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Alzheimer's, Dementia & Mental Health
Unique Community-Wide Approach Confronting Dementia
in Indianapolis
Discovery Network building efficient, effective,
locally sensitive solutions for dementia care
 Oct. 11, 2007 – Dementia, the ailment most senior
citizens fear most, is a growing burden for society as longevity
increases, propelling patients and caregivers to increasingly use the
health-care system. A year ago, local researchers, health-care
professionals, and community advocates came together to form the
Indianapolis Discovery Network for Dementia (IDND) to enhance dementia
care in the nation’s twelfth largest city.
On Oct. 20, IDND will launch RAPID-PC –
Recognizing and Assessing the Progression of Cognitive Impairment and
Dementia in Primary Care with a summit meeting for researchers,
clinicians, nurses, nurse practitioners and physician assistants to
share experiences and progress.
The group is drawing upon unique features of the
Indianapolis health-care environment, the most wired in the nation, to
develop a model which they believe other communities can use to enhance
the delivery of dementia care.
“If tomorrow we developed a breakthrough in
dementia treatment such as a vaccine, it would take 17 years and $800
million for that development to become available as a prescription and
it would reach only a fraction of those who could benefit from it. That
isn’t acceptable,” 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.
Dr. Boustani, IDND’s chief research officer, bases
his estimates on a systematic review of drug development literature.
According to Dr. Boustani, in the state of Indiana,
which he says is representative of the U.S. as a whole, 60 percent of
people with dementia or pre-dementia (also known as mild cognitive
impairment) are not recognized as having these conditions when they go
to a hospital.
 Also, 80 percent are not recognized as having dementia
or pre-dementia by their primary care physicians.
The result is that less than 10 percent receive
medications appropriate to their level of cognitive impairment and
approximately a quarter receive medications which are inappropriate.
“Nationwide, the health-care system is not
delivering good dementia care because we have not presented a
comprehensive assessment of the biopsychosocial needs of a person with
dementia and have not followed up with solutions that are sensitive to
local community needs and resources,” said Dr. Boustani, who is a
geriatrician.
Eight out of 10 individuals with dementia living in
the community have significant behavioral and/or psychological symptoms
that require medical and psychological care.
He also notes that caregivers have been largely
ignored in spite of the fact that they provide millions of unpaid care
hours per year (180 million hours valued at $1.7 trillion in Indiana in
2005) and are hospitalized at a very high rate (24 percent over a
six-month period in Indiana).
With Rapid-PC, IDND is taking a major step toward
its goal of building efficient, effective, locally sensitive solutions
for dementia care.
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