Petersen R.C.,Rochester College |
Thomas R.G.,University of California at San Diego |
Aisen P.S.,University of Southern California |
Mohs R.C.,Eli Lilly and Company |
And 2 more authors.
Neurology | Year: 2017
Objective: To examine the variability in performance among placebo groups in randomized controlled trials for mild cognitive impairment (MCI). Methods: Placebo group data were obtained from 2 National Institute on Aging (NIA) MCI randomized controlled trials, the Alzheimer's Disease Cooperative Study (ADCS) MCI trial and the Alzheimer's Disease Neuroimaging Initiative (ADNI), which is a simulated clinical trial, in addition to industry-sponsored clinical trials involving rivastigmine, galantamine, rofecoxib, and donepezil. The data were collated for common measurement instruments. The performance of the placebo participants from these studies was tracked on the Alzheimer's Disease Assessment Scale-cognitive subscale, Mini-Mental State Examination, and Clinical Dementia Rating-sum of boxes, and for progression on these measures to prespecified clinical study endpoints. APOE status, where available, was also analyzed for its effects. Results: The progression to clinical endpoints varied a great deal among the trials. The expected performances were seen for the participants in the 2 NIA trials, ADCS and ADNI, with generally worsening of performance over time; however, the industry-sponsored trials largely showed stable or improved performance in their placebo participants. APOE4 carrier status influenced results in an expected fashion on the study outcomes, including rates of progression and cognitive subscales. Conclusions: In spite of apparently similar criteria for MCI being adopted by the 7 studies, the implementation of the criteria varied a great deal. Several explanations including instruments used to characterize participants and variability among study populations contributed to the findings. © 2017 American Academy of Neurology.
Tousi B.,Cleveland Clinic |
Kanetsky C.,Alzheimers Association |
Udelson N.,Alzheimers Association
American Journal of Alzheimer's Disease and other Dementias | Year: 2017
Currently, there is not enough time or staff in the physician's office to provide education about Alzheimer's disease for newly diagnosed patients and their family members. The Alzheimer's Association Cleveland Area Chapter has implemented a novel approach for individuals to connect to helpful information about Alzheimer's disease and related dementias while at the physician's office. This project is being piloted at two memory assessment clinics of The Cleveland Clinic as a way to give assessment center staff the opportunity to connect families right away with the free support services available at the Association. © The Author(s) 2016.
Primetica B.,Benjamin Rose Institute on Aging |
Menne H.L.,Benjamin Rose Institute on Aging |
Bollin S.,Alzheimers Association |
Teri L.,University of Washington
Journal of Applied Gerontology | Year: 2015
With a growing number of evidence-based programs, it is necessary to understand the translation activities, experiences, and challenges of program replication in a community setting. This article reviews the implementation tasks necessary for agencies to implement the Reducing Disability in Alzheimer's Disease (RDAD) intervention. It presents the importance of using original evidence-based program protocols and enhancing them to best fit service settings by reviewing the translation and implementation activities of (a) selecting and training program and supervisory staff; (b) recruiting, screening, and consenting participants to enroll in the program; and (c) developing a manual to guide community-based program replication. Furthermore, the process revealed that the replication of an evidence-based program can take place within the realities of a community setting with input from program oversight, implementation, and evaluation staff and the original researcher. © The Author(s) 2013.
Teri L.,University of Washington |
McKenzie G.,Oregon Health And Science University |
Logsdon R.G.,University of Washington |
McCurry S.M.,University of Washington |
And 3 more authors.
Gerontologist | Year: 2012
The need for evidence-based non-pharmacological community programs to improve care of older adults with dementia is self-evident, considering the sheer numbers of affected individuals; the emotional, physical, and financial toll on affected individuals and their caregivers; the impact on our health care system; and the growing availability of evidence regarding the potential for psychosocial interventions to enhance care and decrease costs. To address this need, the Administration on Aging has begun funding translation of evidence-based programs into community settings. Two programs, Reducing Disability in Alzheimer's Disease and STAR-Community Consultants (STAR-C), were selected by the Ohio Department of Aging (in collaboration with the Alzheimer's Association Chapters in Ohio) and the Oregon Department of Health Services (in partnership with Area Agencies on Aging and the Oregon Chapter of the Alzheimer's Association) to be implemented by their staff. Both programs are designed to improve care, enhance life quality, and reduce behavioral problems of persons with dementia and have demonstrated efficacy via randomized controlled trials. This article addresses the developmental and ongoing challenges encountered in the translation of these programs to inform other community-basedorganizations considering the translation of evidence-based programs and to assist researchers in making their work more germane to their community colleagues. © 2012 The Author.
Jack Jr. C.R.,Mayo Medical School |
Albert M.S.,Johns Hopkins University |
Knopman D.S.,Mayo Medical School |
McKhann G.M.,Johns Hopkins University |
And 4 more authors.
Alzheimer's and Dementia | Year: 2011
Background: Criteria for the clinical diagnosis of Alzheimer's disease (AD) were established in 1984. A broad consensus now exists that these criteria should be revised to incorporate state-of-the-art scientific knowledge. Methods: The National Institute on Aging (NIA) and the Alzheimer's Association sponsored a series of advisory round table meetings in 2009 whose purpose was to establish a process for revising diagnostic and research criteria for AD. The recommendation from these advisory meetings was that three separate work groups should be formed with each assigned the task of formulating diagnostic criteria for one phase of the disease: the dementia phase; the symptomatic, pre-dementia phase; and the asymptomatic, preclinical phase of AD. Results: Two notable differences from the AD criteria published in 1984 are incorporation of biomarkers of the underlying disease state and formalization of different stages of disease in the diagnostic criteria. There was a broad consensus within all three workgroups that much additional work is needed to validate the application of biomarkers for diagnostic purposes. In the revised NIA-Alzheimer's Association criteria, a semantic and conceptual distinction is made between AD pathophysiological processes and clinically observable syndromes that result, whereas this distinction was blurred in the 1984 criteria. Conclusions: The new criteria for AD are presented in three documents. The core clinical criteria of the recommendations regarding AD dementia and MCI due to AD are intended to guide diagnosis in the clinical setting. However, the recommendations of the preclinical AD workgroup are intended purely for research purposes. © 2011 The Alzheimer's Association. All rights reserved.
Baumgart M.,Alzheimers Association |
Snyder H.M.,Alzheimers Association |
Carrillo M.C.,Alzheimers Association |
Fazio S.,Alzheimers Association |
And 2 more authors.
Alzheimer's and Dementia | Year: 2015
An estimated 47 million people worldwide are living with dementia in 2015, and this number is projected to triple by 2050. In the absence of a disease-modifying treatment or cure, reducing the risk of developing dementia takes on added importance. In 2014, the World Dementia Council (WDC) requested the Alzheimer's Association evaluate and report on the state of the evidence on modifiable risk factors for cognitive decline and dementia. This report is a summary of the Association's evaluation, which was presented at the October 2014 WDC meeting. The Association believes there is sufficient evidence to support the link between several modifiable risk factors and a reduced risk for cognitive decline, and sufficient evidence to suggest that some modifiable risk factors may be associated with reduced risk of dementia. Specifically, the Association believes there is sufficiently strong evidence, from a population-based perspective, to conclude that regular physical activity and management of cardiovascular risk factors (diabetes, obesity, smoking, and hypertension) reduce the risk of cognitive decline and may reduce the risk of dementia. The Association also believes there is sufficiently strong evidence to conclude that a healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. © 2015 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.
Khachaturian Z.S.,Campaign to Prevent Alzheimers Disease by 2020 PAD2020 |
Khachaturian A.S.,Campaign to Prevent Alzheimers Disease by 2020 PAD2020 |
Thies W.,Alzheimers Association
Alzheimer's and Dementia | Year: 2012
This perspective updates the status of the "National Plan to Address Alzheimer's Disease" and the recommendations of the NAPA Advisory Council's Sub-committee on Research. Here, we identify some of the critical issues the future reiterations of the National Plan should consider during implementation phase of the plan. The Journal invites the scientific community to contribute additional ideas and suggestions towards a national research initiative. © 2012 The Alzheimer's Association. All rights reserved.
Alecxih D.L.,Alzheimers Association
Generations | Year: 2012
Progress towards making HCBS a mainstream choice for older adults is challenging when an older person has moderate to severe cognitive impairment. These individuals need a modified continuum of care: one that is dementia-capable. This article discusses approaches that make a difference for people with Alzheimer's Disease and related dementias who want to live at home and in their communities-and for their family members. Copyright © 2012 American Society on Aging; all rights reserved.
McGillick J.,Alzheimers association |
Murphy-White M.,Alzheimers association
Generations | Year: 2013
The Affordable Care Act's and the Centers for Medicare & Medicaid's funding changes highlight how to make acute care more affordable and efficient, particularly for vulnerable Medicare beneficiaries. The focus has largely been on preventing admission or readmission for those with pneumonia, congestive heart failure, and obstructive pulmonary disease. But the missing link is that many of these people also have dementia, which complicates their hospital stay and results in poor outcomes. The time has come to transform hospitals into dementia-friendly environments in which staff are well-trained in the best practices that could reduce adverse outcomes, involve families, and tap into their wisdom, while reducing costly incidents and functional decline involving persons with dementia. This article describes one model addressing this issue. © 2013 American Society on Aging.
Sibener L.,Alzheimers Association |
Zaganjor I.,Alzheimers Association |
Snyder H.M.,Alzheimers Association |
Bain L.J.,Independent Science Writer |
And 2 more authors.
Alzheimer's and Dementia | Year: 2014
By 2050, more than 13 million Americans of all ages are estimated to be living with Alzheimer's disease (AD), and the aggregate costs of care will swell to approximately $1.2 trillion. The rapidly climbing number of those affected with AD includes a growing population of aging military veterans affected who may have an added risk for the disease as a consequence of traumatic brain injury, posttraumatic stress disorder, and/or service-related injuries. The increasing number of individuals, the long duration of disability, and the rising cost of care for AD and other dementia to our society are important public health challenges facing many older adults. These challenges are further compounded by a burgeoning military veteran population that is much younger, with an increased risk of AD and other dementia, and who may experience decades-long periods of disability and care. This outlook underscores the critical need for investments in research at the federal and international levels to accelerate the pace of progress in developing breakthrough discoveries that will change the trajectory of AD and related dementia. © 2014 Published by Elsevier Inc. on behalf of The Alzheimer's Association.