$2.3 Million Grant Will Enhance Alzheimer’s Diagnosis, Treatment

The funding was obtained by a partnership between the Alzheimer’s Disease and Memory Disorders Center (ADMDC) and the school’s Division of Geriatrics and Palliative Medicine for their efforts to significantly improve the screening, diagnosis and treatment of Alzheimer’s disease and other dementias (AD/D) by providing state-of-the-art care and educating primary care providers, patients and their caregivers.

Bruce R. Troen, MD, professor of medicine and chief of geriatrics and palliative medicine, is co-principal investigator on the grant along with Kinga Szigeti, MD, PhD, associate professor of neurology and director of the ADMDC. Both see patients through UBMD Physicians Group.

The ADMDC will serve as a strong central and referral anchor and will be complemented by the expanded outreach and network services that were previously provided by the Alzheimer’s Disease Assistance Center, which was the predecessor to the CEAD. Medical services will be provided at the ADMDC and supported by partnering and outreach efforts in the community.

The ADMDC will also provide dedicated tertiary referral care, which can support primary care practitioners whose patients require additional diagnostic and treatment approaches.

“We’re able to provide a set of services that will enhance population health on the front line while enhancing accessibility to care and bolstering research,” Troen says.

The major goals of the CEAD WNY are:

• provide education and training to health care providers and students in health care professions promoting the benefits of early diagnosis and treatment of individuals with AD/D, utilization of available treatments and enrollment in clinical trials
• diagnose AD/D and comorbid conditions
• prescribe effective treatment of AD/D, including palliative care and appropriate non-pharmacological treatment of behavioral symptoms
• provide follow-up care on at least an annual basis
• utilize an interdisciplinary team approach for patient diagnosis and care; patient, family and caregiver support; and community linkages
• offer care management services — including needs assessment, care planning, case coordination, counseling, consultation and referrals — through close working relationships with service providers within a designated geographic area to individuals with AD/D and their caregivers
• expand and enhance the health care system’s capability to diagnose and treat individuals with AD/D
• provide technical assistance to health care and other service providers in the designated service area of Erie, Niagara, Genesee, Wyoming, Chautauqua, Cattaraugus and Allegany counties
• promote benefits of participation in research such as clinical trials, studies and patient registries

The center will emphasize a holistic approach to patients starting with early diagnosis and treatment with medications that are known to work and that slow down progression of the disease, Szigeti says.

“We try to catch Alzheimer’s disease and treat it at its earliest stages, ideally before it starts or when only mild symptoms, such as a little forgetfulness, are present,” she says. “A lot of people are afraid of the diagnosis, but the earlier they get diagnosed, the longer time they can spend in the mild stages of cognitive impairment.”

One of the goals of the Center of Excellence is to improve access to clinical trials for any new treatments that arise, Szigeti added, noting the ADMDC has an active research program at the UB Clinical and Translational Science Institute. In addition, the CEAD will promote the general benefits of participation in research. 

The combination of an academic health center with strong community partnerships helped the grant proposal succeed, according to Troen, who notes a key emphasis of the grant is partnering with providers of health care and community assistance, such as social workers, to extend care and support throughout the area.

The Center of Excellence will work with multiple primary care clinics and providers throughout the region, including the Great Lakes Health System and the Veterans Affairs Western New York Healthcare System, including its Geriatric Evaluation Management Clinic, the Geriatric Center of Western New York at DeGraff Hospital, Dent Institute and others.

“We’ll bring our ‘road show’ of nurse practitioners and coordinators to primary care doctors in urban and rural areas,” Troen says. “Our goal is to inform and assist them in early screening and diagnosis of cognitive impairment, Alzheimer’s disease and other dementias.”

The grant also will help educate future health care professionals at the medical school about dementia and geriatrics, which is becoming increasingly important as the patient population ages.

One of 10 such grants throughout the state, the funding is especially important given WNY’s proportion of older adults, which at 16.7 percent is higher than the 14.4 percent statewide, or 13 percent national average.

To meet the growing demand for care, the ADMDC has expanded its multidisciplinary team: Margaret W. Paroski, MD, professor of neurology, has joined the medical team and Tatyana P. Raby, PhD, clinical assistant professor of neurology, has joined Ralph H. Benedict, PhD, professor of neurology, to provide full neuropsychological assessments.

Other co-investigators, all of whom have extensive experience with patients who are elderly or have dementia, include: Linda Steeg, DNP, clinical associate professor at the School of Nursing; Marsha Lewis, PhD, dean of the School of Nursing; Steven L. Dubovsky, MD, professor and chair of the Department of Psychiatry; and Daniel J. Morelli, MD, chair of the Department of Family Medicine.