June 16, 2011

Noted geriatric psychiatrist Petrie returns to VUMC

William Petrie, MD

Noted geriatric psychiatrist Petrie returns to VUMC

Sometimes 75-year-old Shirley Wiles is sweet and loving. Sometimes she pinches and grabs her husband, Jim, and tells him she has never loved him. You never know which Shirley you’re going to get at any given hour of any day.

Such is the life of a patient with Alzheimer’s disease.

Wiles is the patient of William Petrie, M.D., a geriatric psychiatrist who has returned to Vanderbilt University Medical Center after 30 years to lead the Geriatric Psychiatry Outpatient Program, which includes a senior assessment clinic for patients with behavioral and memory problems, like dementia and Alzheimer’s disease, and to provide support for their families.

William Petrie, M.D.

William Petrie, M.D.

“Our patients have difficult symptoms and may require medication, but their families are in distress and need support,” said Petrie, professor of Clinical Psychiatry and a graduate of both Vanderbilt University and Vanderbilt University School of Medicine.

“There is an immense need for this type of care and there aren’t many doctors in town who do this type work – working with both the patient and their families. These families have a high rate of depression and other medical illnesses and co-morbidities. With high levels of stress you get reduced immune function, and these caregivers are not getting enough sleep.”

Petrie said most families of patients with Alzheimer’s don’t have the community and professional help they need.

“It’s a downward progression. The spouse of a typical Alzheimer’s disease patient is providing care about 80 hours a week. We’re talking about 75 and 85 year olds. It’s like working a full-time job, and going out and getting another job at Wal-Mart,” he said.

“Bill, without a doubt, is the premier geriatric psychiatrist in all of Tennessee,” said Stephan Heckers, M.D., chair of Psychiatry. “He is also one of the busiest clinicians you will ever find. It was a coup to get him back.”

Heckers said the geriatric clinic will provide the full spectrum of service for the evaluation and treatment of dementia-related illnesses. “The clinic is not just for those with serious memory problems, it’s also for those who feel they are forgetting too much. We have the ability to do an assessment to rule out dementia.”

The addition of Petrie to the faculty and the new program will have an impact on the training of future psychiatrists, Heckers said. “We will have the ability to train all residents in geriatric psychiatry, and we also plan to complement outpatient geriatrics with an inpatient component, part of our strategic plan,” he said.

Petrie said the fastest growing segment of the population is in those older than 85. “And because Alzheimer’s is age-related, the older you get, the more likely you are to get it,” he said.

The risk, which doubles every five years, increases from one in 100 at age 60 to one in three at 90.

“We need to get young doctors and young nurses interested in treating older patients. It’s a huge job,” Petrie said. “As baby boomers get older, we don’t have the doctors and nurses to take care of them.”

Petrie said that Vanderbilt’s expertise in imaging will prove invaluable in the care of patients with dementia-related illnesses.

“One of our agendas is to develop clinical tools for use. We have a state-of-the-art imaging department and a strength in genetics, but the problem, in both areas, is that we really haven’t figured out what to do. We have terrific imaging, but we don’t know what it means with Alzheimer’s and other dementias. And Alzheimer’s and most dementias are determined by multiple genes that we don’t really understand.”

Petrie is bringing his own research program to Vanderbilt, studying the antibody treatment and immune therapies used to reduce the amyloid burden in Alzheimer’s disease.

Another goal of Petrie’s and Vanderbilt’s is to develop new medications for patients with Alzheimer’s. There are currently four drugs available for Alzheimer’s patients, none of them very effective, Petrie said.

“We need to develop new drugs aimed specifically at the illness. Current drugs are not. They are fairly non-specific and not powerful enough to provide the help that patients and their families need.”

For Shirley Wiles, her family continues to struggle with the frequent personality changes and they wait for her to wander, as most Alzheimer’s patients do.

“I wake up in the middle of the night and check on her,” Jim Wiles said. I’m with her 24 hours a day, seven days a week. Sometimes her daughters take her shopping and I’m able to relax.”

Liles said that his wife’s medication has helped her moods. “It’s made her a little happier. He (Petrie) is helping us by helping her.”