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By Cait Kearney

In 2013, Sarah was diagnosed with dementia caused by Alzheimer’s disease. In the years to follow, Sarah’s communication skills declined, and she stopped interacting with people. Occasionally, when looking at her image in the mirror, she would mumble a few incomprehensible sounds, but otherwise she didn’t speak.

Twice, Sarah did something that startled her family — she suddenly began saying words that were recognizable. She clearly said to her husband, on two occasions, “I’m scared. I want you to come with me.”

Shaken by the experience, he sought advice from Sarah’s physician.

These moments of sudden, clear communication in someone with progressive neurodegenerative disease, like those detailed by Sarah’s family, are episodes of what researchers call “paradoxical lucidity.”

“A person seems to be lost to their disease, but then there’s this unexpected and fleeting spark of clarity,” said Andrew Peterson, PhD, MA, a philosopher for the Penn Program on Precision Medicine for the Brain (P3MB) who studies paradoxical lucidity. “It could transform the way we think about dementia.”

By Alison Lynn, PMC associate director of social work

There was a time when it felt shameful to tell someone you go to therapy. Luckily, over the past few decades, it’s become increasingly normal to be open about ones need for professional support. Particularly post-pandemic, it is impossible to scroll through Instagram without seeing some kind of infographic or inspirational story related to mental health. But, despite this wealth of new information, many still don’t know what actually happens at therapy in enough detail to decide whether it might be helpful for them. What happens in the treatment room (or, on Zoom) can feel mysterious and intimidating.

In this two-part series, I’ll explain how to get started and what to expect from a first session, as well as how therapy can specifically help individuals with Alzheimer’s disease and their family caregivers.

On January 11, the Centers for Medicare and Medicaid Services (CMS) announced its much-anticipated coverage proposal for monoclonal antibody treatments that target amyloid for the treatment of Alzheimer’s disease. According to the proposed policy, this class of drugs, which includes aducanumab, also known by the brand name Aduhelm, would be covered for people with Medicare only if they are enrolled in qualifying clinical trials.

Penn Memory Center (PMC) Co-Director Jason Karlawish, MD, joined the Dementia Matters podcast to discuss the recent proposal, share his reaction to the decision, and tell you how this coverage policy could impact the development of other Alzheimer’s disease treatments in the future.

Discrimination, mistrust of medical professionals, and other barriers have caused Black and African Americans to be underrepresented among Alzheimer’s disease and related dementias (ADRD) researchers and research participants.

Increasing the representation of Black and African Americans in ADRD research is essential to developing treatments and providing quality care.

Learn more about three featured researchers at PMC who are breaking boundaries and working to advance equity in ADRD research.

Estevana Isaac

Estevana Isaac, MD
Role at PMC: Clinical fellow
Research interest: Disparities in health outcomes for patients with diverse cultural backgrounds

“As a clinical doctor, in addition to providing medical and social support to meet daily needs, I will continue to educate the public, patients, and caregivers to ensure safer environments. As a health services researcher, I intend to focus on solutions to better coordinate care and decrease costs for vulnerable patient populations as such. As a Black woman, I expect that my presence in these arenas continues to decrease biases and open more doors for diverse persons and perspectives, ultimately changing the face of healthcare.”

This past summer, Penn’s Alzheimer’s Disease Research Center (ADRC) held its inaugural session of the Aging Research Summer Internship.

Interns experienced hands-on research in laboratories across the ADRC and day-to-day activities and projects in various areas of the Penn Memory Center, such as communications, social work, clinical care, and neuropsychological testing.

“[The Aging Summer Research Internship] has been so enriching. It will help me towards my goal of becoming a psychiatrist,” said student intern Lorette Thomas.

Interns were paired with a mentor — a faculty member who provided support and guidance throughout the program — and assisted the mentor with their research.

By Daniel Gibbs, MD, retired neurologist and author, and Jason Karlawish, MD, co-director of the Penn Memory Center, geriatrician, and author

Both of us are physicians dedicated to the care of persons living with Alzheimer’s disease. We’ve heard thousands of moving stories from persons struggling with a fading capacity to exercise their free will and their friends and family members devoting time, effort, and resources to care for them. We feel their desperation.  

For one of us, this feeling isn’t simply professional. It’s intensely personal. Nine years ago, Dan retired from practicing neurology because of mild cognitive impairment (MCI) caused by Alzheimer’s disease.   

We wish we could have celebrated in June, when the Food and Drug Administration (FDA) approved Biogen’s drug aducanumab, marketed as Aduhelm, for the treatment of Alzheimer’s disease. We wish we were now condemning the Centers for Medicare and Medicaid Services (CMS) for its recent proposal to limit coverage of the drug to patients enrolled in a clinical trial of Aduhelm, known as “coverage with evidence development.” Instead, we weren’t celebrating in June, and now we thank Medicare for its courageous and reasonable proposal.