University Alzheimer Center Becomes University Memory and Aging Center

The University Alzheimer Center has a new name. Now the University Memory and Aging Center, it remains part of University Hospitals of Cleveland and Case Western Reserve University.

The new name reflects an important broadening of the Center's mission and research direction over the past few years, according to Karl Herrup, Ph.D., the Center's director and professor of neuroscience and neurology in the CWRU School of Medicine. "This change reflects a new vision for all aspects of who we are and what we do," said Dr. Herrup. "We've begun seeking people with milder memory loss - in addition to those we already serve who have more serious memory problems. We believe that this broadening of our service and research activities may help us to more quickly unlock the mysteries of the aging brain and its vulnerability to memory loss."

The move to the new name also affects the Center's interest in caregiving research. "I hope that we can start to investigate how the caregiving relationship unfolds and what can be done in the early stages to prepare a stronger foundation for the changing relationship that inevitably lies ahead," said Dr. Herrup.

The name change reflects directives from the national Institute of Aging, which partially funds the Center as Ohio's only Alzheimer Disease Research Center. "Years ago, our only focus was Alzheimer's disease," said Dr. Herrup. "The National Institute of Aging told us to widen our scope, to serve the community better by studying other dementias. So we've moved from only seeking people diagnosed with Alzheimer's to include all dementias end even those concerned about their memory who want to talk with a physician."

"Improved strategies for treating and preventing Alzheimer's disease are more and more attainable goals," said Dr. Herrup. "As we move toward this new era, it is crucial to learn how to identify and work with Alzheimer's in its earliest stages. That is when the new interventions and therapies will have the largest impact on an individual's quality of life."

Memory Changes - Is this Normal or is it Alzheimer's?

Did I unplug the coffee pot? Where are my keys? WHAT is her name? Why do I have all these "senior moments"? Do I have Alzheimer's disease?

Regardless of age, we often forget routine acts and where we have put things. But when these common memory lapses are noted in older adults, the question, "Is this Alzheimer's disease?" is often asked. This question may be even more intense for individuals with a family history of Alzheimer's disease or those who know or are caring for a loved one with the disease. Researchers throughout the country, and in particular here at the University Memory and Aging Center, are investigating how to help people answer this question.

As our Center develops new programs focusing on a broader range of memory problems, we would like to provide you with some general information on what is normal and what may be signs of a more serious memory problem like Alzheimer's disease. Normal age related changes that may begin as early as the mid 40s include a general slowing in our ability to retrieve information, or that felling of knowing a word or name, but being unable to get it out. There is also a general slowing in our ability to learn new things. It also becomes more difficult to "multi-task" or do multiple things at once, such as talking on the telephone, making the grocery list, and organizing your kitchen at the same time. It is also important to realize that memory is affected by multiple factors such as stress, distractions, change, loss, grief, depression, boredom, fatigue, physical illness, medications, poor nutrition, and vision and hearing changes.

The Alzheimer's Association has developed a list of ten warning signs to look for. These include:

1. Recent memory loss that affects job skills or every day household abilities
2. Difficulty performing familiar tasks
3. Problems with language
4. Disorientation to time and place
5. Poor or decreased judgement
6. Problems with abstract thinking/problem solving
7. Misplacing things
8. Changes in mood or behavior
9. Changes in personality
10. Loss of initiative

A key to knowing when you should worry is paying attention to how often problems are experienced and how much it affects you day to day life. Early detection is crucial to the treatment and prevention of Alzheimer's disease. It is best to seek expert advice from you family physician as a first step, should you have any concerns at all, or please call 216-844-6300 to see if you are eligible for evaluation in our newly established Memory Clinic at the University Foley ElderHealth Center, 12200 Fairhill Road, Cleveland, Ohio.

Memory Clinic

We would like to introduce our new Memory Clinic at the University Foley ElderHealth Center. The Memory Clinic provides you with an integrated, one-stop package of comprehensive interdisciplinary memory, cognitive, and functional assessment to identify the character and severity of reported memory or cognitive problems. A physician, neuropsychologist, nurse, and social worker will evaluate you in a 2-hour clinic visit, with a return visit in three to four weeks to review results of the testing and to plan for future care. For those who have concerns about their memory and/or thinking, please call 216-844-6300 to see if you are eligible for evaluation in our newly established Memory Clinic at the University Foley ElderHealth Center, 12200 Fairhill Road, Cleveland, Ohio.

Autopsy Program Update

A diagnosis of Alzheimer's disease is now being made in the earlier stages of the disease, which allows the individual to actively participate in planning for their future care. One area of consideration in the planning process should be whether to seek confirmation of the diagnosis at the time of death Although the clinical diagnosis obtained is 85% accurate, many families desire to know the diagnosis with 100% certainty in order to bring closure, and to possibly help with future generations in their family.

The following are frequently asked questions about the brain autopsy:

Q: Who can legally authorize an autopsy by signing the autopsy permit?
A: Written consent must be obtained at the time of death by one of the following persons: spouse, adult children, parents, brothers or sisters, legal guardian, or any other relatives if there are no surviving persons listed above.

Q: What does a brain autopsy entail?
A: A brain autopsy involves a single incision with minimum disfigurement at the lower back of the head allowing for an open casket funeral, if the family chooses. The entire brain is removed and examined under a microscope by a neuropathologist.

Q: Does the autopsy delay funeral arrangements?
A: No, however to ensure that there is no delay, it is highly advised that the autopsy decision and arrangements are made well in advance.

Q: What is the cost of brain autopsy?
A: There is no cost to individuals who are participants in the University Memory and Aging Center Research Registry. For families who are not in the Registry, cost may vary depending on location. The standard University Hospitals cost is approximately $700.

Q: When will I received the results of the brain autopsy?
A: Families who are participants in the Research Registry should receive a complete report approximately 6 months after the autopsy. A feedback session will be scheduled for these families with our clinical director to review the findings in the report and answer any questions the family may have.

For information regarding our program or to have questions answered, please call LaWanda Crawl at 216-844-6411 or email at lyc@po.cwru.edu. To request enrollment forms, please call Laura Miodragovic at 216-844-6374 or email at lxs53@po.cwru.edu.

Religion, Spirituality, and Dementia Caregiving

Jon Stuckey, Ph.D., is continuing his studies about how much family caregivers rely on religious or spiritual beliefs for support during stressful times. Dr. Stuckey has already interviewed caregivers from several faith traditions. He now hopes to interview by phone, caregivers from additional traditions, as well as caregivers who do not have any particular religious affiliation. If you would like to learn more about this study, please call Patricia McCrone at 216-844-6408 or 1-800-252-5048, extension 46408 or email at pxm59@po.cwru.edu.

REVEAL Study

The REVEAL study explores the impact of receiving a genetic risk assessment for developing Alzheimer's disease. People who have/had a parent with Alzheimer's disease and have no signs of cognitive impairment or depression may qualify for this study. For additional information, please contact Melissa Barber at 216-844-6329 or email at mjb31@po.cwru.edu.

News from Clinical Trials

What is a Clinical Trial?

A clinical trial is a research study that enables physicians and scientists to determine the safely and effectiveness of new drugs or treatments. Clinical trials evolve over a long period of time, in order to ensure the safety of all people who use the drug. The government sets strict guidelines and regulations as to the practice of clinical trials, and sponsoring pharmaceutical companies, hospitals, and academic institutions also require that studies be carried out precisely as planned.

Benefits of Clinical Trials

Clinical trials can benefit participants by:

• Offering access to new treatments that are not available to the public
• Regular contact with medical experts at the University Memory and Aging Center (UMAC)
• Opportunities to contribute to advancements in treatment for Alzheimer's disease now and for future generations

Eligibility

While everyone has the potential to participate in a clinical trial, each trial has specific criteria for participation. For most trials, we have no flexibility in altering eligibility requirements, which are set by the sponsoring drug company or the federal government. At the UMAC, we generally have several active trials and are always starting new ones. If you are not eligible for a current study, there may be an appropriate study for your consideration soon.

Participating in a Trial

Before entering a clinical trial, it is the responsibility of the Center staff to make sure you meet the eligibility requirements, and to let you know what the study will involve. This is accomplished by thoroughly discussing the study and answering any questions you may have. At that point, if you agree to participate, you will be asked to sign an informed consent, which documents the fact that you have chosen to be in the study. Even though you have signed the informed consent, your participation is completely voluntary, and you may leave a study at any time you feel is necessary.

The Clinical Trials Office at the UMAC includes a study team of physicians, nurses, psychologists and coordinators who work together to make your clinical trial experience comfortable, informative, and meaningful.

Future Trials at UMAC

We will soon be enrolling volunteers for new studies.

• Severe Alzheimer's Disease - This study will examine the effectiveness of a drug to slow or delay cognitive loss in people who have progressed to a severe stage. If you have any questions regarding this study, please call Nancy Slocum at 216-844-6328 or email at nas10@po.cwru.edu.
• PGZ - This study will look at the use of a drug that acts as an anti-inflammatory in brains of people with mild to moderate Alzheimer's disease. If you have any questions regarding this study, please call Lani Holland at 216-844-6419 or email at ljh4@po.cwru.edu.
• Prevention Instruments - This study will look at the development of new or improved measures for evaluating the clinical effectiveness of drugs being tested for prevention or treatment of Alzheimer's disease. We will be looking for healthy volunteers with no memory problems or with very mild memory problems. if you have any questions regarding this study, please call Nancy Slocum at 216-844-6328 or email at nas10@po.cwru.edu.

CWRU Scientist Makes Exciting Discovery

Dr. Gary Landreth, CWRU professor of neurosciences, recently made an exciting discovery that could lead Alzheimer's medication research in a new direction. He noticed that a drug already approved by the Food and Drug Administration for use with diabetic patients appeared to work as an anti-inflammatory on brain cells. One school of thought in Alzheimer's disease research is that inflammation in the brain is an important contributor to the progressive worsening of the symptoms.

A clinical trial to test this process, which is different from any of the already approved drugs for use with Alzheimer's disease, is in development. Drugs approved for use with Alzheimer's disease thus far work by increasing a substance that helps brain cells communicate.

Dr. David Geldmacher, UMAC clinical director, says, "If the study takes place here, it would be our first case where "homegrown" research discovered in our own labs would be tested in one of our clinical trials."

Helpful Resources

Alzheimer's Disease Education and Referral (ADEAR) is a service of the national Institute on Aging (NIA) that provides excellent information to the public free of charge by telephone, a newsletter Connections, and through their Web site. You can contact them at 1-800-438-4380; ADEAR Center PO Box 8250, Silver Spring, MD 20907 or at their Web site at http://www.alzheimers.org.

The NIA has updated its very popular book Talking with Your Doctor: A Guide for Older People to help older people communicate successfully with their doctors. The 30-page booklet is available free of charge by contacting the NIA Information Center at 1-800-222-2225 or email: niaic@jbs1.com or write to NIA, PO Box 8057, Gaithersburg, MD 20898.

Donations

For information on making a donation to the University Memory and Aging Center (UMAC), please contact Joann Franko at 216-844-6412 or email at jcf5@po.cwru.edu. Checks can be made payable to the University Memory and Aging Center and sent to her attention at 12200 Fairhill Rd., Cleveland, OH 44120-1013.

All donations are appreciated and will be acknowledged.

To view past/archived copies of the Research Register, click on the links below:

Summer 2001

Spring 2001

Fall 2000

Spring 2000