Gina Green-Harris

THE AMAZING GRACE CHORUS, A CULTURALLY TAILORED CHORUS FOR AFRICAN AMERICANS WITH DEMENTIA: ADDRESSING STIGMA AND FACILITATING COMMUNITY ENGAGEMENT FOR QUALITY OF LIFE

modelled the relationship between MMSE and EQ-5D utility/VAS scores and EQ-5D domains (no problems vs any problems), respectively, with MMSE as independent variable. Missing MMSE scores were imputed from Hasegawa scores, using multiple imputation. Regressions adjusted for age, sex, BMI, comorbid conditions, concomitant medications, behavioural symptoms and retirement status. Results:Analysis was conducted on 145 patients. Decreasing MMSE was significantly associated with decreasing EQ-5D utility (p1⁄40.002), self-care (p1⁄40.003) and usual activities (p1⁄40.047), as measured by EQ-5D domains. MMSE was not associated with EQ5D VAS (p1⁄40.100), or EQ-5D domains of mobility (p1⁄40.079), pain/discomfort (p1⁄40.191), and anxiety/depression (p1⁄40.863). Models indicated a mostly linear association between MMSE and EQ-5D utility (e.g. approximately -0.02 per unit decrease for MMSE 20-10), but the likelihood of a patient having problems with self-care or usual activities rose most sharply in the approximate MMSE ranges 20-10 and 30-15, respectively. Conclusions: There is a strong association between MMSE severity and a patient’s quality of life, measured by EQ5D. Examination of specific EQ5D domains indicated that in order to have most impact to maintain self-care and usual activities an intervention would have to come early.

KEY ELEMENTS SUPPORTING RECRUITMENT AND RETENTION OF UNDERREPRESENTED GROUPS INTO RESEARCH: OUR EXPERIENCE IN THE AFRICAN AMERICAN COMMUNITY

care partner of a person with Alzheimer’s/another dementia); 2) multisensory enrichment group for person with dementia held in parallel with care partner support group; 3) early journey support group for persons with recently diagnosed mild cognitive impairment or early stage Alzheimer’s who attend with their primary family care partner (spouse and/or adult child); and 4) fronto-temporal dementia support group for care partners only. Groups lasts 90 minutes, are held weekly for 8-10 consecutive weeks, have 8-16 participants, and are led by licensed clinical social workers/counselors. Weekly sessions are guided by a unique handout that facilitates decompression (talking about experience of being a person with dementia or care partner), education (various topics addressing common cognitive, physical, and emotional challenges), problem solving (skills for addressing behavioral and psychological symptoms of dementia), and relationship building (strengthening relationships between person with dementia, care partner, and family members). After completing an 8-10-week support group, the person with dementia and their care partner have the opportunity for individual, couple, or family counseling. Care partners can also participate in a 90 minute monthly maintenance support group that focuses on decompression. The 8-10 week groups are offered three times a year and feed into the monthly group, resulting in a comprehensive and sustainable support group program for person with dementia and their care partners. Results: Over last 6 years, the usual attrition rate per group is 15-20%. Participants evaluate their support group experience when group ends. Over 90% rate the following as “5” on a Likert scale of 1 (not at all) to 5 (very much) for these measures: group met expectations, I felt safe and accepted, knowledge of dementia was increased, coping skills enhanced, and facilitators were knowledgeable/compassionate. Conclusions: A comprehensive, sustainable support group program for person with dementia and family care partners is feasible and beneficial. Challenges and future plans will be discussed.

BARRIERS AND FACILITATORS TO PARTICIPATION IN CAREGIVER SUPPORT PROGRAMS FOR AFRICAN-AMERICAN FAMILIES

Cooperation fr neighbors PARTICIPATION IN CAREGIVER SUPPORT PROGRAMS FOR AFRICAN-AMERICAN FAMILIES Sheryl L. Coley, Rebecca L. Koscik, Andrea D. Garr, Kristen Felten, Alberto E. Castro, Gina Green-Harris, Katelyn Marschall, Jane Mahoney, Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; The Wisconsin Alzheimer’s Institute, University of Wisconsin, Madison, Madison, WI, USA; Milwaukee County Department on Aging, Milwaukee, WI, USA; Wisconsin Department of Health Services, Madison, WI, USA; United Community Center, Inc., Milwaukee, WI, USA. Contact e-mail: sheryl. coley@wisc.edu

DEMENTIA VERSUS MAJOR NEUROCOGNITIVE DISORDER: HOW GUIDELINES RECOMMENDATIONS CHANGE DIAGNOSTIC PATTERNS IN COMMUNITY-BASED MEMORY CLINICS

Background: iASiS envisions the transformation of clinical, biological and pharmacogenomic big data into actionable knowledge for personalized medicine and decision makers. Within the context of iASiS this is achieved by integrating and analyzing data from disparate sources, including genomics, electronic health records, and bibliography. The clinical heterogeneity of Alzheimer’s disease (AD) presents difficulties for the diagnosis, as well as for the assessment of response to, and therefore evaluation of, new treatments. iASiS paves the way towards personalized medicine for AD patients, by harnessing the potential of big data sources to produce evidence-based clinical knowledge in highly novel and potentially powerful ways. Methods: iASiS offers a novel methodology for identifying or confirming associations, responses to treatment, prognosis, and outcomes in AD. The iASiS framework foresees the deployment of an AD-specific knowledge graph. The latter will result from the retrieval, integration and the analysis of AD related biomedical data from heterogeneous resources. iASiS users will be informed on available knowledge relevant to the subject of study. Employing novel inference techniques the iASiS knowledge graph will be able to acquire new knowledge by combining pieces of information that may not be apparent when examining each source separately. The final iASiS system will be a uniquely rich and up to date source of information, which would otherwise be fragmented into different sources.Results:The initial IASIS components tested against a rich data set of biomedical literature comprising more than 150000 textual AD related sources yielded very accurate results. The iASiS components when asked to provide appropriate treatment for AD patients based on the patients’ genetic (allelic) status managed to accurately identify alleles of AD risk with related treatments according to the current bibliography as well as information related to current policies. Conclusions: iASiS will allow the generation of knowledge that will support precision medicine and more effective treatments for Alzheimer’s disease. The iASiS project invites health research centers, hospitals, and health organizations to contribute both with pharmacogenomics and clinical data, and to profit from the data processing and analytics that the iASiS platform will offer.

THE WRAP-AROUND APPROACH: A NOVEL RENTENTION STRATEGY IN THE AA-FAIM STUDY

patients (13.3%) were diagnosed with malignancy (bronchogenic carcinoma, non-Hodgkin’s lymphoma and metastatic carcinoma with unknown primary). On six month follow up, mortality was 10% and all the patients who died were diagnosed with malignancy. One patient required readmission following discharge in the follow up period. Conclusions:Care planning of AD patients require management of chronic and acute medical comorbidities and AD patients who require hospital admission have high short-term mortality rate.

USING ASSET-BASED COMMUNITY INVOLVEMENT TO ADDRESS HEALTH DISPARITIES AND INCREASE AFRICAN AMERICAN PARTICIPATION IN AD RESEARCH: EXPERIENCES FROM THE WISCONSIN ALZHEIMER'S INSTITUTE

O3-02-01 USING ASSET-BASED COMMUNITY INVOLVEMENT TO ADDRESS HEALTH DISPARITIES AND INCREASE AFRICAN AMERICAN PARTICIPATION IN AD RESEARCH: EXPERIENCES FROM THE WISCONSIN ALZHEIMER’S INSTITUTE Gina Green-Harris, Rebecca L. Koscik, Stephanie Houston, Nia Norris, Jane Mahoney, Mark A. Sager, Sterling C. Johnson, Dorothy Farrar Edwards, Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Contact e-mail: greenharris@wisc.edu

CONNECTING THE DOTS: MEETING THE DIAGNOSTIC AND TREATMENT NEEDS OF UNDERSERVED URBAN AFRICAN AMERICAN ELDERS WITH MEMORY LOSS

Germany is financed by a health as well as a care Insurance. This structure made the development of a complete service network (CSN) possible. It will be available for all people with dementia and with other psychiatric diseases. Aim: To describe the elements, processes, organizational and financial preconditions of the CSN. Methods:A cooperation of all persons and institutions involved in care of elderly patients with psychiatric disorders was started. This cooperation was started by the Alexian Research Center. All providers of support structures for people with dementia were brought together in a psycho-social working group. The medical system was integrated with contracts with the GPs of the area. The contracts included GP driven visits of social workers in his rooms whenever a dementia suspect was raised. GP and social worker formed a so-called medico-social team (MST). From this point in time the social worker served as an independent continuous case manager (ICC) over the duration of the whole disease process. For every patient, an individual mixture of a help structure was compiled. Regular visits were performed. Results: An organizational structure with several levels was built. The system starts with the patients. Their needs steer the CSN. No additional funding was necessary to run the CSN. A first descriptive evaluation over a period of 2 years showed that participating in the CSN made prevention of retirement home admission in 87 percent the participants. Measured user satisfaction is high. The numbers of patients with support of the CSN lays about 500 per year the number of GPs in contract above 50. The CSN is still increasing and will be rolled-out to neighboring cities and rural areas. Conclusions:The CSN covers all needs and functions of patients with dementia. The system was investigated on a European level in the Innovate Dementia project of the EU. Actually, in cooperation with politics the roll-out process is negotiated.

An Innovative outreach and service model of African-American recruitment for Alzheimer's research

2010 who reported using FOS before study entry to those not using FOS prior to entering the study. The co-primary outcomes are the rates of change over time in 1) cognition using the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog), and 2) whole brain and hippocampal atrophy determined by serial magnetic resonance imaging (MRI). Longitudinal outcomes for three groups cognitive normals, mild cognitive impairment (MCI), and those diagnosed with AD, stratified by ApoE 4 status, will be analyzed using mixed effect regression models to account for within subject clustering. Mean outcomes will be regressed on time (baseline through 48 month follow-up) and reported use of FOS (days), while controlling for potential confounders (including age, gender, education, race, cardiovascular risk, history of diabetes, smoking history, baseline cognition). In addition, models will include random intercepts. Models will be fitted separately for normals versus MCI and AD groups (which will be adjusted for use of cholinesterase inhibitors/ memantine). Results: Data analysis in process; results available March 2011. Conclusions: A growing body of evidence suggests that the pleiotropic effects of n-3 PUFAs play an essential role in brain health and cardiovascular homeostasis. The neuropathological processes that lead to AD and other dementias occur years before clinical symptoms appear and support the hypothesis that effectiveness of some therapeutic interventions may be timing dependant. A finding that early use of FOS by cognitively normal or at-risk individuals is associated with slowing or stabilization of markers of cognitive decline over time would motivate future AD prevention trials of this low cost, low-risk supplement in middle-aged and older adult populations.