REACHING RURAL COMMUNITIES WITH ALZHEIMER'S EDUCATION

An estimated 4 million Americans suffer from dementia of the Alzheimer's
type and the prevalence of the disorder increases dramatically as a
function of age. Research efforts over the last two decades have
carefully characterized the clinical syndrome and the disorders that
mimic this process so that an evaluation following National Institute of
Neurological and Communicable Disease criteria results in clinical
diagnoses which will be 80-90% accurate at autopsy. Research has also
produced insights into the genetics, potentially important epidemiologic
factors, neurochemistry and neuropathology. Treatment modalities on
promising agents that either halt progression or reverse deficits are in
clinical trials. Research has also addressed the effect of the disease
on caregivers, their risk for depression and the burden of providing care
to Alzheimer's Disease (AD) victims. In spite of major advances in
knowledge on the disease and its effects on caregivers, the standard of
community care for AD lags far behind current knowledge. The purpose of
this proposal is to develop a model community outreach program which
could be broadly disseminated to other rural and frontier states. In
this project the University of Nebraska Medical Center (UNMC) will
disseminate state-of-the-art knowledge on detection, diagnosis,
treatment, management, and family care of AD to community professionals
and organizations in conjunction with the Nebraska Chapters of the
Alzheimer's Association. Nebraskans over the age of 65 comprise 14.1% of
the state's population and the proportion of those also over the age of
85 is among the highest in the United States. It is the group over 85
years of age that is at highest risk for AD. Problems of both diagnosis
and family care are complicated by geographic distance from knowledgeable
health providers and family members. The present proposal will address
these issues through: (1) improving physician knowledge of detection and
appropriate evaluation; (2) development of 8 regional Dementia Assessment
and Treatment Sites (DATS) to assist health professionals and families
with diagnosis and planning; (3) education of health professionals in
care of dementia patients and support of their families; and (4) public
education on dementing disorders. The project is designed to establish
systems for education and support that will persist beyond the project
period.