Dr. Mullady is a clinical assistant professor in the Department of Neurology and Neurological Sciences at Stanford University. She specializes in the care of patient with memory disorders. She has completed her fellowship training in behavioral neurology from University of California, San Francisco (UCSF), where she also received her medical education and residency training. Dr. Mullady is board-certified in neurology and is a member of the American Academy of Neurology.
Dr. Mullady’s interest in medicine stemmed from her desire to advocate and empower underserved and under-resourced communities. As an undergraduate at University of California, Berkeley, she helped run a women’s homeless clinic and witnessed how powerfully a physician can advocate for a patient. She continued working in underserved populations in medical school at UCSF where she helped run a homeless clinic. Her research interests have stemmed from her passion in working with the underserved. She is currently working on understanding how neurodegeneration can affect trajectories into homelessness. She is also passionate about providing excellent clinical care to individuals with cognitive disorders and providing access to neurologic care in underserved communities.
Dr. Mullady hopes to continue providing outreach, advocacy, and care to underserved communities at Stanford as well as igniting the next generation of physician advocates.
Clinical Assistant Professor, Neurology & Neurological Sciences
Board Certification, American Board of Psychiatry and Neurology (2022)
Fellowship, University of California, San Francisco, Behavioral Neurology (2023)
Neurology Residency, University of California, San Francisco, Neurology (2021)
Intern Year, Santa Clara Valley Medical Center, Medicine (2018)
MD, University of California, San Francisco, Medicine (2017)
BA, University of California, Berkeley, BA in Genetics, Genomics & Development Minor in English (2013)
Neurocognitive health of older adults experiencing homelessness in Oakland, California
FRONTIERS IN NEUROLOGY
2022; 13: 905779
The homeless population in the US is aging. Cognitive impairment is prevalent in this population, yet little is known about the neurologic etiologies of such impairment. Addressing this gap in knowledge is important because homeless older adults with cognitive impairment due to neurodegenerative disease may need lifelong tailored support to obtain and maintain housing. In this study, we characterized the neurocognitive health of a sample of adults who experienced homelessness for the first time after age 50 using gold standard behavioral neurology examination practices.We conducted a descriptive cross-sectional study of older adults who first experienced homelessness after age 50. We recruited our sample purposively from an ongoing longitudinal cohort study of adults who were aged 50 and over and homeless when they entered the cohort. For this sub study, we enrolled a convenience sample from those who reported their first episode of homelessness after age 50. We did not exclude individuals based on history of substance use. Neurologists conducted a structured neurocognitive history intake, neurological examination, neuropsychological evaluation, and functional assessment between November 2020 and February 2021. We screened all participants for neurocognitive disorders using gold standard clinical research diagnostic criteria.We evaluated 25 participants, most were men (76%) and Black (84%), with a median age of 61 years. The most common neurocognitive complaints included deficits in recent episodic memory (n = 15, 60%), executive functions (n = 13, 52%), and behavior/mood, with apathy being the most common complaint (n = 20, 80%). Neuropsychological testing revealed a high prevalence of socioemotional deficits (n = 20, 80%). Common neurological examination deficits included difficulties with coordination, such as impaired Luria task (n = 16, 64%), signs of distal peripheral neuropathy (n = 8, 32%), anosmia/hyposmia (n = 4, 21%), and signs of mild Parkinsonism (n = 5, 20%). The most common diagnoses were MCI (n = 7, 28%), bvFTD (n = 4, 16%), AD (n = 4, 16%), and DLB (n = 2, 8%).Our findings suggest that neurocognitive concerns and examination deficits are common among older homeless adults. Specific neurocognitive disorders may be overrepresented in this population, particularly frontotemporal disorders. Longitudinal studies involving brain biomarkers are needed to characterize the neurocognitive health of this vulnerable population more precisely.
View details for DOI 10.3389/fneur.2022.905779
View details for Web of Science ID 000836962900001
View details for PubMedID 35937073
View details for PubMedCentralID PMC9353024
Neurodegenerative Disease and the Experience of Homelessness
FRONTIERS IN NEUROLOGY
2021; 11: 562218
Introduction: Today, half of the American homeless population is older than 50 years of age. This shift in age distribution among people experiencing homelessness has challenged our long-held views of the causes of homelessness. Age-related neurological diseases, especially neurodegenerative diseases of the brain (NDDB), may play a role eliciting homelessness in a significant proportion of vulnerable older adults. This article aims to explore relationships between homelessness and NDDB in a cohort of research participants enrolled in observational studies on NDDB at an academic center. Methods: We reviewed charts of the Memory and Aging Center (MAC) of the University of California, San Francisco's database searching for research participants with NDDB that had direct relationship to homelessness. We reviewed all research visits conducted between 2004 and 2018 (N = 5,300). Research participants who had any relationship to homelessness were included in this analysis. NDDB was diagnosed via comprehensive neurological, functional, neuropsychological, and biomarker assessments. Non-parametric tests were used for analysis. Thirteen participants were found to have a direct relationship with homelessness. Seven were female and the median of education was 16 (IR: 12.0-19.5) years. Participants were divided into two groups: Those who experienced homelessness while symptomatic from a NDDB but before formal diagnosis (n = 5, Group 1); and participants with formally diagnosed NDDB who exhibited a new propensity toward homelessness (n = 8, Group 2). Compared to Group 2, participants in Group 1 were younger (p = 0.021) and showed similar results in the neuropsychological evaluation. In both groups, the most prevalent diagnosis was frontotemporal dementia. In Group 1, the majority of participants became homeless in the setting of a fragile socioeconomic situation and informants believed that NDDB contributed or caused their homeless state. In Group 2, a new propensity toward homelessness became manifest in different ways and it stood out that all of these participants were well-supported by family and friends during their illness. Conclusions and Relevance: This case series highlights the role that NDDB may have in precipitating homelessness among vulnerable older adults, particularly in the setting of challenging socioeconomic circumstances and unsupportive living environments. Social ramifications of these findings, particularly pertaining to challenges around rehousing these individuals is discussed.
View details for DOI 10.3389/fneur.2020.562218
View details for Web of Science ID 000611994600001
View details for PubMedID 33519660
View details for PubMedCentralID PMC7838483