'It takes a village' approach improves dementia care and informs research, study shows

"Collaborative dementia care -- sensitive to local needs and concerns -- combines human interaction of all those involved plus technology. Regular face-to-face meetings of caregivers, clinicians and researchers provide invaluable opportunities to balance human need and the flood of information as we develop and deliver new and innovative dementia care," said Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate director of the IU Center for Aging Research and IU School of Medicine associate professor of medicine. The senior author of the new study in Clinical Interventions in Aging, a peer-reviewed, open-access online journal, Dr. Boustani is founding director of the Indianapolis Discovery Network for Dementia and sees patients at the Wishard Healthy Aging Brain Center.

IDND's interdisciplinary open-source think-tank implementation of innovations short circuits the lengthy -- typically 17-years, according to Dr. Boustani -- research-to-practice timeline, bringing concepts that improve dementia care to patients in a fraction of that time. This "discovery-to-delivery" approach evolves to meet the changing needs of those it serves.

For example, IDND's Anticholinergic Cognitive Burden Scale, which evaluates the effects of common over-the-counter and prescription drugs on the aging brain, was developed, tested and put into clinical practice within four years. The Healthy Aging Brain Care Monitor, a "blood pressure cuff" for dementia put into patient care within two years of development, functions as a screening, diagnostic and management tool. Both tools are now in worldwide use.

IDND works to halt inappropriate or "bad" medicine; counsel and support families; reduce the cost of care by avoiding unnecessary emergency room visits and hospitalizations; and decreasing the likelihood of long-term care.

"Discovering and testing effective solutions for people with dementia is not enough," Dr. Boustani said. "IDND creates a platform that can be adapted to any locality to disseminate, implement and translate discoveries into practice that will work there -- whether a metropolitan area with large, competing health systems like Indianapolis or a totally different environment. Solutions must be localized to be effective, and they can be. Highly competitive organizations like banks collaborate every day to make financial transactions seamless; diverse health care systems surely can find ways to collaborate to improve lives."

A geriatrician, Dr. Boustani focuses on rapid translation of aging brain research discovery into health care delivery using the lens of complexity science, the tools of medical informatics and the methods of public health epidemiology.

"As a geriatrician in community practice, the majority of my patients have dementia. Our close linkage with the researchers at the University through IDND has allowed me to utilize newly developed clinically useful tools early in their development and to provide feedback on their applicability to my patient population," said Patrick Healey, M.D., St. Vincent Health Network.