July 13, 2015

What's Up, Doc?

Every week I scour the medical literature and the media in search of something newsworthy to report about aging and old people.  I discover and sometimes read all kinds of reports—often I wonder whether these reports will have any effect at all or whether they will collect dust in a file cabinet somewhere, though with the internet, there probably aren’t even any physical copies of most of them. There’s the annual report on dementia from the Alzheimer’s Association, there are reports from the Institute of Medicine, surveys from the Pew Center, research papers from AARP. I read and reported on white papers and position papers (I never have known the difference) from organizations such as the FrameWorks Institute and from the British Geriatrics Society. I’ve blogged about important books, not so much on best sellers such as Atul Gawande’s “Being Mortal” as on equally important but less celebrated works such as Angelo Volandes’ “The Conversation” and Sharon Kaufman’s “Ordinary Medicine.” And then there are the medical journals. So it occurred to me to ask what journals publish articles about aging that I think are of interest to both the geriatrician and the general reader?

Just for fun, I looked at what recent articles were cited in either my blog, Life in the End Zone, or in the one other blog that I read regularly, GeriPal, which stands for Geriatrics and Palliative care and is run and largely written by Alex Smith and Eric Widera, both physicians. What appeared in these two blogs reflected my biases and those of my colleagues at GeriPal. A little introspection about my blog reveals that I try to avoid discussing articles that are getting a lot of publicity already, pieces that have already made it into every leading newspaper unless, of course, I have a dissenting view on those studies. I like looking for interesting sounding articles in journals that most doctors don’t read and for reports on relevant topics that were ignored by the mainstream press. As to GeriPal, the authors describe the blog this way: “It is a forum for discourse, recent news and research, and freethinking commentary. Our objectives are: 1) to create an online community of interdisciplinary providers interested in geriatrics or palliative care; 2) to provide an open forum for the exchange of ideas and disruptive commentary that changes clinical practice and health care policy; and 3) to change the world.” Here’s what I found.

In the six months since the beginning of 2015, GeriPal has posted clinical vignettes and personal ruminations along with summaries and commentaries about new research findings. I counted 13 discussions of articles—11 of them newly published studies. Of these 11, 6 appeared in JAMA Internal Medicine. The others were from 5 different journals: the CDC’s Morbidity and Mortality Report, the Journal of Clinical Oncology, the Journal of General Internal Medicine, and the Gerontologist.

During the same 6 months, I discussed 12 newly published articles (along with various books and reports). My most cited journals were JAMA Internal Medicine (same as GeriPal, but by and large, different articles), with 3 studies quoted, and the New England Journal of Medicine (another 3). The remainder were from 6 different sources: the Gerontologist, the British Medical Journal, the Journal of Medical Ethics, JAMA Neurology, Aging Cell, and Health Affairs.

Are there any conclusions from all this? If you are interested in issues affecting the older population and you only have time to look at only one medical journal, you should concentrate on JAMA Internal Medicine. (Remember that while I only discussed 3 articles from this journal, I deliberately avoided focusing on articles that GeriPal had already referenced.) All told, 9/24 articles were from this one journal. Not a single article from the Journal of the American Geriatrics Society, the flagship journal of the leading American professional society for geriatricians, made it into the list.

Now this is a rather eccentric perspective. Remember that I didn’t survey all articles on geriatric topics and then decide in some systematic way which were most important. All I’m asking is what articles happen to have been chosen by one or both of two blogs, one of which is my own, over the past six months. Just thought you might be interested. And kudos to JAMA Internal Medicine!

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