Meet
Memory Maker: Zaldy Tan By CASSIE TOMLIN There is no cure for Alzheimer’s disease, the leading cause of dementia. And since the number of Alzheimer’s patients in the United States is expected to triple over the next 40 years, improved treatments and prevention are more crucial than ever, says Zaldy Tan, MD, MPH, director of the Bernard and Maxine Platzer Lynn Family Memory and Healthy Aging Program, and medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders at Cedars-Sinai. Here, Tan, a leading memory and aging specialist, shares his vision for the future of dementia care.
What are the most significant ways we can improve care for dementia patients?
Managing dementia is extremely challenging, especially in primary care. Patients may miss appointments and have difficulty understanding medication instructions. They can develop behavioral issues, and their caregivers become stressed. In our Bernard and Maxine Platzer Lynn Family Memory and Healthy Aging Program, we are building a truly multidisciplinary team tailored to the complex needs of patients with dementia. It’s an innovative approach. Our team—a memory specialist, pharmacist, neuropsychologist, social worker, genetic counselor and nurse practitioner—gets to know each patient and their needs. It’s crucial to continually evaluate dementia
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patients from several perspectives, addressing their cognitive, behavioral and social challenges. This helps prevent unnecessary hospitalizations or trips to the emergency department, since people with dementia don’t do well in the hospital. We develop personalized, comprehensive care plans for each patient’s family or caregivers, as well as their primary care doctor. It’s also crucial for us to address caregiver depression and burnout, which make it more likely that a patient will end up in the emergency department. We offer caregivers education, support and referrals to communitybased services. Why is your work with caregivers so important? It is
challenging for a family mem-
ber to be thrust into the role of caregiver for a loved one with dementia whose needs may exceed most people’s knowledge and skills. In 2019, I published a study that found that attending a one-day intensive boot camp made caregivers more knowledgeable and more confident in their skills. Busy caregivers have limited time to devote to education and training; we found that even a one-day investment is enough to make a lasting difference. What more do we need to learn about dementia risk and prevention? There are
segments of our diverse Los Angeles community whose dementia risk and outcomes remain largely unexplored. That’s why we are recruiting Asian American and Pacific
Islander (AAPI) and LGBTQ+ individuals at increased family risk for dementia for a study on brain aging. We will be following them for life to help discover why some people develop dementia and some do not. Not much is known about the AAPI population’s risk for dementia—the little data we have seems to show that Asian people have a lower dementia risk. If that’s confirmed, perhaps there are resilience factors we could identify that can help reduce everyone’s risk of developing memory problems. It is also possible that the low incidence may reflect underreporting because there are cultural barriers to obtaining a diagnosis. If the data supports this, we can develop ways to address those barriers for AAPI populations and for other minorities. Though LGBTQ+ patients are diverse in terms of race and culture, one commonality may be exposure to adverse social determinants of health: discrimination, lack of access to good healthcare and social isolation. Many older LGBTQ+ adults live alone without the benefit of traditional family structure and support. We don’t know whether these negative social determinants of health translate to an increased risk for developing dementia. What are the most exciting advances in dementia research? The recent Food
and Drug Administration
