Published June 30, 2018
June is Alzheimer’s & Brain Awareness Month, sponsored by the Alzheimer’s Association. Memory issues and other forms of dementia affect more than 50 million people around the world, according to the association, highlighting the extent of these conditions – and the importance of making strides to staunch and reverse their progression.
Right here in Buffalo, doctors with UBMD Neurology work regularly with Alzheimer’s patients and their families, offering the latest in treatment options while working to research new approaches and performing clinical trials to halt or reverse the disease’s progression.
The Alzheimer’s Disease and Memory Disorders Center (ADMDC) is part of the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo. The Center works on new research and innovation to identify symptoms earlier and intervene with new approaches that can delay or even prevent the loss of memory and cognition associated with Alzheimer’s.
“The ADMDC is a state-of-the-art center specializing in cognitive disorders,” says Dr. Kinga Szigeti, co-director of CEAD – the Center of Excellence for Alzheimer’s Disease in Western New York – and a board-certified neurologist at UBMD Neurology with specialized training in both genetics and cognitive disorders. “We have a multidisciplinary approach with a team of professionals caring for the patients and families. The team includes neurologists, neuropsychologists, neuroimagers, social workers and nursing to address all the needs of the patients and caregivers.”
In addition to offering a full spectrum of care for cognitive disorders, work at the ADMDC also includes research into the use of biomarkers to improve diagnostic accuracy and estimate conversion rates in mild cognitive impairment. By working to find genetic signals to better identify at-risk individuals, the team hopes to ultimately intervene in patients’ lives before the onset of symptoms to produce better overall outcomes for Alzheimer’s and other memory conditions.
At the ADMDC, patients are evaluated through a four-step process, which is typically done over a two-week period.
During the first visit, patients and their family meet with a neurologist to discuss their concerns. The doctor will review previous medical records at this time and take a clinical history, as well as conduct a patient interview in the presence of family members. These family members are also asked to provide background on any problems that they have observed. Finally, most patients will have blood drawn for analysis.
Following the initial appointment, patients are sent for brain imaging, such as a CT scan, MRI or PET. The patient also is asked to complete a comprehensive neuropsychological test which is designed to differentiate between issues that are part of normal aging, issues that may indicate a mild cognitive impairment and issues associated with one of the various types of dementia.
After the tests have been performed, the neurologist will meet with the patient and family again to go over the results and make a diagnosis. Treatment options are discussed at this time and patients and family members may ask questions about the next steps and the course of treatment.
Finally, after a diagnosis has been made, patients and their families meet with a social worker. During this visit, the worker assesses the patient’s living situation and provides counseling on concerns or issues that relate to managing the condition. A consultation letter summarizing the social worker’s recommendations is also sent back to the referring physician to ensure a coordinated approach to patient care.
There are a number of different treatments available that can help manage Alzheimer’s and related conditions.
Treatment options may include:
While there is no cure, these approaches can help patients maintain their mental health and reduce the severity or progression of symptoms.
“After the diagnosis is established, treatment strategies are developed and monitored as necessary. Yearly follow-up is scheduled if there are no active issues,” said Szigeti. “At the yearly follow-up, there is screening for [behavioral and psychological symptoms of dementia]. Caregiver burnout, utilized assistance from the community and additional needs are identified. The social worker meets with the family to reevaluate needs and develop a care plan.”
Active issues are addressed in a timely fashion through as-needed office visits, and the New York State Department of Health offers some additional resources to help both patients and caregivers with ongoing management. Through this comprehensive approach with an emphasis on routine screenings and education, psychiatric hospitalizations are virtually eliminated and the need to be institutionalized is delayed, noted Szigeti.
While Alzheimer’s is the most well-known cognitive condition, a number of different conditions and dementias are treated at UBMD Neurology. The team also works with patients who have been diagnosed with other cognitive and memory ailments. Among these are conditions like amnestic mild cognitive impairment (AMCI), a condition that differs from Alzheimer’s in that only memory is affected. This means that individuals with the condition still can remain independent, taking care of their own daily needs, driving their vehicle, managing finances and more. For these patients, support systems like a family member or caregiver to help monitor bill payments or medication schedules are critical to ensure management of the condition.
There are also a wide variety of different types of dementia, which can manifest in specific ways. For instance, some patients may have visual hallucinations or may act out their dreams, while others may walk slowly or show Parkinson’s-like symptoms – a common manifestation among patients diagnosed with Lewy body dementia. Other forms may cause behavioral problems, difficulty with language, or cognitive issues. By assessing patients thoroughly and arriving at an informed diagnosis, the UBMD Neurology team can decide on a course of action best suited to the patient and their symptoms, helping them manage the condition in many cases.
Today, there is no cure for Alzheimer’s disease, though medical research like that conducted at UBMD Neurology helps to pave the way toward eliminating the disease in the future.
“Although Alzheimer’s disease is not curable yet, with the medications that we have we can slow progression, which means that we can keep individuals at the state where they are for longer periods of time,” said Szigeti. “This means that the earlier the diagnosis is made and treatment is started, the more independence is preserved for longer. If someone comes in very impaired, we cannot reverse it. But if someone comes in with memory problems only, often we can give them several good years.”
UBMD Neurology sees patients for Alzheimer’s appointments and consultations at the practice’s office on Main Street in Williamsville, as well as at the Conventus building on the Buffalo Niagara Medical Campus. To learn more or to schedule an appointment, call UBMD Neurology today at 716.829.5056.
The UBMD Neurology team also pursues a number of treatment studies designed to evaluate the effectiveness of investigational drugs in people with Alzheimer’s disease or other forms dementia, as well as those with early memory loss.
“These studies include the carefully regulated and monitored use of investigational drugs intended to help individuals think and remember better, and/or delay progression of memory and thinking problems,” said Connie M. Brand, clinical research coordinator at UBMD Neurology. “Our team also conducts non-treatment research studies to increase understanding of the aging process in both healthy individuals and people diagnosed with Alzheimer’s disease/dementia.”
Participation in these studies is entirely voluntary, but participants play a valuable role in the research process. Without volunteers to assess the success of new treatment options, there would be no new medications, no new therapies and no new approaches for improving outcomes or preventing Alzheimer’s and other memory and cognitive conditions. These studies also do more than advance medical science, they can also open opportunities to participants to receive cutting-edge treatment options not available to the general public.
“We are dedicated to ensuring that research is conducted ethically, safely and efficiently,” said Brand. “Research activities conducted at UBMD Neurology, are overseen by an Institutional Review Board (IRB). Our IRB ensures that the rights and welfare of clinical study participants are protected in accordance with U.S. Food and Drug Administration regulations.”
For a participant to join a research study, UBMD Neurology requires the commitment of both the individual participant and a caregiver or family member. This is done to ensure that the person receiving treatment or medication for their Alzheimer’s disease or other dementia-related condition has the support and care needed to participate.
To learn more about current research programs and participation opportunities, call Brand at 716.323.0549.