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Alzheimer's Disease and Related Dementias: Experience and Caregiving, Epidemiology, and Models of Care: Proceedings of a Workshop - in Brief
Pages 1-12

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From page 1...
... To achieve these goals, the workshop included four panel discussions: sponsors' perspectives on the study; perspectives from individuals living with Alzheimer's disease and other dementias and AD/ADRD caregivers; epidemiological perspectives on AD/ADRD; and a discussion on models of care initiatives. These panels were followed by a public comment session.
From page 2...
... population is aging rapidly and approaching an inflec tion point in the population 85 and older; this popula tion is going to grow very rapidly, and the oldest ages are at greatest risk for onset FIGURE 1 Life expectancy and projected cognitive health status at age 65, 2000 and 2010. of dementia.
From page 3...
... , underscored the significant role social and behavioral sciences can play in reducing the burden of AD/ ADRD, and stated that AA/ AIM supports all of the proposed areas for review and subsequent research agenda should include the voices of individuals living with the disease, care partners, and caregivers. Tellock noted several areas or questions for further FIGURE 2 National Plans to Address Alzheimer's Disease.
From page 4...
... In addition to educating physicians and promoting research, Huling Hummel noted the need to continue building a robust dementia-capable workforce to support individuals living with AD/ADRD and caregivers. She called for the establishment of Alzheimer's navigators -- professionals who are trained to serve as liaisons who can guide persons living with dementia and care partners "through the maze and through the haze" of a dementia diagnosis, similar to those who work with cancer patients.
From page 5...
... Israelite identified a few areas of research that would be helpful to caregivers: • Identifying promising practices for early interventions and treatments • Increasing understanding about how social determinants of health, such as race, immigrant status, and so cioeconomic status, impact patient access to early intervention and care • Increasing understanding about how these social determinants affect caregiver access to information and support • Examining how fields like social work can help caregivers learn to be better advocates for their loved ones in navigating systems and • Identifying the types of assessments and supports that are effective for decreasing the stress of both the adults living with Alzheimer's disease as well as the informal caregiver -- helping caregivers understand how to reduce stress and how to reduce triggers for loved ones that they are caring for. Seconding Huling Hummel's call for the establishment of Alzheimer's navigators, Israelite commented that even though she comes from a social services background, she found it challenging to navigate service and support systems.
From page 6...
... She also highlighted the importance of improving resource availability in underserved urban settings and isolated rural areas; supporting families struggling with long-term care financing, and disseminating practical information that could be beneficial to individuals with AD/ADRD and their care partners. EPIDEMIOLOGICAL PERSPECTIVES ON AD/ADRD Deborah Blacker, Harvard Medical School and Harvard University, and a member of the study committee, offered her views on what epidemiology can contribute to understanding about disease by providing a sense of the size of the problem, both prevalence now and projected future incidence and prevalence over time.
From page 7...
... The National Academies reported that while there was evidence suggesting that there may be a relationship between dementia risk and three factors -- cognitive training, blood pressure, and physical activity -- the evidence was not strong enough to draw firm conclusions about the effectiveness of physical activity, managing hypertension, or cognitive training for reducing dementia risk. In contrast, Livingston and his colleagues concluded that taking an ambitious approach to prevent dementia was warranted, recommending interventions on nine factors: education, hypertension, obesity, hearing loss, smoking, depression, physical inactivity, social isolation, and diabetes.
From page 8...
... He noted that there are very long periods of preclinical dementia where dementia-related physiological changes are taking place prior to a formal dementia diagnosis. Kivimaki added that when examining the relationship between dementia risk and factors such as BMI and blood pressure, it may be necessary to look at factors at least 10 years or even 20 years prior to diagnosis to discern the direction and strength of the relationship.
From page 9...
... to spur an increase in cognitive impairment detection by primary care and other health care providers: • Kickstart the cognition conversation • Assess for cognitive impairment • Evaluate for dementia • Refer for community resources These four steps together are intended to help older adults and doctors feel comfortable communicating with each other, talking about brain health, moving through a process of assessment and evaluation, and getting connected with resources -- a critical part of postdiagnosis care. Fortinsky also described the KAER toolkit, (see https://www.geron.org/images/gsa/kaer/gsa-kaer-toolkit.pdf)
From page 10...
... found that enrollees had fewer hospital stays and emergency department visits than those in non-aligned plans, Howard reported. Howard noted that several integrated health systems have adopted care coordination models wherein participants with dementia are identified and paired with care coordinators who help the patients and their caregivers connect 10
From page 11...
... Care coordination appears to have the strongest evidence of positive effects when it's targeted, but after a certain point, further targeting yields diminishing returns, Howard commented. She added that it would be helpful to increase understanding about how to align care models that integrate long-term services and supports, acute care, and care coordination with models that are specific to dementia care.
From page 12...
... Chan School of Public Health; Maria Glymour, University of California, San Francisco; Roee Gutman, Association of American Universities; Mark Hayward, Population Research Center and Population Health Initiative at the University of Texas at Austin; Ruth Katz, LeadingAge; Spero M Manson, Centers for American Indian and Alaska Native Health in Colorado School of Public Health, University of Colorado, Denver; Terrie E


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