Psychiatry Newsletter - Synergy At Last
Synergy At Last
Date: March 11, 2009
The latest research meets coordinated dementia care.
Hopkins’ Memory and Alzheimer’s Treatment Center is new, just opened last fall, and it’s something of a phoenix—having risen, not out of ashes, but from a welter of clinics, patient units and research projects across three departments and as many campuses. “We kept bumping into each other while Alzheimer’s explodes as a public health problem,” says Constantine Lyketsos, director of the center. Yet with ample clinic space now available on Hopkins’ Bayview campus and funding freed up, the value of sharing what’s best became amazingly obvious.
While the center still spans Hopkins Hospital, Bayview Medical Center and The Copper Ridge Institute in Sykesville, it now pools expertise. Diagnosis, therapy, dementia care—as outpatient, intermediate or long-term—and experience in educating caregivers continue but without duplication.
Benefits to research are clear. “If you see enough patients under clinical care—our objective for next year is 1,000—a substantial number enter studies, raising our ability to find cures,” Lyketsos explains. But the new center isn’t research-driven, he points out. “We offer a continuum of care from diagnosis to death whether or not patients are in a research protocol. We’re likely unique in the extent of that. Our studies are grounded, however, in that top-shelf clinical care.”
What Lyketsos calls “little pieces of added value” are typical:
• When an Alzheimer’s diagnosis is especially difficult, center clinicians apply advanced imaging techniques originally developed for research. Working with radiologists, they’ve developed a dementia-specific protocol for the 3 Tesla MRI scanner. The scanner’s high magnetic field strong-arms needed resolution into images—enough, for example, to detect microbleeds that underlie some dementia. Combining this with more traditional PET scans brings a new capability to expose brain damage. Combined MRI and PET make diagnosis more trustworthy.
• With Alzheimer’s being a most demanding disease, ongoing care is hard to do well. Years of research and patient contact has let center staff develop the Johns Hopkins Dementia Care Needs Assessment, an 86-item checklist and explanatory manual: Is it time to stop driving? Are you on too many medications? Are guns in the house? The approach keeps patients and caregivers from falling through the cracks.