Hôpital général juif / Jewish General Hospital - The Program for Alzheimer's Disease and Dementia (PADD)

		Preventing Alzheimer's Disease and Dementia
		In brief	In numbers	Fundraising goal	Benefits

Alzheimer’s disease (AD) is a progressive degeneration of the brain, with symptoms of memory loss, disorientation and other intellectual impairment. Diagnosis and knowledge about the disease’s progression have improved tremendously in the past 20 years. However, what causes AD is still not entirely known today, nor can the disease be avoided or prevented – emphasizing the need for more research.

Contrary to popular belief, AD is not a disease of the elderly. While the risk of suffering from this devastating illness increases with age, a growing number of patients under age 65 are also being affected. AD already has a huge impact on our society both in terms of its incidence and its economic and human costs. As baby-boomers approach the stage of life with the highest risk for the ailment (65 and over), AD has the potential to turn into an epidemic of disastrous proportions unless appropriate, wide-ranging measures are taken now.

“It's urgent we come up with better treatment or there will be an epidemic.”

– Dr. Howard Chertkow, Director, JGH Memory Clinic

What is needed is a comprehensive program that provides better education and support for the public, physicians and caregivers across Quebec. Diagnosis and treatment of AD must be accelerated by promoting greater awareness in the public and medical communities about the disease and its progression, coupled with improved access to the required services and support programs. It is also becoming increasingly important to train community family physicians to initiate preliminary diagnoses and treatments and to disseminate information to family medicine groups. Additional health professionals need to be hired and a whole new generation of clinicians and researchers to be taught and trained. Greater involvement in and support for basic and clinical interdisciplinary research into AD is a priority in order to develop better diagnosis and treatment tools and hasten a cure for the disease.

The Anna & Louis Goldfarb JGH/McGill Memory Clinic, run jointly by the Division of Geriatric Medicine and the Department of Clinical Neurosciences, provides unparalleled expertise in the early diagnosis and treatment of memory disorders and dementia. In partnership with the Bloomfield Centre for Research in Aging at the Lady Davis Institute for Medical Research, it is at the forefront of research efforts to achieve a better understanding of Alzheimer’s’ disease (AD), its causes, what makes people susceptible and how it can be prevented.

The clinic is already hard pressed to keep pace with the growing demand for its services and lacks the funding to develop in areas it does not yet address adequately. With increased funding, the Memory Clinic could extend its capacity by attracting clinical fellows to treat additional patients. It would also be able to hire a nurse navigator (infirmière pivot) to facilitate patients’ access to treatment and services, organize public education initiatives, advance research projects and continue in its role as a model for innovation and treatment in Alzheimer’s disease and related dementia.

PADD Objectives.jpg

The creation of a JGH Program for Alzheimer’s’ Disease and Dementia (PADD) is vital to bring together the clinical, teaching, research and educational activities around dementia and build the necessary synergy and momentum to avert an epidemic. Establishing the PADD will contribute to improving the lives of individuals with dementia and those looking after them in our community and across Québec.

MONTREAL COGNITIVE ASSESSMENT (MoCA)

In the earliest stages of dementia, it can be difficult for doctors to distinguish normal from abnormal memory, attention, and thinking (cognition). A team of researchers led by Dr. Howard Chertkow, Director of the JGH Memory Clinic, Dr. Ziad Nasreddine (a University of Sherbrooke cognitive neurologist who attends at the Memory Clinic), and LDI/Concordia psychologist Dr. Natalie Phillips, devised a new rapid screening test to allow physicians to quickly determine if an older individual had abnormal or normal cognitive abilities. The MoCA, developed and tested in the JGH Memory Clinic, has been adopted by Memory Clinics around the world. It has been translated into 17 languages, cited in 300 publications, and has been adopted by the US Alzheimer’s Disease Neuroimaging Initiative and the National Institute of Health Stroke consortium. The 2005 paper introducing the MoCA received an award from Thomson Reuters’ Essential Science Indicators as one of the most cited papers in the research area of memory loss.

IN BRIEF...
The Anna & Louis Goldfarb JGH/McGill Memory Clinic

Is the largest of its kind in Canada, treating 800 patients per year

Assesses 500 new elderly individuals with memory impairment each year

Is recognized as a leader in its field across Canada

Is the center for teaching of dementia at McGill

Has become the centre where the Quebec Dementia Registry was created

Is a major centre for recruitment of memory-impaired or AD subjects into studies of new therapies

Currently has a 12-month waiting list of 200 people in need of assessment

Research based at the Lady Davis Institute and Anna & Louis Goldfarb JGH/McGill Memory Clinic

Development of new diagnostic and screening tools, such as the Montreal Cognitive Assessment (MoCA), which are used around the world

The JGH is a major centre for studies of mild cognitive impairment (MCI) and the prediction of progression to dementia, showing that all patients with MCI do not develop Alzheimer’s disease (AD), and there are simple predictive indices as well as high technology indices may be used to classify the progression risk

Conducted the world’s only trial of low dose oestrogen to prevent memory decline in men with mild cognitive impairment

Basic research on causes of Alzheimer’s at the JGH’s Bloomfield Centre for Research in Aging (BCRA) of the Lady Davis Institute has led to:

The identification of changes in the blood plasma of AD patients, which can be detected very early after onset and possibly in pre-clinical stages of the disease (Dr. Hyman Schipper)

The identification of the critical step involved in converting normal tau protein in the brain to the abnormal protein which may be the cause of AD (Dr. Herman Paudel)

Development of the idea that the initiating molecular alteration causing AD may be abnormalities produced by caspases, an entirely different class of brain enzymes (Dr. Andrea LeBlanc)

These thee initiatives may lead to the development of entirely new drug treatments for AD in the future

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*IN NUMBERS...*

	60,150	160,000	1 in 5

	New cases of dementia each year in Canada	Quebecers will have Alzheimer’s Disease by 2030	Baby-boomers will develop Alzheimer’s Disease in their lifetime

	17,140	1 in 11	5

	Quebecers living with Alzheimer’s Disease or a related dementia are under age 65	Canadians over the age of 65 are affected by Alzheimer’s Disease, the most common form of dementia	Every 5 minutes, someone is diagnosed with Alzheimer’s Disease and/or related disorders

	33%	20%	25%

	Of all Canadians know somebody who has Alzheimer’s Disease	Of Canadians have a family member who has Alzheimer’s Disease	Less than 25% of cases of Alzheimer’s Disease in Canada are diagnosed and treated

	20	$15 billion	$153 billion

	Alzheimer's begins about 20 years before symptoms appear	Current costs of Alzheimer’s Disease per year	Yearly costs of Alzheimer’s Disease in 2038
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FUNDRAISING GOAL: $5 million
Public prevention and education program Education program for caregivers Memory Clinic professionals Memory Evaluation Unit Endowment Fund for research Fellowships (4/year) and hiring of more health professionals
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BENEFITS
Of the Program for Alzheimer's Disease and Dementia (PADD)

Stable long-term support for the ongoing operation of the largest Memory Clinic in Canada.

Shortening of the Memory Clinic’s waiting list from 12 months to just two months.

Optimized diagnosis and treatment.

Improved access to treatment and services.
Better public awareness materials on dementia prevention.

Mentorship program and teaching materials for family physicians.

Training and support program for caregivers.

Advanced research into preventing and curing Alzheimer’s disease.

Increased attraction and retention of scarce researchers and clinicians.

Creation of a nurse clinician position that will become the link between the tertiary clinic and the primary care physicians.

Support of two neuropsychologists and their students who provide essential clinical and research assessment of cognition in patients (evaluation unit).

Improved quality of life of individuals with dementia and those looking after them across Quebec.

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