Pennsylvania Department of Health Awards Jefferson $3.5 Million from Tobacco Settlement Funds to Establish a New Center of Excellence on Neurodegenerative Diseases
New Jefferson State Grant Focused on Early Detection, Prevention of
Alzheimer's and Caregiver Relief
PHILADELPHIA, March 17 /PRNewswire/ -- How can a family tell if a loved
one is in the beginning stages of Alzheimer's disease? Are there changes
individuals can make in their lifestyle to reduce or perhaps delay the effects
of the disease? What can caregivers do to lessen their burden?
These are some of the questions Jefferson investigators hope to answer. Sam
Gandy, M.D., PH.D. is principal investigator of a four-year, $3.5-million
grant from the Pennsylvania Department of Health to support a Center of
Excellence on Neurodegenerative Diseases at the Farber Institute for
Neurosciences at Thomas Jefferson University in Philadelphia. The health
research grant is awarded from Pennsylvania's share of the national tobacco
settlement.
The new Jefferson center, co-directed by Barry Rovner, M.D., and Laura
Gitlin, PH.D., will work in collaboration with the Philadelphia Corporation
for Aging, in order to conduct several research projects, each focusing on a
different aspect of the Alzheimer's disease equation. The researchers plan,
for example, to test innovative screening methods to better identify dementia
in a racially and economically diverse population. They also are going to
examine the effectiveness of an in-home skills training program for caregivers
to see if it can help delay patients from going to nursing homes, and at the
same time, help reduce the stress on the caregiver.
"The disease goes on for five to 15 years of intense stress for the
family, especially the primary caregiver," says Dr. Gandy, director of the
Farber Institute for Neurosciences and professor of neurology and biochemistry
and molecular pharmacology at Jefferson Medical College of Thomas Jefferson
University. "Available medications are inadequate, making it imperative that
caregivers be trained in how best to create an environment conducive to the
care of someone with Alzheimer's."
Alzheimer's disease is a major public health cost for the nation and
particularly for Pennsylvania, which has a large elderly population.
Alzheimer's and related disorders cost an average of $80,000 a year per
patient, and $25 million per year overall in Pennsylvania. The costs will rise
to an estimated $40 million a year by 2050.
"The unique aspect of this project is the focus on developing a convenient
diagnostic test that many caregivers and case workers can administer, and on
training caregivers in non-drug related strategies that can help keep patients
at home longer prior to nursing home placement," says Dr. Gandy.
The researchers would also like to identify lifestyle factors in the
development of Alzheimer's, and how modifying them - changing dietary
cholesterol, for example - might affect the course of the disease, in addition
to measuring objective biological markers of stress and of disease risk, such
as the buildup of sticky amyloid in the brain.
Barry Rovner, M.D., director of Clinical Alzheimer's Disease Research at
the Farber Institute for Neurosciences at Thomas Jefferson University and
professor of psychiatry and neurology at Jefferson Medical College, will
direct the development and testing of the diagnostic tool. He and his group
are developing a new screening tool combining cognitive tests assessing
patient memory, orientation, language, and other abilities with a
questionnaire given to family members. "Making a diagnosis as soon as possible
is important now because there are clinical trials for drugs aimed at the
early stages of disease," Dr. Gandy says. "We need people to be diagnosed
early to have the best chances of responding."
"Our sense is that Alzheimer's may be under-recognized in some
communities," says Christine Arenson, M.D., director of geriatric medicine in
the Department of Family Medicine at Jefferson Medical College of Thomas
Jefferson University, who is working with Dr. Rovner to both develop and
validate the screening tool.
Dr. Gitlin, director of the Center for Applied Research on Aging and
Health, and professor in the Department of Occupational Therapy at the
Jefferson College of Health Professions at Thomas Jefferson University, will
direct the randomized trial of the home-based skills training program for
caregivers. Building on her previous work in this area, she plans to test
whether such a program can help reduce troublesome behaviors in Alzheimer's
patients by teaching families problem-solving skills, how to engage the
patient in meaningful activities and minimize triggers of behaviors and at the
same time manage their own stress.
"An innovative feature of this randomized controlled trial is that the
intervention will be tested in a real community setting so that if it is
effective, it can easily be translated into the aging network," she says. They
will be working closely with the Philadelphia Corporation for Aging (PCA).
Dr. Gitlin and her colleagues are developing a "risk screen" that PCA care
managers will use to identify family caregivers who are at risk for placing
their family member in a nursing home and who might benefit from the research.
Individuals will be referred for participation in the study to receive either
the innovative treatment or educational materials.
On the biological side, the researchers are developing a database of
ethnically diverse individuals, with special emphasis on the African-American
population. They are looking for markers of disease risk and stress in both
patient and caregiver at two different points in the program.
"This project represents our growing understanding of the disease and
mobilizing the health-care and academic systems to tackle the problem," Dr.
Gandy says.
Farber Institute for Neurosciences at Thomas Jefferson University is a
multidisciplinary neurosciences research center established through a $10
million gift by the Farber Family Foundation, Inc. in 2001. It is initially
focusing its efforts on basic and clinical research in a number of key areas,
including Alzheimer's disease, Parkinson's disease, amyotrophic lateral
sclerosis (ALS) and other neurodegenerative disorders.
