Cohorts: Jason Albaum MD'28

Jason is a native of Kennebunk, ME, who is interested in studying internal medicine, with an eye on geriatrics. He has a long history of assisting the elderly, beginning as a volunteer at nursing homes in middle school. His latest research examined delirium in older patients with the hope of developing a more robust tool for measuring the severity of their condition.

What first brought you to Brown?

My younger brother, Nicholas Albaum '25 PhD'31, came here for his undergraduate studies. I visited him for Family Weekend and I thought Providence was wonderful. Brown seemed great. I even swam in the pool here, as I’m a swimmer in my spare time. I applied to medical school, got on the wait list, and, sure enough, that worked out!

Before coming here, I went to Vassar College in Poughkeepsie, NY, which is a beautiful liberal arts college. I got a degree in biochemistry and music performance, as I’m also a saxophone player.

What does a typical day look like for you?

I spend a good amount of time at the medical school. I enjoy walking on the treadmill and watching my lectures on my computer, simply because I don't like sitting for a long time. If I'm not watching a lecture, I'm reading in my textbook about it, or I'm doing practice questions, which is an all-day thing, every day. I try to stay active and swim. I currently live with a few other medical students and we’re always getting up to something fun, like trying to eat at every taco spot in Rhode Island.

At the 19th Annual Academic Symposium in November, you presented a study characterizing delirium and its severity across three clinical settings in Massachusetts, Florida, and New York. What sparked your interest in researching this and what were your findings?

When I was a teenager I volunteered in a nursing home, and I was always interested in trying to understand some of the neurological conditions that can affect older adults as they age. Before I got involved in this study, Elizabeth Bradley, PhD, President of Vassar College, introduced me to Sharon Inouye, MD, MPH, a Professor of Medicine at Harvard Medical School, who is the project’s principal investigator. I ended up working with Inouye’s lab, which is part of Hebrew SeniorLife in Roslindale, MA, over this past summer. It’s a facility that serves as both a research institute and a nursing home itself, so you not only carry out research but you also volunteer and interact with residents—that was an integrated approach that I loved. I became involved with this particular research project on delirium through a scholarship program called the Medical Student Training in Aging Research, which supported me throughout an internship.

Delirium is, unfortunately, a great example of when the medical system can do more harm than good. Some sort of acute stressor, whether it’s a new prescription or hip surgery, can precipitate delirium and make an older adult “not themself” – confused, agitated, or disoriented. It’s not part of normal aging and can have a very sudden onset, which can be quite distressing for patients and their family members. Although it’s usually temporary, it can be a strong indicator of declining health.  However, delirium is often preventable, especially through nonpharmacologic methods. There are lots of things that we try to throw pills at, but this is one of those conditions that it's actually better to perhaps de-prescribe and focus on reorienting the person to offset potential delirium by keeping them engaged, social, and active. This can involve simple things, too, like making sure that their hearing aids are working. Basically, if we’re proactive in recognizing and preventing delirium, we can potentially mitigate its downstream effects of functional and mental decline.

For this study, we looked at delirium at three different clinical settings across the US to characterize the severity of delirium in people with cognitive impairment. Right now, there's no good tool to measure that. We do have a tool that measures delirium severity with a series of questions and a scoring system, but it’s not designed for people with baseline cognitive impairment. The challenge is deciding what we attribute to the baseline cognitive impairment, and what we attribute to the acute delirium process, as there are a lot of overlapping symptoms.

Across all three sites, we found that people with dementia had much higher delirium severity scores. Those with mild cognitive impairment had slightly lower scores, and then people without cognitive impairment had the lowest delirium severity scores. This tells us that, across a variety of clinical settings, cognitive impairment and more severe delirium seem to go hand in hand. It's going to be important moving forward to develop a tool that can measure delirium severity in these people, because it gives us more information about the patient's current and future state, and we can work towards ways to potentially avoid  the poor outcomes.

What makes this research important to you?

One of the things that got me into volunteering was actually music. Growing up playing in jazz bands and then continuing through college gave me an appreciation for older music. In high school, we also had a music therapy project at nursing homes, so I felt like I had a little bit of knowledge of some of the older songs that these folks would be listening to and that helped me better interact with the residents there. That led me to start volunteering.

More generally, it’s important to me as I’ve been fortunate enough to have grandparents who endlessly love and support me. I believe that, as much as they support me, it’s also up to younger generations to support older people. I truly think of them as the backbone of society. When people can’t age the way they want to, especially when it’s caused by the medical system, that frustrates me. I see this work as a way of giving back to the people who made our communities what they are today.

What do you do outside of your research?

I play the saxophone a few times a semester these days, sometimes at jam sessions on the undergrad campus. I’m an academic mentor and also a mentor for the Doctoring program here. I help coordinate for Brown Students at the Bedside, where we connect medical students with hospital patients who don’t have family nearby, might be socially isolated, or anyone who could benefit from additional social support. Generally those people tend to be older adults, too.

I also lead a course called Death and Dying, which is a very low-stakes, student-run class where we explore aspects of palliative care. We have guest lecturers, activities, and discussions about death and what makes a meaningful life. It sounds a little strange, but it’s very cathartic.