaszek, MD

Univ. of Wisconsin Emergency Medicine @madtownem.bsky.social · 12/08/2026

🫁🔎 A new $3.2M NIH-funded study led by Dr. Michael Pulia aims to evaluate the link between oral health and swallowing problems as synergistic risk factors for the development of pneumonia in older adults. emed.wisc.edu/news/new-gra...

emed.wisc.edu

New grant will examine synergy of oral health and aspiration in pneumonia risk

Led by Dr. Michael Pulia, the NIH-funded study is the first to comprehensively evaluate the link between oral health, dysphagia, and the respiratory tract microbiome in older adults with acute pneumon...

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Art Walaszek, MD @walaszek.art · 11/08/2026

Thanks for asking. I view the data as indicating that primary care clinics are in a good position to help identify older adults who are being mistreated. Clinicians and staff probably need more training in recognizing signs of mistreatment.

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Art Walaszek, MD @walaszek.art · 09/08/2026

About 10% of older adults experience mistreatment each year. This study found that mistreated older adults use primary care at a similar or higher level than other older adults - suggesting avenues for better detection & intervention. agsjournals.onlinelibrary.wiley.com/doi/full/10.... #medsky

Number of primary care visits among older adults known to be experiencing elder mistreatment (n = 114) in the time periods surrounding mistreatment identification in comparison to matched controls (n = 410).

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Art Walaszek, MD @walaszek.art · 09/08/2026

3- The ADEPT (assess, diagnose, evaluate, prevent, and treat) tool provides a recommended approach to the screening, diagnosis, and treatment of older adults with agitation and delirium in the emergency department. www.annemergmed.com/article/S019...

annemergmed.com

Managing Delirium and Agitation in the Older Emergency Department Patient: The ADEPT Tool

Agitation and delirium are common reasons for older adults to seek care in the emergency department (ED). Providing care for this population in the ED setting can be challenging for emergency physicia...