Clin-STAR Journey Story

Starting Young to Help Older Adults with Inflammatory Bowel Disease

Dr. Adam S. Faye is currently Assistant Professor in the Departments of Medicine and Population Health at NYU Grossman School of Medicine, part of NYU Langone Health System. But his interest in medicine began many years ago, when he was a teenager and his father was diagnosed with Guillain‒Barré syndrome, necessitating 3 months of ICU hospitalization. The clinical staff who took care of his dad and family inspired him to make medicine his career path, and he wasted no time getting to work. While still in high school, he launched his first geriatric medicine initiative—a program called MATS for “Make a Tub Safe,” delivering bathmats to older adults to prevent falls in the bathtub.

After his undergraduate years at Harvard, majoring in biochemistry, he completed a year of basic science research at Weill Medical College at Cornell University, where he worked with older oncology patients, testing blood profiles and correlating laboratory results with clinical responses to therapy. This “bench to bedside” experience further reinforced his desire to care for older adults, and he continued at Weill Medical College to earn his medical degree. Once again, family circumstances played a role in Dr. Faye’s career trajectory, as he helped his mother-in-law and other extended family members manage their Crohn’s disease, sparking Dr. Faye’s interest in gastroenterology and inflammatory bowel disease (IBD) in particular.

During his residency, Chief year, and GI fellowship at Columbia Presbyterian Medical Center, Dr. Faye participated in geriatrics rotations and started his research in gastrointestinal conditions, first looking at celiac disease and then IBD outcomes. During fellowship, he also obtained a master’s degree in patient-oriented research from the Columbia Mailman School of Public Health. Passionate about the understudied older adult population with IBD, he continued his training at Mount Sinai Hospital during an advanced fellowship focused on the clinical treatment and outcomes research of IBD.

Dr. Faye has been involved with Clin-STAR since fall 2021 and received a GEMSSTAR scholar award in 2022 sponsored by the National Institute on Aging for his research, “Sarcopenia as a Preoperative Risk Stratification Tool Among Older Adults with Inflammatory Bowel Disease.” He serves as co-chair of Clin-STAR’s frailty research interest group, is a member of the inflammation interest group, and is looking forward to participating as a member of the 2023 Clin-STAR Annual Meeting Planning Committee. Dr. Faye reflects on his Clin-STAR experiences: “These opportunities have been inspiring to connect with transdisciplinary scientists, learn from, and share challenges encountered as we build our careers in this field.”

At the 2022 annual Clin-STAR meeting, Dr. Faye described one aspect of his research—a preoperative risk stratification tool—at a “Shark Tank” session. This forum provides an opportunity for researchers to present their work in 2 minutes with only a few slides. Participants receive feedback from others in attendance and a summary from the judges who identify the winner at the end of the session.

The number of older adults with IBD is increasing, and they have a higher risk of postoperative complications. Per Dr. Faye, “From 2012 to 2019, in just a small subset of hospitals across the United States, more than 9,000 bowel resections were performed in older adults with IBD, with almost 10% requiring an emergency surgery, and many with concurrent infections.” Dr. Faye believes we really need to rethink how we treat IBD in older adults. “We continue to delay surgery, thinking that’s the right thing to do. But is it?”

In his winning Shark Tank presentation, Dr. Faye described his objectives in developing a preoperative stratification tool. “If we can identify lower-risk surgical patients, we can limit preoperative infections and the need for emergency surgery, and intervene before individuals experience physical, nutritional, and cognitive decline. For higher-risk surgical patients, if modifiable preop risk factors can be identified through prospective assessments (eg, sarcopenia, nutrition, etc), we can intervene preoperatively and improve outcomes for thousands of older adults with IBD.”

Up to 40% of older adults with IBD will have an adverse postoperative outcome within the first 30 days, driven, in part, by delays in surgery. And the longer the delay, the more malnourished and frail patients become, which escalates their risk even further. This becomes a self-perpetuating cycle. Dr. Faye says, “Let’s break the cycle. If we can better risk stratify patients up front, we can intervene early and have our patients do better overall.”