Health and Disability

from Info Long-Term Care: 


This tool was developed by the State of Wisconsin, Department of Health and Family Services, Division of Disability and Elder Services to be used as a guide for identifying the elements involved in implementing a person-directed dementia care.

The nine sections of the tool examine specific areas of focus vital in providing person centred care, emphasizing culture change elements. The goal is to provide as much planning to meet an individual's social and emotional needs.

Norman DeLisle, MDRC
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Researchers and clinicians from the Indiana University School of Medicine and the Regenstrief Institute are blurring the distinction between lab and clinic as they debut the second generation of memory care.

Building upon a care model they developed and extensively tested over the past 7 years, the focus of second generation memory care is on two groups -- patients with cognitive disorders such as Alzheimer's disease and their caregivers. Results of the clinical trial of the IU-Regenstrief care model were published in the Journal of the American Medical Association in 2006.

The initial second generation memory center -- the Healthy Aging Brain Center opens at the IU Center for Senior Health at Wishard Health Services this month.

"When we make the lab from which we develop treatments and the clinic into one entity, we are constantly learning from our patients - what works for them and what does not. Our approach to memory care is on the fast track because by eliminating the distinction between the lab and the clinic, we compress the long timeline traditionally needed to go from discovery to treatment. For us and for those we treat, who are both those with memory problems and their caregivers, this means that they will be receiving the support and care they need now," said Malaz Boustani, M.D., M.P.H., an assistant professor of medicine at Indiana University School of Medicine, an Indiana University Center for Aging Research investigator and a Regenstrief Institute research scientist.

An extraordinary new scientific study, which for the first time documents marked improvement in Alzheimer’s disease within minutes of administration of a therapeutic molecule, has just been published in the Journal of Neuroinflammation.

This new study highlights the importance of certain soluble proteins, called cytokines, in Alzheimer’s disease. The study focuses on one of these cytokines, tumor necrosis factor-alpha(TNF), a critical component of the brain’s immune system. Normally, TNF finely regulates the transmission of neural impulses in the brain. The authors hypothesized that elevated levels of TNF in Alzheimer’s disease interfere with this regulation. To reduce elevated TNF, the authors gave patients an injection of an anti-TNF therapeutic called etanercept. Excess TNF-alpha has been documented in the cerebrospinal fluid of patients with Alzheimer’s.

The new study documents a dramatic and unprecedented therapeutic effect in an Alzheimer’s patient: improvement within minutes following delivery of perispinal etanercept, which is etanercept given by injection in the spine. Etanercept (trade name Enbrel) binds and inactivates excess TNF. Etanercept is FDA approved to treat a number of immune-mediated disorders and is used off label in the study.

The use of anti-TNF therapeutics as a new treatment choice for many diseases, such as rheumatoid arthritis and potentially even Alzheimer’s, was recently chosen as one of the top 10 health stories of 2007 by the Harvard Health Letter.