Objective: To describe a unique interdisciplinary clinical dementia program in a primarily underserved community and describe it's research agenda with preliminary data.
Methods: Previous research has shown that there is a need for earlier and better diagnosis of Alzheimer's disease (AD) and related dementias, and this need may be even higher in historically underserved communities. The University of Chicago Memory Center, which opened 3 years ago, provides specialized dementia care and access to a diversified research program within a primarily African-American community on the south side of Chicago. The unique patient population and specialized programs are in contrast to most nationally funded dementia programs, supporting a rare opportunity for integrated care and research.
The first goal of the Center is to provide excellent clinical care to patients in the catchment area. The interdiscplinary team consists of a neurologist, three geriatricians, a geriatric psychiatrist, a neuropsychologist, a social worker, and two nurses. Clinical diagnoses and care plans are proposed and discussed at weekly team meetings.
The second goal is to offer the option of ongoing primary care for patients evaluated at the Center. Therefore, not only would patients recieve specialized dementia care, but they could also receive primary care at the Memory Center, providing a "one-stop" resource and enhanced continuity of care.
The third goal of the Center is to provide dementia-specific education and outreach for professional staff at the medical center and patients and families in the community. Some new programs include The South Side Dementia Consortium (affiliated with the Alzheimer's Assocation) and the Faith-Based Wellness Program (affiliated with the University of Chicago's outreach program).
The fourth goal of the Center is to offer participation in research projects that range from basic genetic research on prion disease to research on the quality of care near the end of life. The Center's database includes general demographic information, details of behavioral and psychiatric symptom presentation, functional abilities, the medical history, neurologic findings, and the clinical diagnosis.
Results: Preliminary demographic findings based on 227 patients meeting criteria for dementia at presentation reveal that 39% are Caucasion, 58% African-American, and 3.5% other race. Findings from one of the Center's current studies, for example, suggest that symptom presentations may differ by race or dementia etiology.
Conclusion: The Memory Center provides a rare opportunity for integrated primary and dementia care in an historically underserved community. Access to these patients affords an unusual opportunity for a broad research program on possible racial differences with symptom presentation or dementia diagnoses, caregiver challenges, or differences in precipitants to accessing care.
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