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PMC neuropsychologist receives grant for goal-directed behavior app

Dawn Mechanic-Hamilton, PhD, ABPP/CN

By Erin Alessandroni

Penn Memory Center Director of Cognitive Fitness Programs and Neuropsychological Services Dawn Mechanic-Hamilton, PhD, ABPP/CN, recently received an Institute on Aging (IOA) pilot grant for a project focused on apathy in patients with neurodegenerative disease. The grant for her project, titled “Development of a Goal-Directed Behavior App: Changing Apathy into Action in Neurodegenerative Disease,” began on July 1.

In dementia patients, apathy, or impairment of goal-directed behavior, is a symptom that has a significant negative impact on a patient’s ability to engage in everyday activities and can increase care partner burden. The project aims to develop a mobile app that will increase goal-directed behavior and decrease apathy by targeting behaviors like motivation, planning, and initiation, with an emphasis on individualized patient goals. The app will measure progress and outcomes for both the patient and care partner.

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Best practices for clinical Alzheimer’s treatment developed

Adapted from an Alzheimer’s Association statement.

There are no universal, multidisciplinary guidelines for clinicians in Alzheimer’s (AD) care, often leading to symptoms going unrecognized or misattributed.

In response, the Alzheimer’s Association convened a group dedicated to creating best practices for clinicians. This group, which includes PMC Co-Director Jason Karlawish, MD, intends for these guidelines to improve timely and accurate diagnosis and disclosure of AD and other dementias, according to an Alzheimer’s Association press release.

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Public fears discrimination in workplace, medical setting for people with Alzheimer’s disease

Shana Stites, PsyD, MA, MS

Adapted from Alzheimer’s Association press release.

Many individuals worry that an Alzheimer’s disease diagnosis will lead to discrimination in the workplace and exclusion in the medical setting, according to Penn Memory Center research. These perceptions may prevent someone from going to the doctor to get the care they need, or from participating in clinical trials needed to advance Alzheimer’s disease research and care.

At PMC, clinical psychologist and researcher Dr. Shana Stites led a team to look at responses from a general public survey featuring descriptions about a man named “Mr. Andrews.” In one version of the survey that went to 317 randomly selected respondents, Mr. Andrews went to the doctor’s office complaining of memory problems and was diagnosed with Alzheimer’s disease. (Other versions had Mr. Andrews diagnosed traumatic brain injury, or not diagnosed with anything at all.)

Respondents were then asked questions about Mr. Andrews. More than half of respondents expected him to face workplace discrimination (55.3%) and to be excluded from medical decision-making (55.3%). Nearly half also thought his health insurance would be limited due to information about his diagnosis being placed in his medical record (46.6%) or based on the result of a test, such as a brain imaging scan (45.6%) or genetic test (44.7%).

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Learning Your Alzheimer’s Risk: Implications for Long-Term Care Insurance

by Puja Upadhyay
Leonard Davis Institute of Health Economics 

Jason Karlawish, MD is Co-Director of the Penn Memory Center; Allison Hoffman, JD is a Professor of Law at Penn.

In the not-too-distant future, individuals may be able to learn their risk of developing Alzheimer’s disease through biomarkers – measures of disease activity – detected up to 20 years before symptoms present. This information would allow individuals (and their loved ones) to prepare for future cognitive and functional decline, but it also has implications for the purchase of private long-term care insurance. In the Journal of Law, Medicine, & Ethics, Jalayne Arias, Jason Karlawish, and colleagues analyze whether, under current state laws, insurers could use biomarkers to deny coverage; in a companion commentary, Allison Hoffman places these findings in a larger context of a failing private market for long-term care insurance, and uses the study to make a case for social insurance for long-term care (LTC).

Individuals with Alzheimer’s disease and related dementias are among the most intensive users of long-term services and supports (LTSS) that help with “activities of daily living,” such as eating or bathing. These services are not considered “medical care” as defined in federal legislation regulating health plans; instead, they are regulated by the states. Medicare and private health insurance do not cover most LTSS, except in limited ways after hospitalization. LTSS are financed primarily by Medicaid (62 percent), individual out of pocket spending (22 percent), and private LTC insurance (12 percent).

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Wide breadth of PMC research on display at 2018 AAIC meeting

By Erin Alessandroni

Penn Memory Center researchers and their collaborators will have prominent spots at this year’s Alzheimer’s Association International Conference (AAIC), an annual research conference hosted by the Alzheimer’s Association.

International investigators, clinicians, and researchers will come together July 22 to 26 in Chicago to share the latest study results, theories, and discoveries to help bring the world closer to breakthroughs in dementia science.

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New summit sets national recommendations for caregiving research

By Kaleah McIlwain

For someone living with dementia, performing everyday tasks like managing money, cooking, or driving presents a challenge. This challenge is lessened with the help of caregivers.

Caregivers provide intensive support to persons with dementia which can be a 24/7 responsibility that they take-on in addition to their own obligations. Caregivers can be spouses, children, parents, or friends who are helping someone they care about, often times with little thought to how it impacts their own emotional and physical health.

Caregivers experience symptoms of depression and anxiety and have feelings of anger, sadness, and frustration. Becoming a caregiver is a great responsibility and it is important to remember that caregivers need to take care of themselves in order to be able to take care of others.

This is what prompted the creation of the National Research Summit on Care, Services, and Supports for Persons with Dementia and their Caregivers last year. The goal of the summit was to discuss research related to dementia patients and their caregivers to identify what they know and do not know in order to accelerate the development, evaluation, and implementation of comprehensive care, services, and supports for people with dementia, their families, and caregivers.

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PMC patient Carl Duzen featured on local news channel for his creation of copper art

Penn Memory Center patient Carl Duzen and his wife Susan Jewett were featured on 6abc news channel last week for copper art, which Mr. Duzen creates from taking apart old electronics. This was a hobby he adopted as a coping mechanism after his Alzheimer’s disease diagnosis at PMC a few years ago. What started out as just a hobby of taking apart discarded TVs turned into an art exhibit after Ms. Jewett, who is also an artist, began to frame the work Mr. Duzen created. 

Mr. Duzen and Ms. Jewett with PMC Co-Directors Dr. David Wolk and Dr. Jason Karlawish at his exhibition opening. (Terrence Casey / Penn Memory Center)

Mr. Duzen’s copper art is currently featured in PMC’s ‘Art of the Mind’ exhibition. The grand opening was in early May when a group of the couple’s close friends and members of the PMC community gathered to celebrate his work.

“Carl Duzen: Shaping Copper, Making Meaning” will be on display outside the Penn Memory Center clinic until late October. Guests can view the exhibition during regular business hours by entering the Perelman Center for Advanced Medicine through the main doors, taking the elevator to the second floor, and following the hallway to the South Pavilion.

Research Nurse Marianne Watson says goodbye after 25 years at PMC

By Kaleah McIlwain 

Marianne Watson, RN, who has served the Penn Memory Center as senior research nurse since its inception 25 years ago, is retiring in July.

Felicia Greenfield, LCSW, executive director of PMC, made the announcement at the 2018 Research Partner Thank You Luncheon. News of Ms. Watson’s pending departure was met with a mix of saddened cries — “no!” and “don’t go!” — cheers of congratulations, and nostalgia.

Ms. Watson announces her retirement at the PMC Thank You Luncheon. (Terrence Casey / Penn Memory Center)

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July Memory Café to feature ‘The Red Letter Locker’ by Beacon Theatre Productions

Penn Memory Center’s July Memory Café will feature Beacon Theatre Productions, who will be putting on an interactive performance of “The Red Letter Locker.” “The Red Letter Locker” is a short play about Arthur Conan Doyle traveling to 2018 through a time machine and ending up in a Philadelphia high school.

Join the Penn Memory Center in welcoming them:

Friday, July 13 | 10:30 a.m. to noon
Christ Church Neighborhood House
20 N. American Street
Philadelphia, PA 19106

To RSVP, contact Alison Lynn at 215-360-0257 or alison.lynn@uphs.upenn.edu.

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Karlawish: How do we distinguish dementia from normal signs of aging?

By: Erin Alessandroni

As we age, it is common to occasionally have trouble finding words or experience a lapse in memory. The question is when those lapses become disruptive enough to indicate the need for a doctor’s assessment of our cognitive abilities.

To help individuals distinguish dementia from normal signs of aging, Penn Memory Center Co-Director Jason Karlawish, MD cites some common signs that often signify true cognitive decline in his latest article published by AARP.

Dr. Karlawish speaking on money management and cognitive decline at a recent Wharton School event. (Photo by SIFMA.)

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