In this episode of Minding Memory, Matt & Donovan speak with Dr. Joanne Spetz, the Brenda and Jeffrey L. Kang Presidential Chair in Healthcare Finance and Director of the Philip R. Lee Institute for Health Policy Studies at the University of California, San Francisco (UCSF). Joanne talks with Matt & Donovan about who makes up the professional workforce of people who provide dementia care and how these individuals play a critical role in the delivery of services. Joanne also discusses how different professional roles interact across setting of care. Lastly, Joanne introduces a new study she is working on with Donovan called the National Dementia Workforce Study (NDWS) that will be surveying a large group of clinicians who provide care for people living with dementia.

In this episode of Minding Memory, Matt & Donovan speak with Dr. Lisa Barnes, the Alla V. and Solomon Jesmer Professor of Gerontology and Geriatric Medicine, Department of Neurological Sciences and Associate-Director of the Rush Alzheimer’s Disease Center at Rush University. Dr. Barnes talks with Matt & Donovan about racial disparities in Alzheimer’s disease dementia and several obstacles that have impeded our understanding of race and dementia.

In 2009, the Health Information Technology for Economic and Clinical Health Act, wow, that's a mouthful, more commonly known as the HITECH Act, spent billions to promote the uptake of electronic health records by US hospitals. Fast forward more than a decade later, and now approximately four out of five healthcare institutions have electronic health record systems in place that integrate clinical notes, test results, medications, diagnostic images, et cetera. The adoption of EHR systems into healthcare introduces new and exciting opportunities to extract information that can be used to augment other types of data for research. As you might imagine though, it can be tricky to pull out meaningful information from the text of clinical notes. In this episode, we'll speak with a University of Michigan researcher, Dr. Vinod Vydiswaran, who's been developing methods to identify dementia from EHR data.

The population of older adults living with dementia is expected to swell to nearly 14 million by 2050 and is estimated to cost the US economy more than 500 billion each year. In the absence of a cure for Alzheimer's disease, the primary cause of dementia, there's interest in understanding modifiable risk factors. In theory, getting a handle on the modifiable risk factors for dementia, would enable public health efforts to reduce cognitive decline in dementia at the population level. We've come a long way in understanding the risk factors for Alzheimer's disease and other related dementias. However, there's still work to be done. In this episode, we'll speak with Dr. Josh Ehrlich, a researcher at the University of Michigan, who has examined vision impairment as a risk factor for dementia.

According to an estimate published in 2015, the global prevalence of dementia was projected to nearly triple between 2015 and 2050, growing from 46 million to over 130 million people globally. And of that worldwide share, 70% of those with dementia will be in low- and middle-income countries. Tackling and ideally preventing dementia requires a global perspective. In this episode, Matt & Donovan speak with Dr. Lindsay Kobayashi, a faculty member in the Department of Epidemiology at the University of Michigan School of Public Health whose research focuses on the social epidemiology of aging from a global perspective. Dr. Kobayashi introduces us to a whole new world of data available to help researchers tackle dementia as a global challenge.

Over thirty percent of individuals living with dementia living in the US each year die either of or with dementia – and almost half of those enrolled in hospice have dementia. As with so many other types of healthcare, there are disparities in both who enrolls in hospice as well as the type of care these individuals receive after enrollment. In this episode, Matt & Donovan talk with Dr. Lauren Hunt from UCSF, an expert in hospice care for persons living with dementia, about dementia at the end of life.

Extreme weather and weather-related disasters are becoming more and more common. Unfortunately, disaster related disruptions in healthcare tend to affect the most vulnerable of populations – including older adults living with cognitive impairment. In this episode, Matt & Donovan speak with University of Michigan faculty member, Sue Anne Bell, about how healthcare disruption due to a disaster can affect the population of older adults living with dementia.

In this episode of Minding Memory, we dive into the newest FDA-approved drug to treat Alzheimer’s – Lecanemab – with Ohio State University stroke neurologist Jim Burke. Dr. Burke discusses the benefits and drawbacks of the new Alzheimer’s drug and also the paradigm shift of how people (clinicians, patients, and the general population) are thinking about these news Alzheimer’s medications.

In this episode, Donovan & Matt talk with health services researcher Betsy White from Brown University about a unique new resource for researchers called the Long-Term Data Cooperative, a provider-led data sharing collaboratory that puts together nursing home EHR data from EHR vendors that can be linked to Medicare claims. This powerful tool is made available to researchers through an online application process.

In this episode, Matt & Donovan speak with University of Michigan School of Public Health Professor, Dr. J. Scott Roberts, who investigates the psychological and behavioral impact of genetic risk disclosure for Alzheimer's disease. In addition to being a professor in the Health Behavior & Health Education department at the School of Public Health, Dr. Roberts is also a core lead of the Michigan Alzheimer’s Disease Center. Dr. Roberts’s research interests focus on the process and impact of risk assessment and disclosure for adult-onset disorders, as well as the ethical, legal, and social implications of advances in genomic science & technology.

In this episode, Matt & Donovan speak with a health economist, Dr. Lauren Nicholas(link is external), whose research investigates how missing a single credit card payment may be a very early indicator of a cognitive issue. Dr. Nicholas is an associate professor in the department of Health Systems Management & Policy at the University of Colorado School of Public Health and has published several studies that examined on how a financial issue might be among the first signs of cognitive decline.

In this episode, Donovan & Matt speak with Geoffrey Hoffman, a faculty member and researcher at the University of Michigan School of Nursing. Dr. Hoffman discusses the transition to the role of caregiver for partners of persons diagnosed with dementia – and the unique emotional burden and stress that they undertake. Dr. Hoffman also discusses using the Health & Retirement Study (HRS) to better explore the emotional stress and onset of depression in caregivers.

In this episode we’ll speak with Dr. Julie Bynum who was the senior author on a recent study that examined how the likelihood of receiving a diagnosis of dementia has changed over the last decade or so. We’ll discuss what this might mean clinically and what researchers that rely on Medicare data should take-away from this finding. We also will talk in general about the various approaches that exist for identification of dementia in Medicare billing data.

In this episode we discuss what’s known about the association between personality type and cognitive function. Further, the idea of resilience—or what protects the cognition of individuals with a high level of neuropathology associated with cognitive decline—might have important implications for dementia prevention. Our guests are Dr. Eileen Graham and Dr. Dan Mroczek. Drs. Graham and Mroczek are both faculty at Northwestern University with interests in how personality factors influence physical and cognitive health over the life course.

Health data analysts are an elusive bunch in the wild. While we see their names periodically show up as middle authors on manuscripts or in the Acknowledgement section they work largely behind the scenes; yet they play a vital role in conducting research that use large data. In this episode we speak with several health data analysts to better understand the role they play in research and, for all the researchers out there, discuss how to make the process as smooth as possible when working with an analyst.