As part of our “Meet Yale Internal Medicine” series, today’s featured faculty is Alexandra Hajduk, PhD, MPH, associate research scientist (geriatrics).
Inspired by her grandmother’s medical condition, Alexandra Hajduk, PhD, MPH, focused her research on cardiovascular disease in the geriatric population.
“After she had a stroke, my grandmother developed pretty profound physical and cognitive difficulties,” explained Hajduk. “The experience of seeing how my grandmother’s condition affected her informed much of my research interest. I also think it's really fascinating that people often underestimate the effect that cardiovascular disease, not just stroke but also heart diseases, can have on other parts of your body, besides the heart, such as your cognitive and physical function. My research examines the intersection of these geriatric phenotypes, such as cognitive impairment and physical impairment, and cardiovascular disease.”
As an undergraduate student, Hajduk thought she would become a pathologist. She was pre-med, but discovered during her first co-op at a clinical lab at Mass General Hospital that a job at the bench was not the right fit for her. Upon returning to her studies, she took a class on community health which ‘spoke to her.’
“I like the idea of being able to affect change in a public way, and being able to reach more people by public health and epidemiology,” said Hajduk.
Hajduk started evaluating fellowship programs, and considered Yale School of Medicine (YSM). At the time, her PhD advisor was collaborating with a team at YSM on the new SILVER-AMI study. Hajduk admits the timing and opportunity were serendipitous.
"I examined geriatric vulnerabilities in heart disease for my dissertation, so coming to Yale to work with the preeminent researchers in Geriatrics and Sarwat Chaudhry, MD, on the SILVER-AMI study, a ‘holy grail’ study combining cardiology and geriatrics, was a perfect next step for my research,” said Hajduk.
Hajduk has been an associate research scientist in the Section of Geriatrics for two years. She sings the praises of her colleagues within the section and her partners on the SILVER-AMI team, which is a combination of geriatric experts, cardiac researchers, and methodological experts in the Sections of General Internal Medicine and Geriatric Medicine.
“There are many great things about Geriatrics at Yale, but one really important research focus here is the medical complexity of older adults. People here do not shy away from complexity in research and clinical situations,” commented Hajduk. “I generally study people with heart attacks, atrial fibrillation, and heart failure, but most of the time, the people who I'm studying have five other diseases so I need to account for and appreciate them too.”
Over the past few years, the SILVER-AMI study published numerous papers highlighting their findings.
In April 2019, the team looked at mobility test performance to predict whether an older heart attack patient would be readmitted to the hospital. They discovered that functional mobility was the strongest predictor of hospital readmission in this patient mix in “Thirty-Day Readmission Risk Model for Older Adults Hospitalized With Acute Myocardial Infarction: The SILVER-AMI Study” published in Circulation: Cardiovascular Quality and Outcomes.
Hajduk was lead author on an October 2019 publication, “Association Between Mobility Measured During Hospitalization and Functional Outcomes in Older Adults With Acute Myocardial Infarction in the SILVER-AMI Study,” evaluating the likelihood of functional decline in older adults following a heart attack, printed in JAMA Internal Medicine. The researchers looked at 2,587 patients across the U.S. and assert that these study results can have important implications for how patient care should be managed after a heart attack.
In addition to her work on the SILVER-AMI project, Hajduk wears several other hats within Geriatrics. She is one of the few epidemiologists within the section and prides herself on doing what she can to contribute to the rigor of geriatric research at YSM. She serves as Associate Program Director of the T32 Training Program in Geriatric Clinical Epidemiology and Aging-related Research, led by Thomas Gill, MD. She considers her role of mentoring future geriatrician-scientists in the section’s fellowship program and teaching epidemiology to first-year medical students as the most rewarding parts of her job.
Hajduk plans to keep expanding her role at YSM, looking for more research in which to participate and additional ways to guide the next generation. As a non-clinician, she admits to some limitations in having that clinical experience to inform her research, but this gives her many reasons to appreciate the collaboration with her clinician colleagues across the school.
“Yale has so many resources,” said Hajduk. “The Yale Program on Aging has a ton of epidemiologic and biostatistical support that's really strong. The collaboration across the various sections is excellent. I’ve tried to craft a career that focuses on team science, which I enjoy, and bring my expertise as an epidemiologist to the amazing clinician investigators here in Geriatrics.”
“Yale is an amazing place, it's just head and shoulders above other institutions out there. The resources are unbelievable. The people are great, they share my passions and want to make the world a better place. That's what really keeps me here. I like getting to nerd out with people who are my kindred spirits.”
To learn more about Hajduk’s work and the Section of Geriatrics, visit Geriatrics.