Art Walaszek, MD
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walaszek.medsky.social
Art Walaszek, MD
@walaszek.medsky.social
2.1K followers 1K following 1.1K posts
I am a medical educator, geriatric psychiatrist, public health researcher & book author in Madison, Wisconsin. The views expressed on this account are mine alone.
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walaszek.medsky.social
1- Assessing risks of surgery w/ respect to cognition is a challenge in the care of older adults.

This editorial recommends:

- perform cognitive screening before & after surgery
- counsel re risk of perioperative neurocognitive d/o...

#medsky

agsjournals.onlinelibrary.wiley.com/doi/full/10....
Editorial Free Access Brain Health Is Central to Good Perioperative Care in Older Adults This article relates to: Karen E. Blackmon First published: 24 September 2025 https://doi.org/10.1111/jgs.70130
November 28, 2025 at 2:13 AM
walaszek.medsky.social
Good social policy has health benefits.

In an analysis of the Health & Retirement Study, participating in SNAP is assoc w/ slower cognitive decline in adults 50+ yo.

However, the protective effect was less in Black & Hispanic adults.

#medsky

agsjournals.onlinelibrary.wiley.com/doi/full/10....
Annual decline in global cognition, memory, and executive function in SNAP users and non-users by race/ethnicity.
November 27, 2025 at 2:16 AM
walaszek.medsky.social
Prescribing 1st-generation antihistamines (e.g., diphenhydramine, hydroxyzine, meclizine) to hospitalized older adults is associated w/ ⬆️risk of delirium, according to this study of 328k inpatient admissions in Canada.

Just don't do it!

#medsky

agsjournals.onlinelibrary.wiley.com/doi/full/10....
Probability of delirium associated with the proportion of each physician's admissions that include a first-generation antihistamine prescription, using mixed effects logistic regression. The red line represents the effect estimate and the gray shading represents the 95% confidence interval.
November 27, 2025 at 2:05 AM
walaszek.medsky.social
The new AI bot in Epic is named Art.

I am named Art.

I think I've achieved the singularity.

#medsky
Draft by Art
November 21, 2025 at 11:00 PM
walaszek.medsky.social
The newest projections of physician workforce in the US suggest substantial shortages, even in scenarios with more GME slots and/or increased involvement by advanced practice providers - up to 329,000 by 2050.

Presented by Michael Dill, @aamc.org

#medsky #aamc2025
Projected physician shortages by 2050: 119 to 329k
November 2, 2025 at 5:14 PM
walaszek.medsky.social
Inspiring words from 19th & 21st Surgeon General of the US, Vivek Murthy, at the @aamc.org Learn Serve Lead conference - sharing his thoughts on trust, leadership, and speaking up during challenging times.

#medsky
Vivek Murthy with David Skorton
November 2, 2025 at 3:40 PM
walaszek.medsky.social
What a wonderful way to start the @aamc.org Learn Serve Lead conference: a performance by the Ballet Folklorico Sol de San Antonio.

#medsky
Performers of the Ballet Folklorico Sol de San Antonio on the stage of the conference.
November 2, 2025 at 3:22 PM
walaszek.medsky.social
Happy #Caturday and Halloween!
A cat dressed as a witch
November 1, 2025 at 2:46 AM
walaszek.medsky.social
2- "By integrating lifelong patterns of challenge, adaptation & supportive environmental interactions, older adults can navigate late-life transitions with dignity, agency & a sustained sense of purpose."
Multidimensional resilience framework across the lifespan. Resilience is portrayed as the woven “warp-and-woof” of life, formed by the continuous interaction of three overlapping domains—physical (yellow), cognitive (magenta), and psychosocial (blue)—all nested within the broader exposome (gray ring). The physical inset shows how a stressor can precipitate diminished resistance and delayed or incomplete physiological recovery; the cognitive inset illustrates how higher baseline reserve can buffer memory decline despite Alzheimer neuropathology; and the psychosocial inset depicts a “resilience reservoir” that is replenished by social support or depleted by wasted resources. Together, these strands highlight the cumulative, lifelong interplay of stressors, adaptations, and supports that ultimately shape each individual's resilience trajectory. Reproduced from reference
October 31, 2025 at 1:16 AM
walaszek.medsky.social
1- Wonderful case study of resilience and aging in @agsjournal.bsky.social, and a lovely example of using a narrative-based approach to challenge ageist assumptions.

Read Cocota's story here:

agsjournals.onlinelibrary.wiley.com/doi/full/10.... #medsky #ageism
Portrait of Cocota (1875–1975), by Avelino-Silva. The portrait of Cocota captures her in profile, an elegant simplification of line and shade that conveys both gravitas and softness. The face, etched with the grooves of a long life, carries the weight of countless stories—episodes of strength, loss, humor, and perseverance. The set of her jaw and the curve of her shoulders suggest dignity. The illustration pays tribute to a woman known for stubborn kindness, for outlasting expectations, and for performing quiet acts of courage.
October 31, 2025 at 1:16 AM
walaszek.medsky.social
There's emerging evidence that GLP-1 receptor agonists
could be helpful for treating substance use disorders by reducing the rewarding properties of alcohol, opioids, nicotine & stimulants.

Learn more in this review. We need more research in this area.

#medsky

academic.oup.com/jes/article/...
Overview of the effects of GLP-1 and GLP-1RAs. GLP-1 is mainly produced by the L cells in the intestines and the NTS in the brain. Endogenous GLP-1 is rapidly degraded by the enzyme DPP-4. GLP-1RAs are engineered to resist degradation by DPP-4, resulting in longer lasting and more potent effects of the drug. Peripheral targets include the pancreatic islets, gastrointestinal tract, thyroid, kidneys, and the heart, among others. GLP-1Rs are widely distributed in brain regions involved in reward processing, stress, satiety, and appetite regulation such as the VTA, NAc, ARC, PFC, and the hypothalamus. GLP-1-induced appetite suppression is not only mediated by interactions with GLP-1R in the hypothalamus, but also via the vagus nerve and the dorsal vagal/NTS complex. Activation of the GLP-1Rs expressed in these peripheral and central organs and tissues modulate various physiological pathways, thus promoting glucose regulation and weight loss. Furthermore, GLP-1RAs have the potential for treating ASUDs, as discussed in this review. Abbreviations: ARC, arcuate nucleus; ASUDs, alcohol and other substance use disorders; DPP-4, dipeptidyl peptidase-4; GLP-1, glucagon-like peptide-1; GLP-1R, glucagon-like peptide-1 receptor; GLP-1RA, glucagon-like peptide-1 receptor agonist; NAc, nucleus accumbens; NTS, nucleus tractus solitarius; PFC, prefrontal cortex; VTA, ventral tegmental area.
October 29, 2025 at 1:20 PM
walaszek.medsky.social
Mental health needs in rural & underserved areas are huge. One way to address these needs is to train psychiatrists in these settings.

Learn more at the @acgme.bsky.social interest group session:

"Psychiatry GME in Rural & Underserved Areas"

11/18 1 pm CT

#medsky

dl.acgme.org/pages/mua-in...
Holding hands
October 27, 2025 at 7:40 PM
walaszek.medsky.social
Thoughtful editorial by Mia Yang & Josh Chodosh in @agsjournal.bsky.social re: barriers to lecanemab administration to veterans with #Alzheimer's disease.

They argue that we should be educating clinicians on comprehensive #dementia care.

#medsky

agsjournals.onlinelibrary.wiley.com/doi/full/10....
Editorial Free Access Navigating the Controversies and Complexities of Implementing Lecanemab in the Veterans Affairs Health System This article relates to: Mia Yang, Joshua Chodosh First published: 05 September 2025 https://doi.org/10.1111/jgs.70073
October 27, 2025 at 6:11 PM
walaszek.medsky.social
Moving account by Anne Enright in @theguardian.com about caring for her mother, then grieving, then clearing her parents' belongings.

"By then, we were not concerned about her personality so much as her personhood, which had to be honored as capacity fell away."

www.theguardian.com/books/2025/o...
Enright with her mother Cora in 2015. Photograph: The Irish Times/ Alan Betson
October 26, 2025 at 2:45 PM
walaszek.medsky.social
Happy #Caturday from a very contented cat, Blankie.
Black & white cat sitting in a window perch
October 26, 2025 at 1:39 AM
walaszek.medsky.social
And more on Angela Lunde here:

mcpress.mayoclinic.org/authors/ange...
Angela Lunde
October 21, 2025 at 12:49 AM
walaszek.medsky.social
Revisiting our informative & engaging Fall Community Conversation on "Addressing Hearing Loss for Better Brain Health," hosted by @wisconsinadrc.bsky.social

Video of the event via link below 👇

#medsky @kmueller123.bsky.social @uw-iea.bsky.social @uwmadison.bsky.social

www.adrc.wisc.edu/fcc2025
Art Walaszek moderating a panel that includes Kim Mueller, Erik Jorgensen, Bobby Gibbs, and Jenna Woestman. Live ASL interpreters plus a monitor with CART. Our keynote speaker, Dr. Kim Mueller. Sanjay Asthana, director of the Wisconsin ADRC
October 20, 2025 at 4:22 PM
walaszek.medsky.social
Meet our new IT staff.

Happy #Caturday!
Black and white cat sitting on a keyboard in front of a monitor that says "Your browser is not supported."
October 18, 2025 at 2:05 AM
walaszek.medsky.social
Deaths related to alcohol use in the U.S. increased by 89% between 1999 & 2024, with highest increases/rates for:

- females 25-34 yo
- males 25-34 yo
- American Indians & Alaska Natives

Liver disease & mental/behavioral disorders are major drivers.

#medsky

journals.plos.org/globalpublic...
Fig 1. Yearly crude rates stratified by age from 1999 to 2024 and by race from 1999 to 2020. Male mortality crude rates are always higher than female crude rates. The most affected groups are (by age) those aged 55-64, and (by race) AIAN populations. Racial stratification is based on “bridged race” categories and cannot extend beyond 2020 since racial categorizations in the CDC WONDER database were changed that year. Yearly crude rates for a given demographic group are defined as the number of fatalities of that group in a given year, divided by the entire population, multiplied by 100,000.
October 15, 2025 at 1:32 PM
walaszek.medsky.social
Psychiatrists Grant Brenner and Ari Gildengers share moving reminiscences of their mothers on Story Corps by @npr.org.

#medsky

www.npr.org/2025/10/10/n...
Grant Brenner & Ari Gildengers
October 11, 2025 at 11:29 PM
walaszek.medsky.social
Great @npr.org interview of Christopher Blevins, first American male XC MTB champ in 34 years and member of a family of prominent Black physicians.

Get out there and ride!

www.npr.org/2025/10/10/n...
Christopher Blevins on his mountain bike with arms extended in victory
October 11, 2025 at 3:45 PM
walaszek.medsky.social
Congratulations to Maria Corina Machado for her very well deserved Nobel Peace Prize for keeping “the flame of democracy burning amidst a growing darkness.”

www.nobelprize.org/prizes/peace...
Maria Corina Machado at a March in Caracas in Feb 2019, Photo by Alexcocopro CC BY-SA 4.0
October 10, 2025 at 1:08 PM
walaszek.medsky.social
Could sex differences in dementia risk - women have generally been shown to be at ⬆️risk - be due in part to comorbidities?

Yes, for some comorbidities but not others:

- when controlling for GU & MSK disease, women = men w/r/t dementia risk

...

#medsky

alzres.biomedcentral.com/articles/10....
The association between sex and the risk of incident dementia (adjusted for eleven demographic or medical domains). HR indicates hazard ratio from the Cox proportional hazards regression model. 95% CIs are Wald 2-sided 95% CIs. P values are for test of the hypothesis HR = 1 vs the hypothesis HR ≠ 1.
October 7, 2025 at 4:42 AM
walaszek.medsky.social
The Giving Voice Initiative leads a worldwide movement to bring dementia-friendly choruses to every community.

These choruses can help people living with #dementia and their caregivers feel more connected with their communities.

#medsky

www.givingvoicechorus.org/giving-voice...
The Giving Voice Network: People standing and singing with arms uplifted
October 6, 2025 at 2:03 PM
walaszek.medsky.social
1- Emotions may be a driver of variability in clinical reasoning & decision-making, according to this review.

Negative emotions (fear, distress, etc.) can impair problem-solving & lead to ordering more tests.

#medsky

journals.lww.com/academicmedi...
The authors categorized emotions as positive, neutral, and negative (x-axis) and activating or deactivating (y-axis)
October 4, 2025 at 9:10 PM