Gina Touch

Interests

Research

Predictors of Dementia and Mild Cognitive Impairment;Impact of Adverse Childhood Experiences on healthcare utilization and healing;Relationships between Emotional Intelligence, physician well-being, and patient outcomes

Teaching

Motivational Interviewing and skills coaching;Cognitive Behavioral Therapy;Living with illness and promoting health across generations; Geriatric assessment and treatment;Dementia and comprehensive care management; Broadening Differential Diagnoses to include The Diagnostic and Statistical Manual, Fifth Edition;Cultivating Emotional Intelligence;Using Balint Group to build physician self-awareness and resilience; Linking Adverse Childhood Experiences, Health Outcomes, and Trauma-Informed Care

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Amin, K., Mercer, G. T., Molinari, V., Pinnell, C. M., Sadek, R., & Wright, K. (2010).

  P3-152: A proposed model of Alzheimer's dementia and PTSD: Pathophysiological processes in coping with traumatic negative affect

  . Alzheimers & Dementia. doi:10.1016/j.jalz.2010.05.1650
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  Based on epidemiological findings and predictive factors of Alzheimer's disease (e.g., genetics, TBI, substance use, lack of linguistic/cognitive complexity, lower levels of education), authors proposed that the processing of chronic negative affect and traumatic stress in a compromised neurologic environment may explain the almost twofold incidence of dementia in older veterans with PTSD (Yaffe et al., 2009). The “neural circuitry of traumatic recall” (Phan et al., 2002) parallels the cognitive processes and brain regions affected in dementia (e.g, hippocampus, mPFC; amygdala, ACC, occipital cortex). The lower prevalence of Alzheimer's dementia among East Indians and American Indians (Manly and Mayeux in Anderson, Bulatao, and Cohen, Eds, 2004) suggests that cultural factors and adaptive coping processes (e.g, acceptance, forgiveness) may diminish the adverse neural impact of negative affect. Literature review. “Traumatic stress,” defined as longstanding unresolved re-experiencing of intense negative affect (e.g., fear, shame, sadness, anxiety, worry, grief, anger, disgust, helplessness) may activate and maintain extreme levels of glucocortisol. Coping styles, in the presence of known risk factors of dementia, may set in motion a chain of neuroimmunological events and processes causing the toxic levels of amyloid and other matter that cannot be sufficiently metabolized. Excessive glucocorticoid levels, chronic activation of CNS processes, and inhibition of normative recuperative processes may cause an excessive hippocampal “load.” This may contribute to the formation of neurotoxic beta amyloid found in patients with Alzheimer's disease. The manner in which longstanding negative affect and trauma-related images and memories are “processed” (e.g., re-experienced, suppressed, or dissociated) in interaction with predictive cognitive and genetic risk factors may result in neurophysiological sequences linked to the development of dementia. We hypothesize that the increased incidence of dementia among older veterans with PTSD may result from pathophysiological processes activated by psychological/affective processing of trauma, specifically, negative affect and insufficient coping. In the presence of protective factors, adaptive coping with traumatic negative affect may even mitigate dementia or minimize its presentation in the presence of risk. The authors invite dialogue to shape directions for further studies in this new research area.
• Kunik, M. E., Mercer, G. T., Molinari, V., Orengo, C. A., Rezabek, P., & Snow, L. (1999).

  Rehospitalization of Older Psychiatric Inpatients: An Investigation of Predictors

  . Gerontologist. doi:10.1093/geront/39.5.591
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  The purpose of this study was to identify a combination of variables that could predict rehospitalization among a sample of 150 geropsychiatric inpatients. Logistic regression analyses testing a modified model identified risk factors for geropsychiatric rehospitalization and correctly classified approximately 80% of inpatients who were rehospitalized for subsequent treatment. Patients' psychiatric diagnosis (mood or schizophrenic disorder), poor general psychiatric functioning, depressive and agitated behavior at discharge, little or no supervision in living arrangements following discharge, limited social support, change in the social support system preceding hospitalization, and maladaptive family functioning could significantly predict geropsychiatric rehospitalization. The strongest independent predictor was maladaptive family functioning.

Presentations

• Bendheim, P. E., & Touch Mercer, G. (2023, May). Brain Wellness: Keeping your aging mind sharp!. Leading Age Arizona annual meeting. Scottsdale, AZ: Leading Age Arizona.
• Bendheim, P. E., Touch Mercer, G., & Zernial, C. (2023, March). Addressing Brain Health in Primary Care through Community Partnerships. American Society on Aging (ASA) Annual meeting. Atlanta, GA: American Society on Aging (ASA).

Other Teaching Materials

• Touch Mercer, G. (2020. Brain Health curriculum for older adults. BrainSavers, Inc..
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  Based on Dr. Paul Bendheim's book, "The Brain Training Revolution" and on current research on brain health, I create a curriculum for older adults on cognitive fitness, socialization, stress management, sleep hygiene, exercise and nutrition, and develop cognitive fitness workouts.