A lot of interesting news came out of the Alzheimer's Association International Conference last week in Boston, and not all of it was bleak. No doubt about it, the scope of the problem is mind-boggling. Five million Americans now have the disease and, barring any major breakthroughs, the number is expected to triple over the next several decades. That doesn't take into account that as many as 50 percent of people with Alzheimer's go undiagnosed.
The burden on individuals, families and the nation's health care system will be tremendous, so it's heartening that the Obama administration has made a priority of finding effective treatments, if not a cure, by 2025.
Equally heartening is that hospitals and health care systems are stepping up to improve early detection, diagnosis and support services. The Alzheimer's Association described several programs around the country in which providers are working with association chapters to accomplish that. Here are three that stand out, and that might provide blueprints for others to confront the challenge:
• Minnesota's statewide collaborative — comprising medical, academic, community, government, business and nonprofit stakeholders, including the Alzheimer's Association Minnesota–North Dakota Chapter — developed two tools to help physicians diagnose and manage people with dementia. The first tool, called a "dementia practice parameter," provides doctors with a streamlined how-to guide to assist their decision-making process in three areas: cognitive evaluation, dementia work-up/diagnosis and disease management. The second tool helps physicians take full advantage of their electronic health record system to further simplify and automate the evaluation, diagnosis and management of people with dementia.
• In Boston, physicians from Beth Israel Deaconess Medical Center, Boston Medical Center and the Veterans Administration Hospital refer patients and caregivers to the Massachusetts/New Hampshire chapter of the Alzheimer's Association for assessment, care recommendations and education. A dedicated care consultant then provides written feedback for inclusion in the patient record. Health outcomes and cost savings also are being tracked. In a second partnership, nurse care managers and primary care physicians from Tufts Health Plan, the largest Medicare Preferred HMO plan in New England, will track psychosocial and health outcomes for caregivers.
• In San Francisco, the only U.S. city with a strategic plan for addressing dementia, Kaiser Permanente San Francisco is working with the association's Northern California and Northern Nevada Chapter and other community organizations on four fronts: improve KPSF's capacity to educate and support caregivers and families; connect caregivers of KPSF members with educational resources; develop an electronic care plan to improve quality of care; and disseminate best practices among KPSF providers and staff.
To learn more about these and other initiatives, click here.