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Dr. Kenneth Sakauye consults with a resident during rounds at the MED.

The processes of aging are complex and often misunderstood, especially mental digression. Dr. Kenneth Sakauye, director of geriatric psychiatry at the University of Tennessee Health Science Center, wants to dispel the myths about geriatric psychiatry by illuminating the realities of cognitive impairment.

He is doing so through his educational efforts at UT and a new book coming out this month, Geriatric Psychiatry Basics: a Handbook for General Psychiatrists.

“The stigma is rampant in medical practice and there is a lot of misinformation about geriatrics,” Sakauye said. “For example, thinking that dementia is normal for aging and [doctors] calling any kind of cognitive impairment Alzheimer’s, when half the time it’s probably the medicines [patients] are using.”

The book tries to answer the central question about aging: which changes are normal and which changes are related to disease processes? Sakauye covers fundamental issues in the field that are not well addressed in general adult training, including the biology of aging, common medical illnesses associated with aging, and the neurobiology of degenerative disorders, along with information on therapeutic modifications and geriatric psychopharmacology.

Ultimately it is a user-friendly handbook for all mental health professionals on how to properly deliver geriatric mental health services.

“It tries to make geriatric psychiatry more common sense and understandable,” he explained.

In the book Sakauye explores the most commonly encountered problems like memory impairment, Alzheimer’s, dementia, depression, anxiety and substance abuse and their assessment, diagnosis and treatment options. Additionally he includes clinical examples that address common pitfalls and critical information on issues like differentiation protocols between normal and abnormal behavior.

A transplant from New Orleans after Hurricane Katrina, Sakauye brings 30 years of academic and professional expertise to UT. He has experience working with the elderly in disaster situations and is part of the disaster relief task force for the American Association of Geriatric Psychiatry (AAGP). In his 18 years at Louisiana State University in New Orleans, his work focused on underserved populations. Sakauye served on the task force for minority elderly for the American Psychiatry Association (APA) where he contributed to the first manuscript in the Resource Guide on Cultural Competence.

“I think the work I’ve done with minority issues is what I’m most proud of,” he said.

While he lamented leaving New Orleans, the crumbled healthcare infrastructure left him no choice. Since the move to Memphis with his family in May 2006, Sakauye has helped initiate progress in his department at UT. For the first time, UT will have a geriatric psychiatry fellowship program of which Sakauye is the director.

“It was no small feat to get training money to start a fellowship,” he said. “That’s hard to come by and we did that.”

The fellowship will include two residents working at the Veterans Administration Hospital and St. Francis Hospital-Memphis. The program begins in July 2008 and will have two fellows a year.

“We’ve managed to do a lot [with] education on geriatrics at the medical school and in residency [which] were lacking, and we’ve been able to expand them,” said Sakauye, highlighting the biggest areas like dementia and Alzheimer’s. “Within the system, we’re trying to standardize and upgrade the type of assessment we do for differential diagnosis for dementia.”

Sakauye has also been instrumental in expanding the clinical trials portion of the department with ongoing drug trials in Alzheimer’s and depression.

Sakauye is actively working within the department and with organizations in the field to make geriatric psychiatry a more funding-friendly field. Geriatric psychiatry is an underserved area, and with virtually no help to fund fellowships after general psych residencies. Residents are inhibited from choosing geriatrics because it gives them few options to repay student loans. Currently Sakauye is working to get legislation passed to amend how the specialty is funded.

“What we’re trying to do as a specialty is get better stipends and loan forgiveness built into this so [medical students] will have part of their loans forgiven if they stay in the field,” he explained.

Sakauye and other specialists in his department are also trying to work with the pharmacy department to get state support for developing an addiction program at UT. Additionally, Sakauye is working to develop a special program for mentally ill indigents.

Sakauye is a Distinguished Fellow of the American Psychiatric Association, and has received numerous awards for his research. He is on the editorial board of Psychiatric Times, and is an ad hoc reviewer for Journal of the American Medical Association, Journal of the American Geriatric Society and Journal of Aging and Health. He is a member of the American Board of Psychiatry & Neurology, American Psychiatric Association (having served as the Chair of the APA Council on Aging), American Association of Geriatric Psychiatry, American Geriatrics Society, and served as chair on the committee on aging for the Group for the Advancement of Psychiatry. He is a grant reviewer for the Alzheimer’s Disease Association, and has worked as a reviewer for the National Institute of Mental Health Administration on Aging, National Institute of Health and the American Board of Psychiatry and Neurology Committee on Certification for Added Qualifications in Geriatric Psychiatry.

In a culture that worships youth even physicians fall prey to avoiding the elderly, but with the aging population growing faster everyday the demand for physicians who know how to care for geriatric patients steadily increases.

“I would like for geriatrics to be more of a mainstream issue,” he concludes, “so people don’t see older people as being different and we can insert more geriatrics into the curriculum.”

His book is available via catalog as of December 2007 and will be available in bookstores April 1, 2008. For more information visit: www.npbcatalog.com.



December 2007

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