MCI and Dementia. Gerontechnology, Normal Cognitive Aging Process. Aging does not equate to loss of all cognitive abilities

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "MCI and Dementia. Gerontechnology, Normal Cognitive Aging Process. Aging does not equate to loss of all cognitive abilities"

Transcription

1 MCI and Dementia Gerontechnology, 2016 Normal Cognitive Aging Process Aging does not equate to loss of all cognitive abilities Commonly Certain held misconception cognitive domains normally decline with age while others remain stable or even improve A lot of individual differences 1

2 Dementia A condition which causes a decline in intellectual abilities & cognitive skills (e.g., memory, attention, language) sufficient to interfere with social and occupational functioning Does not imply etiology/cause (umbrella term) Neurodegenerative the brain over time dementias nerve cells die in Normal Aging Slower to think Slower to do Hesitates more More likely to look before you leap Know the person but not the name Pause to find words Reminded of the past Not Normal Aging Can t think the same Can t do like before Can t get started & can t seem to move on Doesn't think it out at all Can t place the person Words won t come even later Confused about past vs. now 2

3 No Dementia Diagnosis definitive tests (biomarkers in development) Normal aging or mild cognitive impairment which may progress to dementia? Possible Treatable causes Depression Medication side effects Excess use of alcohol Hearing or vision deficits Thyroid problems Poor diet; vitamin deficiencies Differential diagnosis: overlapping symptoms among different types of dementias; can have more than one pathology Vignette 1 Ms. D. was an 80-year-old widow who remained actively involved with her family, church, and volunteering. She was very aware of the need to negotiate her basement stairs carefully; however, she fell down the stairs one morning and found herself in incredible pain and unable to get up. Ms. D was eventually admitted to the hospital for surgical repair of a fractured hip. Over the next 48 hours, Ms. D. became increasingly confused as to time and place. She fearfully questioned caregiving attempts, tried repeatedly to get out of bed, and cried out to people who were not even in the room. Her daughter told the nurses that Ms. D.'s mother had suffered from dementia and she questioned whether her mother was also experiencing dementia. 3

4 Vignette 2 Mrs. C is a 76 year-old married female who has gradually been decreasing her involvement in activities outside the home, including yoga and her church group. She recently began experiencing back pain and was in the hospital having tests completed. While at the hospital, she repeatedly asked her husband what was going to happen to her. She also had difficulty completing hospital paperwork and paying for services. When the nurse asked Mrs. C about these observed difficulties, Mrs. C and her husband both said that Mrs. C has been experiencing difficulties with her memory for the past few years. They also both attributed Mrs. C s difficulties to normal aging. AD Predisposes to delirium Delirium may also predispose to AD 4

5 Costs of Care Skilled nursing home care costs about $80,000 a year By 2050 Medicare spending for AD patients could reach 1 trillion Care-partners Health Care-partners of individuals with AD experience higher levels of emotional distress and physical health problems than other care-partners and non care-partners 5

6 Temporal Lobe Right Temporal Lobe Visual memory Left Temporal Lobe Verbal memory Language Naming Temporal lobe problems can lead to difficulties with learning and remembering new information, understanding language, and word-finding problems Frontal Lobe Executive functions focus, organization, Problem-solving decision making, judgment emotion/behavior control Frontal lobe problems can lead to concrete thinking, difficulty completing tasks, difficulty multi-tasking, disinhibition, fatigue, decreased motivation, personality changes, and difficulty initiating activities 6

7 Parietal Lobe Right Parietal Lobe Visual-spatial information Left Parietal Lobe Language and writing Mathematics Object perception Parietal lobe problems can lead to difficulties with finding ones way around, constructing things, understanding spoken or written language, recognizing objects, mathematics. Occipital Lobe Visual information Damage to the occipital lobe can cause difficulties with visual recognition of shapes, objects and colors. 7

8 Medical Guidelines for Alzheimer s disease (AD) Sperling et al. (2011). Alzheimer s & Dementia, 7, Subjective Cognitive Decline (SCD) Self-report of cognitive decline May be at increased risk for declining to MCI and dementia; some studies suggest as many as 60% of older adults that present with SCD eventually progress (Reisberg et al., 2008) Challenging to identify as perform normally on cognitive tests Jessen et al (2014) criteria 8

9 Biomarkers Diagnostic biomarkers Amyloid imaging (PET) CSF AB/tau (low AB/high tau) Change early, limited progression Do not correlate with cognitive decline Hatashita & Yamasaki, 2013 Progression biomarkers MRI atrophy FDG PET (measures cerebral metabolic rates of glucose a proxy for neuronal activity) Change later; correlate with decline Jack et al., 2013 Subjective Cognitive Complaints, Cognition and Everyday Functioning 9

10 Subjective Cognitive Complaints, Cognition and Everyday Functioning Mild Cognitive Impairment Heterogenous Criteria of NIA Alzheimer s Association workgroup (Albert et al., 2011) ntifying.asp (3:38) 10

11 Symptoms of MCI Symptoms vary across individuals depending on what area of the brain is affected Memory loss (most common): forget things more often, ask questions over Difficulty focusing and concentration: lose thread of thought in conversations Become increasingly overwhelmed by decision-making Problems with judgment Difficulty finding way around familiar environments Difficulty starting and completing projects Other Common Problems that may Accompany MCI? Depression: feelings of hopelessness, shame, or despair Irritability and aggression Anxiety Problems with sleep Apathy: lack of interest, absence of emotion Social withdrawal Employment problems Relationships changes and family adjustments 11

12 MCI Impact on Everyday Functioning Complex everyday activities that are dependent on memory and executive functions Basic activities of daily function not affected Bathing Grooming Finances Medication management Eating Cooking Household repairs MCI How prevalent is MCI? Prevalence rates increase with age Prevalence rates range from 16% to 35% Progression rates from MCI to dementia range between 8% to 15% per year Not everyone with MCI goes on to develop dementia 12

13 What We Don t Know. Is MCI going to progress to dementia? If so, how rapidly? If so, what type of dementia will it be? What is the prognosis? 13

14 Alzheimer s disease (AD) Every 68 sec someone in the US develops AD Most common type dementia (2/3 of cases) Prevalence varies widely but increases w/ age (estimates of > 32% in persons over age 85); 1 in 9 people over age 65 have AD Risk factors see figure Most cases diagnosed after age 60 with life span following diagnosis varying widely (2-20 yrs); women > men; in 70 s > age 85+ Cases diagnosed prior to age 60 typically have known genetic mutation (account for about 3%) ApoE4 = most powerful genetic influence; present in 20% of population with 50-65% of AD patients E4 carriers; 1 e4 > 40% likelihood; 2 e4 > 80% identifying.asp (11:48) Alzheimer s disease risk factors 14

15 Alzheimer s Dementia Microscopic changes: amyloid plaques neurofibrillary tangles neuronal loss reduction in neurotransmitter acetylcholine Typical clinical AD presentation: begins with memory deficits: recent events (medial temporal lobe) followed by word finding & visuospatial deficits (posterior temporal lobe and parietal lobe, respectively) less pronounced deficits in attention and executive functioning (frontal lobe) primary sensory and motor functions initially spared AD can present in many different ways (e.g., visuospatial difficulties, anomia); complicates differential diagnosis; also need to consider overlapping diseases Alzheimer s Disease Cortical Atrophy 15

16 Frontotemporal Dementia (FTD) or Frontotemporal Lobar Dementia Umbrella term for a diverse group of disorders that primarily affect the frontal and temporal lobes Prevalence 2-5% of dementias, some estimates go as high as 10-15% May be somewhat more common in men? Onset typically before age 65 (mid 40s to early 60s; can be younger) Life span following diagnosis varies widely (3-17 yrs); nonmotor form avg. = 8 yrs, motor form avg. = 3 yrs (small number FTD also develop motor neuron disease sometime called FTD with ALS) May have a strong genetic link; up to 50% Risk factors: family history, advanced age Frontotemporal Dementia (FTD) Microscopic changes: neuronal loss, gliosis, & spongiosis; some cases show swollen neurons w/ inclusion bodies, others Pick bodies (abnormal protein filled structures that develop within brain cells) Focal atrophy of frontal lobe (reasoning, personality, social graces), anterior temporal lobe w/ amygdala demonstrating more involvement than hippocampus (language, word finding), or both (can be unilateral or bilateral) 16

17 Subtypes of Frontotemporal Dementia (FTD) Frontal or Behavioral variant FTD (most common) Gradual and progressive changes in behavior predominate (alteration in personality & social conduct; could see disinhibition, withdrawal or repetitive/compulsive behaviors) Attention, abstraction, planning and problem-solving deficits & memory deficits secondary to frontal difficulties Language, perception, & spatial function well preserved Language Variants FTD (Primary Progressive Aphasia) Progressive Non-fluent Aphasia (left frontal lobe) Expressive language dysfunction w/ effortful speech, word-finding errors, and agrammatic sentence structure Semantic dementia (left anterior temporal lobe) Deficit in comprehension of language; see progressive loss of knowledge of words & objects & fluent but empty speech; difficulty w/ recall of remote memory Absence of significant memory, perception, and spatial dysfunction Frontotemporal Dementia (FTD) Differential diagnosis still difficult, especially in very early stages exclude if see early severe amnesia or spatial disorientation 17

18 Dementia w/ Lewy Bodies (DLB) Prevalence as high as 20% male > female Age of onset ranges from Risk factors: advanced age, family hx Average life span following onset of symptoms is 5 years Sometimes occurs alone & sometimes simultaneously with AD or Parkinson s disease (15% cases also have severe AD, 55% some AD pathology) Microscopic changes: cortical Lewy bodies (smooth, round protein lumps contain alpha synuclein- found in nerve cells of brain) Areas of predilection = brainstem, subcortical nuclei, limbic cortex, & neocortex (temporal lobe > frontal lobe = parietal lobe) Progressive cognitive decline w/ most prominent cognitive deficits on tests of reasoning & problem solving (executive), may also see attention and visuospatial difficulties Dementia w/ Lewy Bodies Progressive cognitive decline w/ most prominent cognitive deficits on tests of reasoning & problem solving (executive), may also see attention and visuospatial difficulties Need 2 of 3 below symptoms for probable, 1 for possible DLB Fluctuating Cognition (currently no operational system) May occur rapidly (minutes or hours) or more slowly (weekly or monthly) Common reports: episodes of going blank or spontaneous remission Recurrent Visual Hallucinations Typically well formed & detailed; common theme = people & animals intruding in pts home May have degree of insight into unreality Spontaneous Parkinson s disease, typically mild Usually rigidity & bradykinesia seen Resting tremor not very common Consider also REM sleep disorder and depression 18

19 Dementia w/ Lewy Bodies Diagnostic Criteria Dementia w/ Lewy Bodies Subcortical Dementias Caused by lesions to subcortical structures Basal ganglia Thalamus Brain stem (SN, subthalamic nucleus) Frontal lobe projections that arise from subcortical structures White matter Cardinal Features Memory deficits (retrieval; strategic processes) Executive function deficits Slowed information processing Mood & personality changes May also see extrapyramidal syndromes & speech disorders (slurring, mutism) Examples: PD, HD, HIV-related dementia, some types of vascular dementia 19

20 Characteristics Subcortical Dementia Cortical Dementia Mental speed Significantly slow Relatively normal Attention Below expectations relative to other abilities Relatively preserved Memory Deficient acquisition due to failure of organization; delayed recognition relatively preserved in comparison to recall Impaired acquisition; impaired delayed recall and recognition Executive Disproportionately impaired relative to Deficient in proportion to other abilities; deficient ability to self- other abilities initiate strategies and use feedback Visuospatial Variable Variable Language Word fluency and naming may be below expectation but benefit from structure Early impairment in naming and word fluency, with minimal benefit from structure Motor Motor abnormalities common Motor abn. less common Affect Apathetic, inert, depressed mood Relative lack of concern; defensive about deficits; impulsive, reduced interest Vascular Dementia Prevalence differs depending on criteria using for diagnosis, varies from 6% (NINDS-AIREN) to 25% (Hachinski Ischemic Scale) of dementia cases Male > female; Asian & African American ethnicity also a risk factor Increased incidence of VaD w/ age, especially after age 60 Median survival time after diagnosis is 3.3 years but varies widely Early diagnosis = important so that risk factors leading to cerebrovascular disease can be managed Treat high blood pressure and elevated cholesterol w/ a combination of medicine, healthy diet & exercise Control diabetes, eliminate smoking, reduce alcohol intake Pathology: reduce blood flow & small strokes in the brain that eventually leads to dementia 20

21 Vascular Dementia Diagnosis Requirements Must be demented; loss of memory along with deficits in two other cognitive domains Some form of brain imaging to document stroke; some criteria recognize a single lesion whereas others require more Cognitive deficits and imaging must be related Clinical features that support diagnosis Abrupt deterioration, fluctuating or stepwise course Presence of focal signs History of gait disorder or frequent falls Urinary frequency and incontinence early in dementing course Mixed dementia complicates diagnosis: many believe that AD criteria should take precedence over VaD and term AD w/cvd should be used Predominant memory loss may be a useful feature for differentiating pure vascular cases from those with co-morbid AD 21

22 Vascular Dementia 22

23 Article Rosenberg, L. & Nygard, L. (2014). Learning and using technology in intertwined processes: A study of people with mild cognitive impairment or Alzheimer s disease, Dementia, Study Goal Method of Data Collection Primary Findings Implications of Work Specific implications for ongoing gerontechnology projects Dementia Diagnosis Detailed history Neuropsychological testing Psychiatric assessment Neurologic/Physical exam Blood work/csf biomarkers? Current medications, drug use/abuse, toxic screen CT/MRI (structural imaging) & EEG PET or SPECT (functional imaging) Chest x-ray, EKG Caregiver assessment 23

24 Algorithm Guiding Differential Diagnosis of Dementia Gather information from history, neuropsychological assessment, psychiatric assessment, neurological exam, and caregiver assessment if criteria for dementia are met then ask: Is the cause of dementia apparent? (e.g. hx of trauma, anoxic insult, Huntington s disease or other definitive cause for their dementia) Are any laboratory tests abnormal indicating that a medical illness is present? (e.g. hypothyroidism, B12 deficiency, syphillis, HIV) Is neuroimaging abnormal? (e.g., tumor, abscess, hydrocephalus, subdural hematoma, stroke/vascular dementia) Algorithm Guiding Differential Diagnosis of Dementia Is a movement disorder present? (e.g., progressive supranuclear palsy, Parkinson s disease with dementia, other movement disorders with dementia, Creutzfeldt-Jakob disease) Is there evidence of a depression syndrome present? (e.g., dementia syndrome of depression) If no, then need to consider a differential between Alzheimer s disease: memory, word-finding and visuospatial disturbances predominate Frototemporal dementia: marked personality and/or language changes, relatively persevered visuospatial skills Lewy body dementia: marked visual hallucinations, fluctuating mental status 24

SECTION 1: as each other, or as me. THE BRAIN AND DEMENTIA. C. Boden *

SECTION 1: as each other, or as me. THE BRAIN AND DEMENTIA. C. Boden * I read all the available books by other [people with] Alzheimer s disease but they never had quite the same problems as each other, or as me. I t s not like other diseases, where there is a standard set

More information

What is dementia? What is dementia?

What is dementia? What is dementia? What is dementia? What is dementia? What is dementia? Dementia is an umbrella term for a range of progressive conditions that affect the brain. There are over 200 subtypes of dementia, but the five most

More information

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Dementia Update October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Outline New concepts in Alzheimer disease Biomarkers and in vivo diagnosis Future trends

More information

Mild Cognitive Impairment

Mild Cognitive Impairment Mild Cognitive Impairment James Y Lin, DO, MHSA Program Director, LIGHT (GWEP) VP Senior Services & Adult Living Medical Director, LECOM Senior Living Center Director, LECOM Institute for Successful Aging

More information

2016 Programs & Information

2016 Programs & Information Mayo Alzheimer s Disease Research Clinic Education Center 2016 Programs & Information BROCHURE TITLE FLUSH RIGHT for Persons & Families impacted by Mild Cognitive Impairment Alzheimer s Disease Dementia

More information

Section Objectives. Module 4: Introduction to ID and Dementia. What is the difference between ID and dementia? 12/13/2017

Section Objectives. Module 4: Introduction to ID and Dementia. What is the difference between ID and dementia? 12/13/2017 Module 4: Introduction to ID and Dementia Matthew P. Janicki, Ph.D. mjanicki@uic.edu 1 Section Objectives Participants will be able to: Identify how dementia may appear different in adults with ID. Apply

More information

P20.2. Characteristics of different types of dementia and challenges for the clinician

P20.2. Characteristics of different types of dementia and challenges for the clinician P20.2. Characteristics of different types of dementia and challenges for the clinician, professor Danish Dementia Research Center Rigshospitalet, University of Copenhagen (Denmark) This project has received

More information

Dementia. Assessing Brain Damage. Mental Status Examination

Dementia. Assessing Brain Damage. Mental Status Examination Dementia Assessing Brain Damage Mental status examination Information about current behavior and thought including orientation to reality, memory, and ability to follow instructions Neuropsychological

More information

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient DEMENTIA WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient Progressive and disabling Not an inherent aspect of

More information

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries

Clinical Differences Among Four Common Dementia Syndromes. a program of Morningside Ministries Clinical Differences Among Four Common Dementia Syndromes a program of Morningside Ministries Introduction Four clinical dementia syndromes account for 90% of all cases after excluding reversible causes

More information

FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS

FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS FRONTOTEMPORAL DEGENERATION: OVERVIEW, TRENDS AND DEVELOPMENTS Norman L. Foster, M.D. Director, Center for Alzheimer s Care, Imaging and Research Chief, Division of Cognitive Neurology, Department of Neurology

More information

Palliative Approach to the Person with Advanced Dementia

Palliative Approach to the Person with Advanced Dementia Mid North Coast Rural Palliative Care Project Link Nurse Education 2004 Palliative Approach to the Person with Advanced Dementia Anne Sneesby CNC - ACAT To care for the dying is a very human opportunity

More information

NCFE Level 2 Certificate in The Principles of Dementia Care

NCFE Level 2 Certificate in The Principles of Dementia Care The Principles of Dementia Care S A M P LE NCFE Level 2 Certificate in The Principles of Dementia Care Part A 1 These learning resources and assessment questions have been approved and endorsed by ncfe

More information

DEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease

DEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease What is PRESENTS DEMENTIA? WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: Memory Reasoning Planning Learning Attention Language Perception Behavior AS OF 2013 There

More information

Dementia: It s Not Always Alzheimer s

Dementia: It s Not Always Alzheimer s Dementia: It s Not Always Alzheimer s A Caregiver s Perspective Diane E. Vance, Ph.D. Mid-America Institute on Aging and Wellness 2017 My Background Caregiver for my husband who had Lewy Body Dementia

More information

Decline in Mental Capacity

Decline in Mental Capacity Decline in Mental Capacity Elder Law: Issues, Answers and Opportunities ALI-ABA, February 23-24, 2006 Robert B. Fleming 1 FLEMING & CURTI, P.L.C. 330 N. Granada Ave. Tucson, Arizona 85701 www.elder-law.com

More information

Prof Tim Anderson. Neurologist University of Otago Christchurch

Prof Tim Anderson. Neurologist University of Otago Christchurch Prof Tim Anderson Neurologist University of Otago Christchurch Tim Anderson Christchurch Insidious cognitive loss From subjective memory complaints (SMC) to dementia Case 1. AR. 64 yrs Male GP referral

More information

Delirium & Dementia. Nicholas J. Silvestri, MD

Delirium & Dementia. Nicholas J. Silvestri, MD Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural pathways relating to consciousness Encephalopathy Stupor Coma Dementia Delirium vs. Dementia Delirium Abrupt onset Lasts

More information

Dementia. Types of Dementia. Dementing Disorders. Concepts in the Evolution of Alzheimer s Disease and Treatment Approaches. Criteria for dementia:

Dementia. Types of Dementia. Dementing Disorders. Concepts in the Evolution of Alzheimer s Disease and Treatment Approaches. Criteria for dementia: Concepts in the Evolution of and Treatment Approaches Arnold Bakker, Ph.D. Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine Dementia Criteria for dementia: Memory

More information

Mental Health Counseling for mood, aging, and coping with life transitions and chronic illness.

Mental Health Counseling for mood, aging, and coping with life transitions and chronic illness. Mental Health Counseling for mood, aging, and coping with life transitions and chronic illness. Silver Linings for Seniors Silver Linings for Seniors, Inc. offers on-site confidential Mental Health Counseling

More information

Chapter 15: Late Life and Psychological Disorders

Chapter 15: Late Life and Psychological Disorders \ Chapter 15: Late Life and Psychological Disorders 1. Ageism refers to a. the physical deterioration that accompanies old age. b. the intellectual deterioration that frequently occurs as a person ages.

More information

Caring Sheet #13: Frontotemporal Dementia:

Caring Sheet #13: Frontotemporal Dementia: CARING SHEETS: Caring Sheet #13: Frontotemporal Dementia: A Summary of Information and Intervention Suggestions with an Emphasis on Cognition By Shelly E. Weaverdyck, PhD Introduction This caring sheet

More information

Dementia and cognitive decline

Dementia and cognitive decline Dementia and cognitive decline Expert Briefing Su Ray and Dr Susan Davidson Research Department Together, we can help everyone to love later life 01 Brain basics Normal ageing, cognitive impairment and

More information

Assessing and Managing the Patient with Cognitive Decline

Assessing and Managing the Patient with Cognitive Decline Assessing and Managing the Patient with Cognitive Decline Center of Excellence For Alzheimer s Disease for State of NY Capital Region Alzheimer s Center of Albany Medical Center Earl A. Zimmerman, MD Professor

More information

Seniors Helping Seniors September 7 & 12, 2016 Amy Abrams, MSW/MPH Education & Outreach Manager Alzheimer s San Diego

Seniors Helping Seniors September 7 & 12, 2016 Amy Abrams, MSW/MPH Education & Outreach Manager Alzheimer s San Diego Dementia Skills for In-Home Care Providers Seniors Helping Seniors September 7 & 12, 2016 Amy Abrams, MSW/MPH Education & Outreach Manager Alzheimer s San Diego Objectives Familiarity with the most common

More information

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey ALZHEIMER S DISEASE Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey Topics Covered Demography Clinical manifestations Pathophysiology Diagnosis Treatment Future trends Prevalence and Impact

More information

1 in 3 seniors dies with Alzheimer s or another dementia.

1 in 3 seniors dies with Alzheimer s or another dementia. 2013 Alzheimer s disease facts and figures Includes a Special Report on long-distance caregivers 1 in 3 seniors dies with Alzheimer s or another dementia. Out-of-pocket expenses for long-distance caregivers

More information

Diagnosis and Management of Mild Cognitive Impairment and Dementia in the Primary Care Setting. Meg Skibitsky MD, MPH Neurosciences Clinical Program

Diagnosis and Management of Mild Cognitive Impairment and Dementia in the Primary Care Setting. Meg Skibitsky MD, MPH Neurosciences Clinical Program Diagnosis and Management of Mild Cognitive Impairment and Dementia in the Primary Care Setting Meg Skibitsky MD, MPH Neurosciences Clinical Program Objectives Understand the difference between mild cognitive

More information

Dementia. Jeanette Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine

Dementia. Jeanette Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine Dementia Jeanette Norden, Ph.D. Professor Emerita Vanderbilt University School of Medicine What is Dementia? Dementia is a general term referring to a decline in cognitive/mental functioning; this decline

More information

The Basics of Alzheimer s Disease

The Basics of Alzheimer s Disease 2017 Memory Loss Conference The Basics of Alzheimer s Disease Tom Ala, MD Center for Alzheimer s Disease and Related Disorders Southern Illinois University School of Medicine Springfield, Illinois SIU

More information

Patterns of Cognitive Impairment in Dementia

Patterns of Cognitive Impairment in Dementia Patterns of Cognitive Impairment in Dementia Lindsay R. Clark, PhD Assistant professor (CHS) Department of Medicine - Division of Geriatrics & Gerontology UW-Madison School of Medicine & Public Health

More information

Delirium, Dementia, and Amnestic Disorders. Dr.Al-Azzam 1

Delirium, Dementia, and Amnestic Disorders. Dr.Al-Azzam 1 Delirium, Dementia, and Amnestic Disorders Dr.Al-Azzam 1 Introduction Disorders in which a clinically significant deficit in cognition or memory exists The number of people with these disorders is growing

More information

The progression of dementia

The progression of dementia PBO 930022142 NPO 049-191 The progression of dementia Although everyone experiences dementia in their own individual way, it can be helpful to think of the progression of dementia as a series of stages.

More information

Caring Sheet #2: Brain Changes and the Effects on

Caring Sheet #2: Brain Changes and the Effects on : Brain Changes and the Effects on Cognition By Shelly E. Weaverdyck, PhD Introduction This caring sheet describes the brain changes in dementia and the impact these changes have on cognition. It is the

More information

Mild Cognitive Impairment

Mild Cognitive Impairment Mild Cognitive Impairment Victor W. Henderson, MD, MS Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences Stanford University Director, Stanford Alzheimer s

More information

Old Age and Stress. Disorders of Aging and Cognition. Disorders of Aging and Cognition. Chapter 18

Old Age and Stress. Disorders of Aging and Cognition. Disorders of Aging and Cognition. Chapter 18 Disorders of Aging and Cognition Chapter 18 Slides & Handouts by Karen Clay Rhines, Ph.D. Northampton Community College Comer, Abnormal Psychology, 8e Disorders of Aging and Cognition Dementia deterioration

More information

United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline

United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline United Council for Neurologic Subspecialties Geriatric Neurology Written Examination Content Outline REV 3/24/09 The UCNS Geriatric Neurology examination was established to determine the level of competence

More information

Brain Health and Risk Factors for Dementia

Brain Health and Risk Factors for Dementia Welcome To Brain Health and Risk Factors for Dementia Presented by Kamal Masaki, MD Professor and Chair Department of Geriatric Medicine John A. Burns School of Medicine, UH Manoa April 4, 2018 10:00 11:00

More information

The Frontal Lobes. Anatomy of the Frontal Lobes. Anatomy of the Frontal Lobes 3/2/2011. Portrait: Losing Frontal-Lobe Functions. Readings: KW Ch.

The Frontal Lobes. Anatomy of the Frontal Lobes. Anatomy of the Frontal Lobes 3/2/2011. Portrait: Losing Frontal-Lobe Functions. Readings: KW Ch. The Frontal Lobes Readings: KW Ch. 16 Portrait: Losing Frontal-Lobe Functions E.L. Highly organized college professor Became disorganized, showed little emotion, and began to miss deadlines Scores on intelligence

More information

GERIATRIC MENTAL HEALTH AND MEDICATION TREATMENT

GERIATRIC MENTAL HEALTH AND MEDICATION TREATMENT Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences GERIATRIC MENTAL HEALTH AND MEDICATION TREATMENT RUTH KOHEN ASSOCIATE PROFESSOR UW DEPARTMENT OF PSYCHIATRY 5-4-2017

More information

Patterns of Cognitive Impairment in Dementia

Patterns of Cognitive Impairment in Dementia Patterns of Cognitive Impairment in Dementia Lindsay R. Clark, PhD Assistant professor (CHS) Department of Medicine - Division of Geriatrics & Gerontology UW-Madison School of Medicine & Public Health

More information

Confronting the Clinical Challenges of Frontotemporal Dementia

Confronting the Clinical Challenges of Frontotemporal Dementia Confronting the Clinical Challenges of Frontotemporal Dementia A look at FTD s symptoms, pathophysiology, subtypes, as well as the latest from imaging studies. By Zac Haughn, Senior Associate Editor Ask

More information

In-Service Education. workbook 3. by Hartman Publishing, Inc. second edition

In-Service Education. workbook 3. by Hartman Publishing, Inc. second edition In-Service Education workbook 3 second edition by Hartman Publishing, Inc. Alzheimer s Disease Dignity Diabetes Restraints and Restraint Alternatives Abuse and Neglect Death and Dying Managing Stress Perf

More information

Is it Alzheimer s or Another Dementia? Reversible dementias. Key Points. Delirium. Toxic reactions to drugs

Is it Alzheimer s or Another Dementia? Reversible dementias. Key Points. Delirium. Toxic reactions to drugs Is it Alzheimer s or Another Dementia? Bonus Article for HELPGUIDE.ORG from Harvard Health Publications For physicians and families intent on pinning down a diagnosis, one major complicating factor is

More information

Alzheimer's disease (AD), also known as Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer s is the most common form of dementia.

Alzheimer's disease (AD), also known as Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer s is the most common form of dementia. CHAPTER 3 Alzheimer's disease (AD), also known as Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer s is the most common form of dementia. This incurable, degenerative, terminal disease

More information

Scams: Influencing the Aging Brain

Scams: Influencing the Aging Brain Neuropsychology: study of the brain and how it relates to cognition, emotion, and behavior Neuropsychological Assessment: a comprehensive evaluation of how the brain is functioning. Examines cognitive

More information

Fact Sheet Alzheimer s disease

Fact Sheet Alzheimer s disease What is Alzheimer s disease Fact Sheet Alzheimer s disease Alzheimer s disease, AD, is a progressive brain disorder that gradually destroys a person s memory and ability to learn, reason, make judgements,

More information

What is Neuropsychology?

What is Neuropsychology? Alzheimer s Disease Neurological Bases and Informed Behavioral Interventions Peter T. Keenan Clinical Neuropsychologist Marshfield Clinic Minocqua Center What is Neuropsychology? Science of the relationship

More information

LANGUAGE IN INDIA Strength for Today and Bright Hope for Tomorrow Volume 8 : 2 February 2008

LANGUAGE IN INDIA Strength for Today and Bright Hope for Tomorrow Volume 8 : 2 February 2008 LANGUAGE IN INDIA Strength for Today and Bright Hope for Tomorrow Volume 8 : 2 February 2008 Managing Editor: M. S. Thirumalai, Ph.D. Editors: B. Mallikarjun, Ph.D. Sam Mohanlal, Ph.D. B. A. Sharada, Ph.D.

More information

MANAGING YOUR COGNITIVE SYMPTOMS. Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director

MANAGING YOUR COGNITIVE SYMPTOMS. Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director MANAGING YOUR COGNITIVE SYMPTOMS Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director The information provided by speakers in workshops, forums, sharing/networking sessions and any

More information

Biomarkers: Translating Research into Clinical Practice

Biomarkers: Translating Research into Clinical Practice Biomarkers: Translating Research into Clinical Practice AFTD Education Conference San Diego, April 2015 Nadine Tatton, PhD Scientific Director, AFTD HelpLine 866-5507-7222 u info@theaftd.org u www.theaftd.org

More information

Moving Targets: An Update on Diagnosing Dementia in the Clinic

Moving Targets: An Update on Diagnosing Dementia in the Clinic Moving Targets: An Update on Diagnosing Dementia in the Clinic Eric McDade DO Department of Neurology School of Medicine Alzheimer Disease Research Center Disclosures No relevant financial disclosures

More information

What is dementia? Symptoms. alzheimers.org.uk

What is dementia? Symptoms. alzheimers.org.uk alzheimers.org.uk What is dementia? This factsheet explains what dementia is, including the causes and symptoms, and how it is diagnosed and treated. It also looks at some of the different types of dementia.

More information

What is dementia? alzheimers.org.uk

What is dementia? alzheimers.org.uk alzheimers.org.uk What is dementia? If you, or a friend or relative, have been diagnosed with dementia, you may be feeling anxious or confused. You may not know what dementia is. This factsheet should

More information

Managing Behaviors: Start with Yourself!

Managing Behaviors: Start with Yourself! Slide 1 Managing Behaviors: Start with Yourself! Teepa Snow, Positive Approach, LLC to be reused only with permission. Slide 2 Time Out Signal copyright - Positive Approach, LLC 2012 Slide 3 REALIZE It

More information

Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana

Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana Roger E. Kelley, M.D. Professor and Chairman Department of Neurology Tulane University School of Medicine New Orleans, Louisiana FINANCIAL DISCLOSURE No potential conflict of interest to disclose. OBJECTIVES

More information

A BRIEF LOOK AT DEMENTIA

A BRIEF LOOK AT DEMENTIA Dementia A BRIEF LOOK AT DEMENTIA David Kaufman, MD Neurology Consultants of Bellin Health November 2, 2017 Defined as a progressive decline in cognitive function that impairs daily activities. Always

More information

DEMENTIA 9/29/16. Introduction. Introduction. Signs and Symptom. Epidemiology. Dementia. Dr. Yotin Chinvarun M.D. Ph.D.

DEMENTIA 9/29/16. Introduction. Introduction. Signs and Symptom. Epidemiology. Dementia. Dr. Yotin Chinvarun M.D. Ph.D. Introduction DEMENTIA Dr. Yotin Chinvarun M.D. Ph.D. Neurology, Pramongkutklao hospital In 1901 Auguste Deter, a woman in her early 50s, became 1 st person diagnosed with Alzheimer's disease, a form of

More information

Brain-based disorders in children, teens, and young adults: When to know there is a problem and what to do

Brain-based disorders in children, teens, and young adults: When to know there is a problem and what to do Brain-based disorders in children, teens, and young adults: When to know there is a problem and what to do Timothy A. Fratto, Ph.D. Neuropsychology Associates of Fairfax What is Neuropsychology? The study

More information

A Personal Guide to Organic Brain Disorders

A Personal Guide to Organic Brain Disorders A Personal Guide to Organic Brain Disorders What is Dementia? Dementia is the decline of cognitive functions of sufficient severity to interfere with two or more of a person s daily living activities.

More information

Epilepsy in dementia. Case 1. Dr. Yotin Chinvarun M..D. Ph.D. 5/25/16. CEP, PMK hospital

Epilepsy in dementia. Case 1. Dr. Yotin Chinvarun M..D. Ph.D. 5/25/16. CEP, PMK hospital Epilepsy in dementia Dr. Yotin Chinvarun M..D. Ph.D. CEP, PMK hospital Case 1 M 90 years old Had a history of tonic of both limbs (Lt > Rt) at the age of 88 years old, eye rolled up, no grunting, lasting

More information

The Impact of Ageing & Dementia for People with Down Syndrome. Evelyn Reilly Clinical Nurse Specialist Dementia

The Impact of Ageing & Dementia for People with Down Syndrome. Evelyn Reilly Clinical Nurse Specialist Dementia The Impact of Ageing & Dementia for People with Down Syndrome Evelyn Reilly Clinical Nurse Specialist Dementia We need to support a rapidly expanding older population with Down syndrome. Ageing & Down

More information

Neuropsychiatric Manifestations in Vascular Cognitive Impairment Patients with and without Dementia

Neuropsychiatric Manifestations in Vascular Cognitive Impairment Patients with and without Dementia 86 Neuropsychiatric Manifestations in Vascular Cognitive Impairment Patients with and without Dementia Pai-Yi Chiu 1,3, Chung-Hsiang Liu 2, and Chon-Haw Tsai 2 Abstract- Background: Neuropsychiatric profile

More information

homeinstead.com Each Home Instead Senior Care franchise office is independently owned and operated Home Instead, Inc.

homeinstead.com Each Home Instead Senior Care franchise office is independently owned and operated Home Instead, Inc. Each Home Instead Senior Care franchise office is independently owned and operated. 2010 Home Instead, Inc. homeinstead.com Many of us may joke about having old timers disease, but when cognitive impairment

More information

The Neurobiology of Attention

The Neurobiology of Attention The Neurobiology of Attention by Nadia Fike, MD/PhD Pediatric Neurology Center for Neurosciences Disclosures Nadia Fike, MD/PhD No relevant financial or nonfinancial relationships to disclose. Objectives

More information

Know the 10 Signs: Early Detection Matters

Know the 10 Signs: Early Detection Matters Importance of Early Detection Know the 10 Signs: Early Detection Matters If we could have had a correct diagnosis even two years earlier, it would have given us more time to plan, to do the things that

More information

Know the 10 Signs: Early Detection Matters

Know the 10 Signs: Early Detection Matters Know the 10 Signs: Early Detection Matters 1 Importance of Early Detection If we could have had a correct diagnosis even two years earlier, it would have given us more time to plan, to do the things that

More information

The progression of Alzheimer s disease and other dementias

The progression of Alzheimer s disease and other dementias The progression of Alzheimer s disease and other dementias Factsheet 458LP April 2015 Each person experiences dementia in their own way, but the way the condition progresses can be seen as a series of

More information

The PD You Don t See: Cognitive and Non-motor Symptoms

The PD You Don t See: Cognitive and Non-motor Symptoms The PD You Don t See: Cognitive and Non-motor Symptoms Benzi M. Kluger, M.D., M.S. Associate Professor of Neurology and Psychiatry Director Movement Disorders Center University of Colorado Denver Goals

More information

Mental Health Disorders Civil Commitment UNC School of Government

Mental Health Disorders Civil Commitment UNC School of Government Mental Health Disorders 2017 Civil Commitment UNC School of Government Edward Poa, MD, FAPA Chief of Inpatient Services, The Menninger Clinic Associate Professor, Baylor College of Medicine NC statutes

More information

Piano playing skills in a patient with frontotemporal dementia: A longitudinal case study

Piano playing skills in a patient with frontotemporal dementia: A longitudinal case study International Symposium on Performance Science ISBN 978-94-90306-01-4 The Author 2009, Published by the AEC All rights reserved Piano playing skills in a patient with frontotemporal dementia: A longitudinal

More information

Dementia. Memory Evaluation Center Neurology

Dementia. Memory Evaluation Center Neurology Dementia Memory Evaluation Center Neurology Topics Overview of dementia Stages Medications Advanced planning What is Dementia? Dementia = significant global decline in cognitive function not due to medicine

More information

Alzheimer s disease is an

Alzheimer s disease is an Alzheimer s Disease FACT SHEET Alzheimer s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest

More information

Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases

Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases Keith A. Josephs, MD, MST, MSc Professor of Neurology 13th Annual Mild Cognitive Impairment (MCI) Symposium: Alzheimer and Non-Alzheimer

More information

Erin Cullnan Research Assistant, University of Illinois at Chicago

Erin Cullnan Research Assistant, University of Illinois at Chicago Dr. Moises Gaviria Distinguished Professor of Psychiatry, University of Illinois at Chicago Director of Consultation Liaison Service, Advocate Christ Medical Center Director of the Older Adult Program,

More information

Objectives. My Patient: The story 10/6/2017

Objectives. My Patient: The story 10/6/2017 Objectives Our Grey Matter Matters: A Case in Point Vivien Brown MDCM, CCFP,FCFP, NCMP Assistant Professor, University of Toronto Vice President, Medical Affairs, Medisys Healthy Group Past President,

More information

What is frontotemporal dementia?

What is frontotemporal dementia? What is frontotemporal dementia? Introduction Information in this introductory booklet is for anyone who wants to know more about frontotemporal dementia (FTD). This includes people living with FTD, their

More information

CSE511 Brain & Memory Modeling Lect 22,24,25: Memory Systems

CSE511 Brain & Memory Modeling Lect 22,24,25: Memory Systems CSE511 Brain & Memory Modeling Lect 22,24,25: Memory Systems Compare Chap 31 of Purves et al., 5e Chap 24 of Bear et al., 3e Larry Wittie Computer Science, StonyBrook University http://www.cs.sunysb.edu/~cse511

More information

Clinical Research on Treating Senile Dementia by Combining Acupuncture with Acupoint-Injection

Clinical Research on Treating Senile Dementia by Combining Acupuncture with Acupoint-Injection Clinical Research on Treating Senile Dementia by Combining Acupuncture with Acupoint-Injection Yemeng Chen, M.D. Acupuncture Department, Huashan Hospital Shanghai Medical University, Shanghai 20040, P.

More information

Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for Clinical Practice. Hypothesized Key Players in the Pathogenesis of AD

Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for Clinical Practice. Hypothesized Key Players in the Pathogenesis of AD AD is a Neurodegenerative Disease as Seen in the PET Scan and is Characterized by Amyloid Plaques and Neurofibrillary Tangles Mild Cognitive Impairment or Mild Neurocognitive Disorder: Implications for

More information

Stroke School for Internists Part 1

Stroke School for Internists Part 1 Stroke School for Internists Part 1 November 4, 2017 Dr. Albert Jin Dr. Gurpreet Jaswal Disclosures I receive a stipend for my role as Medical Director of the Stroke Network of SEO I have no commercial

More information

Making a difference together: Understanding dementia

Making a difference together: Understanding dementia Making a difference together: Understanding dementia Dan Herron, PhD candidate Centre for Psychological Research Keele University Email: d.l.herron@keele.ac.uk About this PowerPoint This PowerPoint contains

More information

Parkinson s Disease in the Elderly A Physicians perspective. Dr John Coyle

Parkinson s Disease in the Elderly A Physicians perspective. Dr John Coyle Parkinson s Disease in the Elderly A Physicians perspective Dr John Coyle Overview Introduction Epidemiology and aetiology Pathogenesis Diagnosis and clinical features Treatment Psychological issues/ non

More information

How to Diagnose Early (Prodromal) Lewy Body Dementia. Ian McKeith MD, FRCPsych, F Med Sci.

How to Diagnose Early (Prodromal) Lewy Body Dementia. Ian McKeith MD, FRCPsych, F Med Sci. How to Diagnose Early (Prodromal) Lewy Body Dementia Ian McKeith MD, FRCPsych, F Med Sci. Parkinson s Disease Lewy Body Disease Time PD Dementia Lewy Body Dementias Dementia with Lewy Bodies (DLB) Diagnostic

More information

Lecture Three: Pain and Mood It s a Brain Thing

Lecture Three: Pain and Mood It s a Brain Thing Lecture Three: Pain and Mood It s a Brain Thing 1 Pain and Mood: Who is to blame? People are often blamed for their persistent pain due to their depressed and anxious mood Which came first the pain or

More information

Regulatory Challenges across Dementia Subtypes European View

Regulatory Challenges across Dementia Subtypes European View Regulatory Challenges across Dementia Subtypes European View Population definition including Early disease at risk Endpoints in POC studies Endpoints in pivotal trials 1 Disclaimer No CoI The opinions

More information

The PD You Don t See: Cognitive Symptoms. Joanne M. Hamilton, PhD, ABPP Clinical Neuropsychologist Division of Neurology Scripps Health

The PD You Don t See: Cognitive Symptoms. Joanne M. Hamilton, PhD, ABPP Clinical Neuropsychologist Division of Neurology Scripps Health The PD You Don t See: Cognitive Symptoms Joanne M. Hamilton, PhD, ABPP Clinical Neuropsychologist Division of Neurology Scripps Health OBJECTIVES To understand why cognitive changes occur in a motor disease

More information

DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017.

DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017. DEMENTIA and BPSD in PARKINSON'S DISEASE. DR. T. JOHNSON. NOVEMBER 2017. Introduction. Parkinson's disease (PD) has been considered largely as a motor disorder. It has been increasingly recognized that

More information

To help you prepare for your doctor's visit, the Alzheimer Society has developed the following list:

To help you prepare for your doctor's visit, the Alzheimer Society has developed the following list: The Alzheimer Society has a tool kit to help you prepare for a conversation with your doctor or health provider about your concerns and questions about a possible dementia diagnosis. Symptoms of dementia

More information

Alzheimer's Disease, Prevalence, and Caregiving

Alzheimer's Disease, Prevalence, and Caregiving Alzheimer's Disease, Prevalence, and Caregiving Specific information in this year s Alzheimer s Disease Facts and Figures includes: Proposed guidelines for diagnosing Alzheimer s disease from the National

More information

Inception, Total Recall, & The Brain: An Introduction to Neuroscience Part 2. Neal G. Simon, Ph.D. Professor Dept. of Biological Sciences

Inception, Total Recall, & The Brain: An Introduction to Neuroscience Part 2. Neal G. Simon, Ph.D. Professor Dept. of Biological Sciences Inception, Total Recall, & The Brain: An Introduction to Neuroscience Part 2 Neal G. Simon, Ph.D. Professor Dept. of Biological Sciences http://www.youtube.com/watch?v=wfmlgeh dije Summary from September

More information

Language After Traumatic Brain Injury

Language After Traumatic Brain Injury Chapter 7 Language After Traumatic Brain Injury 10/24/05 COMD 326, Chpt. 7 1 1 10/24/05 COMD 326, Chpt. 7 2 http://www.californiaspinalinjurylawyer.com/images/tbi.jpg 2 TBI http://www.conleygriggs.com/traumatic_brain_injury.shtml

More information

Navigating The Cognitive Internet: Introduction. Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System

Navigating The Cognitive Internet: Introduction. Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System Navigating The Cognitive Internet: Introduction Wendy Lemere DNP, GNP-BC Gerontological Nurse Practitioner Henry Ford Health System What s so hard about diagnosing dementia? Diagnosis relies on synthesis

More information

Dementia is not normal aging!

Dementia is not normal aging! The Future of Alzheimer s Disease Treatment Adam L. Boxer, MD, PhD Director, Alzheimer s Disease Clinical Trials Program Memory and Aging Center Assistant Professor of Neurology University of California,

More information

Presenter Disclosure Information. I have no financial relationships to disclose:

Presenter Disclosure Information. I have no financial relationships to disclose: Sandra Weintraub, Ph.D. Cognitive Neurology and Alzheimer s Disease Center Northwestern University, Feinberg School of Medicine Chicago, Illinois http://www.brain.northwestern.edu/dementia/ppa/index.html

More information

T1: RESOURCES TO ADDRESS THE NEEDS OF PERSONS WITH DEMENTIA AND THEIR CAREGIVERS 2014 GOVERNOR S CONFERENCE ON AGING AND DISABILITY

T1: RESOURCES TO ADDRESS THE NEEDS OF PERSONS WITH DEMENTIA AND THEIR CAREGIVERS 2014 GOVERNOR S CONFERENCE ON AGING AND DISABILITY T1: RESOURCES TO ADDRESS THE NEEDS OF PERSONS WITH DEMENTIA AND THEIR CAREGIVERS 2014 GOVERNOR S CONFERENCE ON AGING AND DISABILITY Melanie Chavin, MNA, MS Alzheimer s Association, Greater Illinois Chapter

More information