About

Natalie A. Sanders, MD, is associated with the University of Utah Health Care Faint and Fall Clinic. Her work focuses on understanding and preventing falls in older adults, emphasizing that falls are a serious marker of decline rather than just accidental events. Dr. Sanders explains that falls can lead to loss of independence, increased risk of injury, and are the number one reason for admission to nursing homes. Her approach involves comprehensive evaluation of risk factors, including gait, balance, vision, blood pressure, medication use, and overall physical decline, often referred to as frailty. She advocates for specialized clinics that provide detailed assessments and personalized interventions, including exercises and environmental modifications, to prevent future falls. Her work highlights the importance of early evaluation, even for those who have not yet fallen but may be at risk due to fear of falling or other factors. Dr. Sanders's contributions aim to improve the understanding of fall risk factors and develop effective strategies to maintain independence and safety among older populations.

Research topics

• Psychiatry
• Psychology
• Medicine
• Clinical psychology
• Gerontology
• Developmental psychology
• Medical emergency

Selected publications

• Alignment of the ACGME milestones for internal medicine and family medicine residents with a curriculum in priorities-aligned decision-making

  Academic Medicine · 2025-12-31

  article

  PROBLEM: Clinical decision-making for persons with multiple chronic conditions is a challenge because of uncertain benefits and harms of many treatments and variability in what health outcomes are most important to patients. Patient Priorities Care (PPC) is an evidence-based approach to aligning decision-making for persons with multiple chronic conditions with their own health priorities. Curricula for health professional trainees in the PPC approach would equip them with the skills necessary to optimize care for this complex population. However, given the time limitations during medical training, program leadership must prioritize competency-based medical education. The authors determined alignment of internal medicine (IM) resident and family medicine (FM) resident Accreditation Council for Graduate Medical Education (ACGME) milestones with core PPC skills. APPROACH: From June 2023 through December 2023, PPC at 3 academic institutions examined ACGME milestones for IM and FM residents and identified milestones that overlap with core PPC skills. Then from June 2024 through December 2024, US Program Directors within IM (S.S.) and FM (M.M.B.) reviewed the findings. OUTCOMES: The 8 core skills of PPC align with 13 of the 21 IM ACGME milestones and 10 of the 19 FM ACGME milestones. PPC addresses ACGME IM/FM milestones in patient care, medical knowledge, systems-based practice, practice-based learning and improvement, and interpersonal and communication skills. A pilot PPC curriculum with IM residents demonstrated increased confidence in several core PPC skills. NEXT STEPS: After demonstrating milestone alignment, authors are developing educational materials for use in various clinical and educational settings with trainees and also practicing health professionals. Tools to assess skills will be created to guide medical educators who implement the PPC trainings. Following that, authors will work with key stakeholders including IM and FM residents, program directors, and geriatrician clinician-educators to assess the feasibility of implementing a PPC curriculum throughout residency training.

  PublisherDOI

• “Being careful”: How much caution is enough? The relational context of fear of older adult falling in older adult-family caregiver dyads

  Geriatric Nursing · 2023 · 4 citations

  • Psychology
  • Developmental psychology
  • Clinical psychology
  PublisherDOI

• Acceptability, feasibility, and utility of a safety aid reduction treatment in underserved veterans: a pilot investigation

  Cognitive Behaviour Therapy · 2022-11-03 · 6 citations

  articleOpen access

  = 22) were assessed prior to, immediately after, and one month following the 8-week treatment. The majority of veterans found START useful and acceptable. Additionally, recruitment and retention rates suggest that the treatment was feasible. Notably, results revealed reductions in overall anxiety, depression, and safety aid usage, which were maintained throughout the brief follow-up period. These findings add to a growing body of literature highlighting the utility of transdiagnostic approaches in the amelioration of various anxiety and related disorders. Limitations include the small sample size and uncontrolled design.

  PublisherOA PDFDOI

• Fear of Older Adult Falling Questionnaire for Caregivers

  PsycTESTS Dataset · 2020-01-01

  dataset
  PublisherDOI

• Fear of older adult falling questionnaire for caregivers (FOAFQ‐CG): Evidence from content validity and item‐response theory graded‐response modelling

  Journal of Advanced Nursing · 2020 · 14 citations

  • Psychology
  • Clinical psychology
  • Gerontology

  AIMS: (1) Determine the content validity of the Fear of Older Adult Falling Questionnaire-Caregivers using a panel of gerontological experts and a target sample of family caregivers (Stage 1) and (2) Examine the response patterns of the Fear of Older Adult Falling Questionnaire-Caregivers and compare it with older adult version of Fear of Falling Questionnaire Revised using graded-response modelling (Stage 2). DESIGN: Cross-sectional mixed-method design. METHODS: Five content experts and 10 family caregivers were involved in the Stage 1 study and 53 family caregiver-older adult dyads (N = 106) were included in the Stage 2 study. The content-validity index and graded-response modelling were used to analyse data. RESULTS: Among experts, the Fear of Older Adult Falling Questionnaire-Caregivers content-validity index for relevancy, importance, and clarity of individual items and total scale ranged from 0.60-1.00 and from 0.77-0.87, respectively. Among family caregivers, the ratings of the item and scale level content-validity index for relevancy, importance, and clarity ranged from 0.90-1.00 and from 0.95-0.97, respectively. Combining feedback from both groups, we revised one item. Subsequently, the graded-response modelling revealed that a 1-factor, 3-item version of the Fear of Older Adult Falling Questionnaire-Caregivers had acceptable psychometric properties. CONCLUSIONS: The brief 3-item version of the Fear of Older Adult Falling Questionnaire-Caregivers is promising for assessing caregivers' fear of their older adult care recipient falling. IMPACT: A significant concern for family caregivers is fearing that older adult care recipients will fall, but a lack of validated measures limits the study of this phenomena. A 3-item version of the Fear of Older Adult Falling Questionnaire-Caregivers has the potential to identify family caregivers with high fear of older adult falling so that fall risk can be appropriately assessed and addressed.

  PublisherDOI

• Knowledge of HIV and HPV Among Women With Serious Mental Illness

  Psychiatric Services · 2020 · 5 citations

  1st authorCorresponding
  • Medicine
  • Psychiatry
  • Psychology
  PublisherDOI

• TNF-α–driven inflammation and mitochondrial dysfunction define the platelet hyperreactivity of aging

  Blood · 2019-07-17 · 310 citations

  articleOpen access

  Aging and chronic inflammation are independent risk factors for the development of atherothrombosis and cardiovascular disease. We hypothesized that aging-associated inflammation promotes the development of platelet hyperreactivity and increases thrombotic risk during aging. Functional platelet studies in aged-frail adults and old mice demonstrated that their platelets are hyperreactive and form larger thrombi. We identified tumor necrosis factor α (TNF-α) as the key aging-associated proinflammatory cytokine responsible for platelet hyperreactivity. We further showed that platelet hyperreactivity is neutralized by abrogating signaling through TNF-α receptors in vivo in a mouse model of aging. Analysis of the bone marrow compartments showed significant platelet-biased hematopoiesis in old mice reflected by increased megakaryocyte-committed progenitor cells, megakaryocyte ploidy status, and thrombocytosis. Single-cell RNA-sequencing analysis of native mouse megakaryocytes showed significant reprogramming of inflammatory, metabolic, and mitochondrial gene pathways in old mice that appeared to play a significant role in determining platelet hyperreactivity. Platelets from old mice (where TNF-α was endogenously increased) and from young mice exposed to exogenous TNF-α exhibited significant mitochondrial changes characterized by elevated mitochondrial mass and increased oxygen consumption during activation. These mitochondrial changes were mitigated upon TNF-α blockade. Similar increases in platelet mitochondrial mass were seen in platelets from patients with myeloproliferative neoplasms, where TNF-α levels are also increased. Furthermore, metabolomics studies of platelets from young and old mice demonstrated age-dependent metabolic profiles that may differentially poise platelets for activation. Altogether, we present previously unrecognized evidence that TNF-α critically regulates megakaryocytes resident in the bone marrow niche and aging-associated platelet hyperreactivity and thrombosis.

  PublisherOA PDFDOI

• The Frailty Syndrome and Outcomes in the TOPCAT Trial

  European Journal of Heart Failure · 2018-09-18 · 170 citations

  articleOpen access1st authorCorresponding

  AIMS: The impact of frailty on outcomes in randomized heart failure with preserved ejection fraction (HFpEF) trials has not been previously reported. This analysis sought to characterize frailty in a large contemporary HFpEF clinical trial cohort and to evaluate its impact on patient relevant outcomes. METHODS AND RESULTS: Using data from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, a frailty index (FI) was constructed at baseline using 39 clinical, laboratory, and self-reported variables. The relationship between frailty and outcomes and the role of frailty in modulating the benefits of spironolactone were examined in a subset of 1767 TOPCAT patients. For the cohort as a whole (mean age 71.5 years, 49% female), the mean FI at baseline was 0.37 ± 0.11. Four frailty classes were defined ranging from FI < 0.3 to FI ≥ 0.5. Overall, 94% of subjects were considered frail (defined as a FI > 0.21). Mean age was lowest for the most frail class (69 ± 9 years for Class 4; 73 ± 10 years for Class 1; P < 0.001). Body mass index, systolic blood pressure, and pulse pressure all increased as FI increased. Both primary and secondary outcomes increased as frailty severity increased. There was no interaction between frailty class and treatment effect of spironolactone. CONCLUSIONS: Frailty was very common in TOPCAT HFpEF participants. Greater frailty was associated with a higher risk of cardiovascular outcomes and mortality. The benefit of spironolactone on outcomes in TOPCAT was not attenuated by frailty class.

  PublisherOA PDFDOI

• Clinical News

  British Journal of Hospital Medicine · 2018-11-02

  article1st authorCorresponding
  PublisherDOI

• Marine Protected Areas and Offshore Wind Farms

  2017-01-28 · 4 citations

  other1st authorCorresponding

  This chapter discusses the potential negative impacts that an offshore wind farms (OWFs) can have on marine biodiversity and the ways an OWF can increase species abundance, richness and biodiversity to establish whether OWF and Marine Protected Areas (MPAs) can in fact ever co-exist. It also discusses the future prospects for OWF development that may reduce the initial impact, thereby enhancing their co-existence. The chapter considers examples where OWFs and MPAs exist in the same place as well as examples of where the existence of an MPA has prohibited or stalled the construction of an OWF. There are three main stages in the life of an OWF: construction, operation and decommissioning. The chapter discusses some of the known effects of OWF noise on marine mammals, such as temporary hearing loss and permanent tissue damage.

  PublisherDOI

Frequent coauthors

• Matthew T. Rondina

  University of Utah

  9 shared

• Mohamed H. Hamdan

  University of Tabuk

  6 shared

• Eric P. Wartchow

  Children's Hospital Colorado

  6 shared

• Rumei Yang

  5 shared

• Amanda M. Raines

  Louisiana State University Health Sciences Center New Orleans

  4 shared

• Tawni L. Jetter

  University of Utah

  4 shared

• Gala True

  4 shared

• Ginette A. Pepper

  University of Utah

  4 shared

Education

• B.S.

  College of Osteopathic Medicine of the Pacific

• M.D.

  University of Utah

• Other, Geriatrics Fellowship

  University of Utah