Capstone Project Helped Physician Assistant Alum Advance Her Career

It was during a clinical rotation at a geriatrics practice in which the preceptor she was working with was lecturing about the different types of dementia that Lauren Bunnell, MMS ‘22, came up with the topic for her capstone project. 

“He went through the basics — Alzheimer’s, strokes, the more known causes — and he also mentioned he noticed his patients with schizophrenia typically have some level of cognitive impairment,” said Bunnell, who graduated from Bloomsburg University in 2020 with a degree in Health Sciences. “He didn’t really know how to account for it and noticed it tended to happen a little younger than we normally see dementia start to onset, even if it was more of a mild cognitive impairment than full-blown dementia. I thought that was kind of interesting and I wanted to look into it.”

The Honesdale, Pennsylvania native’s capstone project, titled “Do people diagnosed with schizophrenia have an increased risk of developing cognitive impairment?” did just that.

Once she dove into researching the topic, Bunnell had to narrow the focus to (1) Is there a risk? (2) If there is, why? Is it due to the fact that some patients are on a lifetime medication after they get diagnosed, and that the medication may play a role in cognitive impairment? Is it due to structural changes that happen to the brain due to the disease process? Or something completely different?

Bunnell looked into a couple of different theories for the project and decided to stick with looking at medication use in general as well as structural changes to the brain.

“With studies on antipsychotic medications,  there were a lot of variations in the results,” said Bunnell. “Some studies showed decreases in certain aspects of cognition but not others, whereas other studies would then show a decrease in cognitive functioning in some areas that weren’t accepted in other studies.”

​She found there was a little bit of shared correlation that all the patients studied seemed to have some decrease in cognition in one way or another, but there wasn’t a universal trend found among the studies. The brain structure studies she looked at generally suggested there may be an increased rate of brain aging in schizophrenic patients, which may account for decreased cognitive function scores among participants of the studies.

Bunnell said doing the Capstone project helped her when reading articles and medical journals and to better understand what they were about.

“It can be pretty tricky reading a complex article and being able to pull relevant information from it,” she said. “In that way, doing the capstone project definitely helped me, and it will help going forward because medicine is always changing. If you can’t read the papers on new studies and new medications, it will be a lot more difficult to find out what’s the best choice of treatment for your patients.”

Bunnell recently accepted an urgent care position in Middletown, New York. Further down her career path, she may explore specializing in geriatric care.

“I really do love working with older adults. Part of why I chose that capstone topic is cognitive impairment is such a relevant thing for the geriatric population,” she said. “I thought it was an interesting topic and I’m glad I chose it.”