It’s no secret that mental health tends to decline as we age (Alzheimer’s, dementia, etc). Some is natural cognitive decline; some is disease with severe cognitive impairment due to diseases associated almost entirely with aging.
By 2020 there will be 43 million Americans over 65 and 15 million over 85 (double the figures of 1980). Almost certainly, we are facing an unprecedented number of mentally impaired citizens.
Hope for cures is not a strategy. What should we be doing to prepare to meet the needs of tens of millions of mentally impaired older citizens?
Meet the Challenge Team
The Challenge Team Members are leaders in their fields and reflect multi-disciplinary, passionate and thoughtful perspectives for the Challenge they represent.
Challenge Team members participate in the discussion held by the Great Challenges community, and will be creating responses to questions submitted by the community on the discussion tab.
Dr. Brangman is a graduate of Syracuse University and earned her medical degree from SUNY Upstate Medical University in Syracuse, New York. She completed her internship, residency, and geriatric fellowship programs at Montefiore Medical Center in the Bronx, New York.
She is Professor of Medicine and Division Chief of Geriatric Medicine at SUNY Upstate Medical University. She is also Director of the Central New York Alzheimer’s Disease Assistance Center. Dr. Brangman is board certified in internal medicine and geriatric medicine.
Dr. Brangman has received many honors, including Best Doctors of Northeast Region and Hartford Geriatrics Leadership Scholars Award. Upstate Medical University recently established the Sharon A. Brangman, M.D. Endowed Professorship in Geriatric Medicine in honor of her leadership in geriatrics at Upstate and the Central New York region.
She serves on the board of The OASIS Institute based in St. Louis, and the Foundation for Health in Aging. She has been active in the American Geriatrics Society, serving on the Board of Directors for ten years, and recently completing terms as President and Chair of the Board.
Geriatric medicine encompasses so many more clinical issues than Alzheimer’s disease, but I spend a significant amount of clinical time helping patients and families manage this devastating disease. Perhaps with the exception of cancer, there is no other diagnosis that people fear and dread more. Alzheimer’s disease removes the memories that make us all unique and leads to the unwinding of an individual’s independence, personality and relationships that take a lifetime to develop.
I typically have two “patients” in my office; the official patient who is assigned to see me, and the caregiver who brought the patient in. Successful patient care means helping the caregivers as well.
Meryl Comer is an Emmy-award winning reporter and syndicated business talk show host with over 30 years of experience in broadcast journalism. She was one of the first women to host a nationally syndicated TV debate show that specialized in business news as it relates to public policy.
Comer was named President of the Geoffrey Beene Foundation Alzheimer’s Initiative in 2008. Winner of the 2005 Shriver Profiles in Dignity Award and the 2007 Proxmire Award, Ms. Comer has provided testimony before Congress on behalf of the Alzheimer’s Association and served on the 2008-09 Alzheimer’s Study Group, charged with presenting a National Strategic Plan to Congress. She is credited with the spirited Rock Stars of Science campaign to salute our researchers and attract the next generation to careers in science. For the last 16 years, she has cared for her physician/researcher husband with early onset Alzheimer’s. Ms. Comer is currently writing a book, Slow Dancing with a Stranger, to benefit Alzheimer’s research.
I am a former TV journalist, not a scientist, nor a neurologist or a gerontologist. Why do my personal observations warrant a place in this scientific conversation? Let’s just say I have put in almost two decades of “on the job training” and “real time testing” of the latest therapies designed to slow the progression of a disease that will ravage the baby boom generation. Alzheimer’s disease is a pending epidemic greater and deadlier than a flu pandemic. No one survives its onslaught.
Studies show that those who get the disease have the bio marker in them between 10 to 20 years before exhibiting any symptoms. We are ticking time bombs without even knowing it. How ironic that the generation that wouldn’t trust anyone over age 30 and still embraces youth is now succumbing to a scourge linked to age.
Jeffrey L. Cummings, M.D., Sc.D. is director of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas, Nevada and Cleveland, Ohio -- a clinical care, translational research, and clinical trials enterprise specializing in care of patients with neurocognitive deficits and development of new therapies for neurodegenerative disorders. He also chairs the Neurological Institute of Cleveland Clinic.
Cummings’ research and leadership contributions in the field of Alzheimer’s disease have been widely recognized with prestigious awards from the American Geriatrics Society, the John Douglas French Alzheimer’s Research Foundation, the national Alzheimer’s Association, the American Association of Geriatric Psychiatry and others.
Cummings is expert in clinical trial design and analysis, global trial implementation, and trial outcome measures. He is the author of the Neuropsychiatric Inventory (NPI) which is the most commonly used tool for clinical trials characterizing behavioral disturbances in dementia syndromes. He has authored or edited over 30 books and published 600 peer-reviewed papers.
As a neurologist who cares for patients with Alzheimer’s disease and a clinical trialist who works to test drugs in clinical trials and find new solutions for Alzheimer’s, I am aware of the tremendous challenges patients and caregivers face. New solutions for involving patients in trials and advancing new therapies are urgently needed.
Guy Eakin is the Vice President of Scientific Affairs at the BrightFocus Foundation.
Eakin leads the foundations efforts to identify promising and innovative research to combat Alzheimer’s disease, macular degeneration, and glaucoma. Dr. Eakin works to ensure continued research progress in each of the over 100 active research projects throughout the world.
Prior to coming to BrightFocus Foundation, Eakin worked in medical research at Memorial Sloan Kettering Cancer Center in New York City, and at the University of Texas, M.D. Anderson Cancer Center in Houston, Texas. During his research career, he studied and developed new ways of visualizing complex microscopic events in living cells and animals.
Eakin holds a Ph.D. in Developmental Biology from Baylor College of Medicine, and a Bachelor of Science degree in Biology from Indiana University. In addition to his oversight of the scientific programs, Dr. Eakin is a spokesperson for the organization, having been featured in works presented by Prevention magazine, Oprah.com, the National Press Foundation, and others. He previously served on the board of directors of the Grants Managers Network, a 2000-member organization committed to best practices in grants management.
My leadership role at the BrightFocus Foundation has provided opportunities to hear the desperation of our public constituents mirrored by the very real concerns of the scientists whom we fund. Our public friends undergo heroic personal struggles in a vacuum of therapeutic advances against Alzheimer’s disease. Meanwhile, our scientists survive no less heroically in a paradoxical culture of shrinking research budgets in the face of increasing disease prevalence.
This lead me to commit my professional life to science advocacy, helping the world’s most promising scientists secure the resources necessary to meet this unique and growing 21st century challenge.
William H. Thies, Ph.D., is Chief Medical and Scientific Officer for the Alzheimer’s Association in Chicago. Thies oversees the world’s largest private, nonprofit Alzheimer’s disease research grants program. Under his direction, the annual grants budget has more than doubled, and the program has designated special focus areas targeting the relationship between cardiovascular risk factors and Alzheimer’s, caregiving and care systems, and research involving diverse populations.
Under Thies’ stewardship, the annual Alzheimer’s Association International Conference has grown into the world’s leading forum on dementia research, attracting 4,000 scientists to six days of state-of-the-art presentations on virtually every topic of significance in the field.
Thies played a key role in establishing the Association’s Research Roundtable, a consortium of scientists from industry, academia and government who meet regularly to explore topics of mutual interest in drug discovery and eliminate barriers to progress.
In previous work at the American Heart Association, Thies formed a new stroke division that became the American Stroke Association. Prior to joining AHA, he held faculty positions at Indiana University in Bloomington and the University of Pittsburgh. Thies earned a B.A. in biology from Lake Forest College and a Ph.D. in pharmacology from the University of Pittsburgh School of Medicine.
My position with the Alzheimer’s Association provides me the privilege of interacting with a great variety of people who are deeply involved in the cause of ending Alzheimer’s disease.
I regularly meet with academic and industry scientists, and I see their passion for discovery and for conquering this awful disease. I have many opportunities to engage with people with Alzheimer’s and their families. I feel their desperation and weariness; and also their bravery, perseverance and hope.
These connections, plus my involvement in public policy, show me that Alzheimer’s is a problem that affects everyone in the community – and which cries out for community-driven solutions.
George Vradenburg is the Chairman and Co-Founder of the USAgainstAlzheimer’s Network and USAgainstAlzheimer’s, a 501c(3)/c(4) education and advocacy network and campaign committed to educating and mobilizing America to stop Alzheimer’s by 2020. Through USAgainstAlzheimer’s, George launched the SPRINT Agenda, a public/private effort to accelerate the therapeutic pipeline from basic research to Alzheimer’s therapies in the market. George has brought powerful voices to the fight against Alzheimer’s as co-convener of Leaders Engaged on Alzheimer’s Disease (LEAD), a network of major Alzheimer’s-serving organizations. He served on the National Alzheimer’s Advisory Council to advise the National Alzheimer’s Strategic Plan and he helped conceive and support the Alzheimer’s Study Group and the Alzheimer’s Disease International’s World Alzheimer’s Reports. Through the Vradenburg Foundation, George and his wife Trish launched and co-chaired the National Alzheimer’s Gala for eight years, raising over $10 million for the Alzheimer’s Association.
George is active in the civic and philanthropic community, as Chairman of the Board of The Phillips Collection and the Geoffrey Beene Foundation’s Alzheimer's Initiative. He is also the co-founder and Vice Chairman of the Chesapeake Crescent Initiative and serves on the board of the University of the District of Columbia. Vradenburg is also a member of the Council on Foreign Relations and the Economic Club.
Before his retirement, George served in senior executive positions at AOL/Time Warner, CBS and Fox.
Alzheimer’s robbed my mother-in-law of her zest for life and her dignity. Once I saw how this disease ravages not just individuals, but entire families, I made a commitment to stop Alzheimer’s. This is not just a personal issue; Alzheimer’s is a national health and fiscal crisis as well. After a career in the media, entertainment, and Internet worlds, I founded USAgainstAlzheimer’s to turn my global advocacy experience in championing the growth of the Internet, freedom of the press and policy issues to create a movement to reject the “business as usual” attitude toward Alzheimer’s and aggressively battle this disease through innovation, public-private partnerships and policy change.
Challenge Team Perspectives
We selected 10 questions out of the many submitted by our Great Challenges Community, to be addressed by each of our Team members.
See their responses and perspectives, below.
Question 1Not everyone who cares for the elderly is a geriatrician. How can we prepare all clinicians – doctors, nurse practitioners, etc., – who treat older people to recognize and respond to signs of dementia?
Enhancing the quality and efficiency of care provided is the very important second goal of the National Plan, and better educating all providers is a priority action. I fully support this effort and have encouraged the government agencies working on this project to be very clear in terms of their goals for dissemination and application of the training materials and how they will measure success. I also believe we must establish quality measures so that providers understand what quality dementia care is and is not – and that we must move to eventually hold providers accountable for their performance on such indicators, particularly as we move into a world where ideally healthcare will be more coordinated and less fragmented.
In addition to these efforts, specialty societies can be encouraged to offer continuing medical education (CMEs) that focus on Alzheimer's and dementia to build a dementia-capable workforce. This is another way to reach those already in the field. Finally, I think we must start as early as possible including in pre-service training so that nurses, nurse practitioners, physicians and others are exposed to issues related to Alzheimer's and dementia early and often in their curriculum. Given the aging of the nation and world that I spoke of earlier, taking such measures to adequately prepare our healthcare workforce for the challenges they will face makes complete sense.
Select a Question to View The Challenge Team's Responses
The following questions were submitted by the TEDMED Community and selected for further discussion. The Team Members have weighed in on each, select below to see their responses: