Approximately 5.7 million people in the United States are living with dementia, with Alzheimer’s disease accounting for 60% to 70% of the cases. But the number of new cases of dementia is increasing each year both here and around the world. In fact, a 2018 study projects that 13.9 million people in the US alone will be diagnosed with Alzheimer’s or related dementias by 2060.
An initiative being developed by Penn’s Department of Neurology and the neurosciences and primary care service lines is attempting to better align that growing population with the limited available resources.
“Most patients with dementia are seen by their primary care doctors. A few of them trickle over to neurology, but most of them are taken care of locally, out in the community,” says Sanjeev Vaishnavi, MD, PhD, Assistant Professor of Neurology at the Perelman School of Medicine and a Physician Researcher at the Penn Memory Center. “So the idea is, how can we best take care of those individuals? And, how can we in neurology, along with other specialists in psychiatry and geriatrics, help the primary care doctors provide the best and most appropriate care for those individuals, while also finding people who may be appropriate for more specialized care or research here at our facility?”
The initiative was a finalist for the Penn Medicine Center for Health Care Innovation Accelerator Program, which provides grants to applicants from the Penn Medicine and University of Pennsylvania community for concepts that illustrate potential to: achieve better health outcomes, redesign care, improve the clinician and care team experience, enhance the patient experience, and/or leverage nontraditional data and technology to support patient engagement, improve care, and uncover new clinical insights.
Dr. Vaishnavi says the “dementia pathway project,” as he describes it, is still in its earliest phase, which made it difficult to quantify in the grant application how much of an impact it could ultimately have.
“There’s been no implementation yet,” he says. “Right now, it’s kind of more getting all the key players in the same room and discussing how we currently take care of these individuals. We’ve gone through establishing who is seeing what here in our system. The next step will be to look at processes to see how we can improve care.”
Dr. Vaishnavi says he expects to reapply for the accelerator program grant next year, once the specific nature of the intervention is developed.
“The goal,” he says, “is that by the end of the academic year, we would have a pilot project, in terms of something that we could take out to the community with changes to how dementia patients are referred or managed.”