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Subspecialty Programs: Aging and Dementia

The Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital

Diagnosis  Treatment   Research  Clinical Trials  Staff  Directions
The Alzheimer's Disease and Memory Disorders Center was established in 1989 to provide specialized consultation for people with a variety of memory disorders. Since then it has become a regional referral center for southeastern New England, serving patients from Connecticut and Massachusetts, as well as Rhode Island.  

The center relocated from Memorial Hospital to Rhode Island Hospital in 2005 to combine its high quality neurological services with the exceptional neuropsychologic and psychiatric services of Rhode Island Hospital, thus creating a comprehensive diagnostic and treatment center for patients with memory disorders.

There are many different kinds of chronic memory disorders.  The most common chronic memory disorder is Alzheimer’s disease, which affects approximately 4.5 million people in the United States. Alzheimer’s disease is a progressive disorder of the brain that slowly destroys a person’s memory and ability to learn, reason, communicate and perform daily activities. Another common memory disorder, vascular dementia occurs when blood flow to the nerve cells in the brain is reduced. Because there are more than 70 different causes of dementia, a comprehensive diagnostic evaluation is an important first step when dealing with symptoms of memory loss.

Some people with memory difficulties are actually suffering from depression, rather than a progressive brain disorder. Although they may have symptoms similar to early Alzheimer's disease, they respond to treatment once a correct diagnosis is made.

In Rhode Island, with its large elderly population, Alzheimer's Disease is particularly common, affecting an estimated 20,000 men and women. As a result, many of the Center's services are tailored to this particular problem.

There is currently no cure for Alzheimer’s disease and other degenerative memory disorders, but new treatments are available to help alleviate patients’ symptoms and slow their progression. Aggressive research studies are ongoing and are continually shedding new light on these illnesses.

Comprehensive Assessment

The center’s neurologists are memory specialists, who offer their patients the latest advances in memory disorder diagnosis and treatment.

To ensure an accurate diagnosis we provide a thorough evaluation of each patient, which includes a careful look at his or her medical history, a physical examination and neuropsychological testing of mental functions. Neuroimaging - positron emission tomography (PET), single photon emission computed tomography (SPECT), magnetic resonance imaging (MRI), and computed tomography (CT) - may also be used during the evaluation process, along with other laboratory tests.

In addition to this clinical diagnostic evaluation and treatment, we offer:

  • Consultation with Rhode Island Hospital staff psychiatrists for counseling and treatment of behavioral problems
  • Genetic testing for hereditary dementia
  • Social services and referrals to help our patients and their families find the support they need within their communities
  • Educational literature from the Rhode Island Chapter of the Alzheimer's Association and other organizations
  • Community lectures and support group presentations
  • Support for our patients’ caregivers, who are an important part of each patient’s health care team.  Family members are encouraged to attend the office visits and take an active role in both the evaluation and the development of management plans.

Making Plans

After the evaluation, a plan to manage the memory problem is developed. This plan, which is outlined during a follow-up visit to the office, often includes:

  • Counseling about the diagnosis and prognosis
  • Information on support services
  • Medications for symptoms like memory loss, sleep disturbance, anxiety or depression

The patient's management plan is recommended to his or her primary physician in a complete consultation letter. In some cases, the plan may be instituted by the neurologist at the Center.

Patients and their families are encouraged to return for follow-up visits every three to six months to monitor progress.

In addition, the Center's ongoing research program assures patients that they will be kept aware of the latest advances in treatment.

Research

Clinical research is an important part of the Center.   A weekly consensus meeting is held, which provides a forum for dementia researchers to discuss and plan current research projects.  We support the Brown Brain Tissue Resource Center and encourage brain donations from patients to further vital research at Brown into the pathology of Alzheimer's disease and related dementia disorders. 

We support research on cerebrospinal fluid dynamics and biomarkers of Alzheimer's disease. 

    In addition to brain donations, we accept blood and cerebrospinal fluid specimens which are
    banked for future collaborative research projects. 

    Dr. Querfurth heads a basic laboratory that explores the effects of intraneuronal beta amyloid on synaptic
    function and the relationships between beta amyloid pathology and inclusion body myositis.  He is also
    developing a non-invasive method to measure intracranial pressure.

    Dr. Conrad Johanson heads a basic laboratory.  His research involves models of ischemia,   
    hydrocephalus, and aging to clarify how CSF and brain interstitial fluid homeostatic
    mechanisms are altered in Alzheimer's disease. The goal is to identify pharmacological   
    strategies for preventing or repairing damage to 'barrier cells' that defend the integrity of
    brain fluids.

In keeping with our comprehensive approach for helping patients, we are working with other institutions to understand the various cognitive and behavioral problems of persons with dementia. The Center is conducting major longitudinal studies of drivers with dementia and caregiving for persons with dementia, sponsored by the National Institutes of Health.  Studies of pharmacoepidemiology in nursing homes are conducted by Dr. Daiello in collaboration with Dr. Kate Lapane and Dr. Susan Miller from the Brown University Department of Community Health. 

Other research areas of interest include:

We participate in large multicenter clinical trials of investigational drugs, which may help to alleviate symptoms and slow the progression of Alzheimer's disease.   Past studies have included research on tacrine, velnacrine, linopirdine, donepezil, metrifonate, estrogen, melatonin, idebenone, non-steroidal anti-inflammatory drugs, neotrofin, neramexane, memantine, B vitamins, DHA, and valproate.  The Center is a primary site for clinical trials sponsored by the Alzheimer's Disease Cooperative Study (ADCS), funded by the National Institutes of Health.

For more information on the Center's research programs and whether you could participate, e-mail or call Michele Astphan at (401)444-6440.

Ongoing and Upcoming Clinical Trials


Neurofeedback Clinical trial of a cognitive therapy for memory loss administered over 6 months in people with mild cognitive impairment and early Alzheimer's disease compared to normal older people.
Bapineuzumab Intravenous
National multicenter study to determine whether intravenous administration of a specific antibody against beta amyloid every 3 months is safe and can slow the progression of Alzheimer's disease over 18 months.
Bapineuzumab Subcutaneous
National multicenter study to determine whether subcutaneous administration of a specific antibody against beta amyloid every month is safe and can slow the progression of Alzheimer's disease over 18 months.
IGIV 
National multicenter trial to determine whether intravenous administration of multiple antibodies against beat amyloid is safe and can slow the progression of Alzheimer's disease over 18 months.


The Center's Staff

The Center's director is Dr. Brian R. Ott, a Professor in the Brown University Department of Neurology. He is board certified in neurology, geriatric medicine, and internal medicine.  Dr. Henry Querfurth, an Associate Professor in the Brown University Department of Neurology, is the Co-Director of the Center.  He is also board certified in neurology.  Dr. Michael Friedman, an Assistant Professor in the departments of Neurology and Psychiatry, is trained in both specialties.  Drs. Ott and Querfurth perform neurologic evaluations of all patients who come to the Center.  Psychiatric consultations are provided by Dr. Friedman and Dr. Colin Harrington.

Rhode Island Hospital staff neuropsychologists, Dr. Geoffrey Tremont, Dr. Holly Westervelt, and Dr. Jennifer Davis, as well as Dr. Ronald Cohen from Miriam Hospital neuropsychology, are integral parts of the diagnostic team.  Research and training opportunities are provided for neurology residents, geriatric neurology fellows, geriatric psychiatry fellows, geriatric medicine fellows and post-doctoral neuropsychology fellows.  Also, psychology students from Brown University are engaged in research studies of memory impairment in the Cognitive Neuroscience Laboratory under the direction of Dr. William C. Heindel and Dr. Elena Festa-MartinoDr. Lori Daiello is a Doctor of Pharmacy, and works as a research associate at the Center.  She is involved with the clinical trials program as as well pharmacoepidemiology research at the Center.

Research coordinator Esther Oden, Elysia Gaynor, RN, Nancy Faucher, RN, and research nurse manager Michele Astphan, RN, assist the physicians in conducting clinical research trials.

Julie Herzlinger provides social service evaluations and assistance.  Wendy Mullen is the Center's adminstrative secretary. Geri Daniels and Sandra Ramos are the front desk secretaries.

To Make An Appointment

The Center is located at Rhode Island Hospital, Ambulatory Patient Center (APC) -- 6th Floor, 593 Eddy Street, Providence, Rhode Island, 02903. Appointments can be made by calling (401)444-6440.  

Getting To The Center

Directions

Valet parking is available at the entrance to the APC building.