Features on people and efforts that bring the knowledge we seek on Alzheimer’s disease and lifelong brain health ever closer in sight from the
P E N N
M E M O R Y
C E N T E R
Fall 2016/Winter 2017
Typical Day Using photography to document daily life with mild cognitive impairment | Page 2
PENN MEMORY CENTER PERELMAN CENTER FOR ADVANCED MEDICINE
215-662-7810
www.pennmemorycenter.org
by Darby Marx
H
er car parked on the side of a steep Green Lane, Michele Davis looks out over her hometown.
Ahead, there’s the iconic Manayunk Bridge, the face of the neighborhood visible to passers-by on the Schuylkill Expressway. Below, there’s Main Street, where 20-somethings fill the streets on warm summer afternoons and the bars on cold winter nights. Behind her is the Manayunk she knew as a child: the community center she sneaked into without a membership, the church she attended each weekend, the old neighbors’ homes which have since been sold to strangers. She takes out the camera, frames the scene before her, presses the shutter, and... *click*
Mild Cognitive Impairment (n) | Mild cognitive impairment (MCI) is a condition in which people have more memory or other thinking problems than normal for their age, but their symptoms do not interfere with their everyday lives. (National Institute on Aging)
Typical Day A typical day for Davis begins at 5:30 in the morning, when she says a quick prayer before rising from bed. If the weather permits, she opens the windows downstairs so she can enjoy a cup of coffee with a side of fresh air. At 8 a.m., her peaceful morning transitions to a hectic day as a social worker, placing into rehabilitation patients who are suicidal, addicted to drugs, and often uninsured. Some days, she heads right home after work. On other days, she might be found enjoying happy hour with coworkers or putting in overtime hours at a nearby rehab facility. Each day is meticulously scheduled and requires finding a balance between stress and relief. Every day but Sunday. “That is my mental health day,” she said. “I really try not to do anything on Sundays. I like that to be my peaceful day.” A typical day might seem like a simple rehashing of events, but the recollection can and often does provide invaluable data for clinicians looking to diagnose possible neurodegenerative diseases.
Above: Photos taken by research participants. INSIGHT
“The stories of what’s a typical day as told by the patient and by their informant provide a personalized narrative that opens up a precise assessment of the patient’s quality of life,” Penn Memory Center Co-Director Dr. Jason Karlawish wrote in a column (page 16). “A day that is busy, engaged and safe is arguably better than one that begins and ends with sitting on a couch before a TV, punctuated only by three meals, a snack and a nap.”
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Abo
Above, from left: Doris Yarbrough, Gerson Alexander, Jean Segal, and Donna Fountain.
In Focus
This was to be the conclusion of the project, until Hailu opened an email from Damari McBride.
Tigist Hailu was planning a capstone project while pursuing her Master of Public Health degree when she learned of the importance of “What’s a typical day?” The PMC coordinator for diversity in research and education wanted to build an engaged community of research participants who, through photography and stories, could change the way others think about Alzheimer’s disease research by adding a touch of humanity. Hailu hoped her work would lead to an increase in participation in this research, especially from minorities. Funded by grants from Penn Medicine CAREs and Penn Medicine Neurosciences, Hailu recruited a dozen participants diagnosed with mild cognitive impairment and asked them to capture a typical day through a series of photographs. Over the course of a week, each participant photographed the people, places and things that made their lives easier or more difficult as they lived with an MCI diagnosis. In addition to photographing the landmarks of Manayunk, Davis focused on items of faith in her life, including her parish’s Christmas decorations, the religious-themed calendar above her desk, and a statuette of the Blessed Mother and baby Jesus. “Everyone threw themselves into it,” said Bob Ibold, another Typical Day participant. He had focused his lens on family members and the technology he uses on a daily basis. Ibold, Davis, and the other participants then sat down with Hailu to discuss their thoughts behind each photo. Hailu analyzed these interviews with the guidance of her advisor, social epidemiologist Dr. Carolyn Cannuscio, to determine how patients live with MCI. INSIGHT
McBride, a New York-based photographer, educator, and art activist, was seeking a partner for a community engagement photography project, and Hailu had been looking for a way to expand her project. McBride volunteered to stage professional portraits of each Typical Day participant. To capture the dramatic, lively photos, he employed a technique called “one key lighting,” in which there is one light and a black background. In the foreground, however, “they are still upbeat,” McBride said. “We wanted to keep them in color to highlight the contrast, and we wanted to keep it simple, yet stick to this dramatic style.” Davis recalled having fun during her session with McBride. They discussed the photos she had taken, and he captured her reactions to her own shots.
On Display McBride’s portraits are on display alongside the participants’ snapshots and corresponding descriptions in the Perelman Center for Advanced Medicine, where the Penn Memory Center clinic resides. The combination of photos and stories is “very moving,” Ibold said. The public exhibit opened in late September with a reception hosted by PMC and Penn Medicine Neurosciences. It will travel throughout the Philadelphia region when it leaves the Penn campus. An expanded, permanent exhibit and more information can be found online at www.mytypicalday.org. _________________________________________________ Darby Marx is a senior at the University of Pennsylvania and is a communications intern with the Penn Memory Center.
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Whealthcare: A strategy to tackle one of dementia’s earliest signs by Adam Clair
A
mong the populations most at risk for losing their financial security are older adults, and as the population ages and financial predators become craftier, threats to financial security are growing. Older adults can experience cognitive aging and lose the ability to manage their money, leaving them at risk for financial abuse and exploitation, but patients with dementia caused by Alzheimer’s and other diseases are even more vulnerable to threats to their financial security. The Consumer Financial Protection Bureau (CFPB), which oversees banks and financial institutions, estimates total annual losses from financial exploitation and abuse of seniors range anywhere from $3 billion to $40 billion. A Delaware senior advocacy group received twice as many complaints in 2015 as it had 10 years earlier. The number of complaints specifically addressing financial exploitation tripled. “Financial decision-making demands a lot of our cognitive abilities and so it’s often one of the first signs that someone is experiencing cognitive problems from a disease like Alzheimer’s,” said Penn Memory Center Co-Director Dr. Jason Karlawish. “Among our brain-based daily activities, managing our financial matters demands we orchestrate our attention, concentration, memory and decision making.” Because financial difficulty is one of the first signs of cognitive problems, however, Karlawish believes it presents an opportunity.
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If we start to look after people’s wealth, we can also effectively monitor their health.
“If we want to start identifying people who are having clinically significant cognitive changes,” he said, “one way to go about doing that in a naturalistic, non-threatening and ecologically valid way is to figure out ways to surveil how people are doing on their day-to-day financial matters. “If we start to look after people’s wealth, we can also effectively monitor their health. It suggests a new paradigm for seeing this issue as part of a public health problem.” Karlawish explains that this new paradigm unifies groups that people once thought of as fairly disparate, particularly professionals in health care and financial services. Karlawish coined the term “whealthcare” to describe this paradigm of merging banking and financial services — that is, wealth — with healthcare. Though financial abuse and exploitation is typically seen as and handled as a law enforcement issue, Karlawish believes we can address elder financial abuse and neglect more effectively if we frame them as part of the public health issue of assuring financial security with aging. “Much like infectious diseases, one of the reasons it’s a public health problem is because it affects other people,” he said. “As individuals lose the ability to manage their money, they’re not in a position to make up the lost funds. They can’t go back to work. Someone else has to step in and cover for the losses. That’s either family or society, through tax dollars. It’s a problem that the methods of public health, namely education, empowerment and surveillance, can begin to help to identify it so that intervention can occur. The frontline of the surveillance is not doctors but bankers.”
INSIGHT
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The Many Faces of Financial Exploitation Financial abuse and exploitation can take many forms. Predators can pose as financial services firms or debt collectors or even be or pretend to be friends or family members of a potential victim. In some cases, a predator will approach the victim of a scam with an offer to help them recover, only to take further advantage of them. In cases like these, however, financial predators can only exploit those who have given them access to their funds or accounts in some way.
challenging when caregivers are immediate family members. Parents often have liberal financial relations with their children, for example, paying for their education or providing a safety net if a child needs help paying a bill. Financial abuse and exploitation is not always easy to assess, and the issue is compounded by the deep feelings of fault it engenders. A 2010 study published in the American Journal of Public Health found that more than five percent of seniors reported having been victims of financial abuse at the hands of a family member, but very few of them reported it to authorities.
“A vampire can’t come in your house uninvited, and I see financial predators the same way,” said Markita Morris-Louis, senior vice president of community affairs and general counsel at Clarifi, a non-profit financial services organization. “If you don’t invite them in, it’s harder for them to get access.”
“There’s a level of embarrassment and shame that makes it the second most underreported crime, after rape,” said Roslyn Quarto, executive director of Empowering and Strengthening Ohio’s People, a non-profit financial counseling agency. But it’s an increasingly common problem that cuts across every demographic.
If financial predators had capes and fangs, they’d be easy to spot (and could be thwarted with just a head of garlic). In the real world, though, they look like everybody else. In fact, they are usually someone close to you: 59 percent of the perpetrators of financial exploitation and abuse are the family members and friends of the victim, which can make it hard to see it happening.
“One misconception is that people who are victims lack intelligence or that it’s their fault,” said Naomi Karp, senior policy analyst in the Office for Older Americans at the Consumer Financial Protection Bureau. “People with cognitive impairment are more vulnerable, but these scams can happen to anyone.”
Caregivers can be the most helpful resources for protecting those with dementia, but they’re also the most likely to commit abuse. Detecting that abuse can be especially
Education is a big part of the fight. Seniors themselves and especially the caretakers of those with dementia can find financial literacy resources at the Consumer Financial Protection Bureau and other non-profits. (Continued on Page 6.)
Whealthcare is featured on a new website, www.whealthcare.org, where visitors can view Dr. Jason Karlawish’s recent presentations on the topic as well as find more information about whealthcare from the media. INSIGHT
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“We like to emphasize that financial caregiving is an important subset of being a caregiver,” Karp said. “It’s not just the activities of daily living and healthcare and the things you think of as long term care. Financial management is a big piece of it. People are often not equipped to do that, and we’re trying to give them tools for that.” In addition to the Consumer Financial Protection Bureau, seniors and caregivers can go to their local attorneys general, AARP, and other non-profit organizations for help. Caregivers are among the most valuable resource to ensure individuals with dementia live with quality of life and financial security. They can help an older adult keep an eye on his or her finances, checking bank statements and pulling credit reports. Seniors most at risk for financial abuse and exploitation are those who live in isolation. Having people around not only provides extra eyes to monitor for signs of abuse, but it also provides opportunities for engagement, which can slow the cognitive decline caused by Alzheimer’s and other forms of dementia.
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Naturally, though, banks and other financial institutions are in a position to provide protection.
These bank tellers are the first line of defense.
Age-Friendly Banking “These bank tellers are the first line of defense,” said Roslyn Quarto. “Some seniors leave home for three reasons: to go food shopping, to go to church, and to go to the bank.” Bankers can notice changes in a client’s behavior, such as if someone has been spending the same amount of money each month for years but suddenly is spending significantly more. Simple changes in appearance or showing up to the bank with someone else doing all the talking for them can also indicate problems. Financial institutions around the world are beginning to incorporate a new concept called “age-friendly banking,” which includes things like making ATM cards with brighter colors, bigger numbers, and arrows to indicate which direction to insert in the machine, alerts for certain types of account activity and read-only access for a third party to see account transactions. “Anything can be considered, but it’s really sitting down with your customers in focus groups and figuring out what INSIGHT
your customers want,” said Joe Snyder, director of older adult protective services at Philadelphia Corporation for Aging. “The most loyal customers and the ones with the most money are the older customers.” Though banks are making progress on the age-friendly banking front, Karlawish believes there’s more to be done. In particular, the power of attorney model that many seniors follow can be problematic, as entrusting someone with that power can also give him or her the opportunity to exploit. He advocates for greater resources allowing third parties to view a senior’s accounts without having access to trade or transact on it. Karlawish notes that multiple people can serve in this role “so there are more eyes watching. You can imagine a role for banks to watch over their clients to minimize what is simply the fact that a lot of abuse and fraud occurs at the hands of family and friends.” Karlawish suggests other changes. “In the world of whealthcare, the financial institutions that have charge of my accounts have the names of trusted others they can reach out to if they suspect there’s something wrong with me,” he said. “If they, for example, start getting calls from me five times in one day to execute the same trade, they have someone they can call. “The second thing is the bank or financial services institution has set up technology that can unobtrusively identify that I’m having problems. If they start to notice changes in my bill paying habits or withdrawal habits, they can reach out to me and see how I’m doing, and have the resources to do that. “The staff will be trained on how to talk to an older adult who may be having problems. If that system was integrated with my physician, that they could reach out to my physician and say this is what we’ve noticed about your patient, and we want to make you aware of this so you can look into what’s going on.” Though there are changes banks and financial institutions can begin implementing now, Karlawish also believes some regulatory changes are necessary. In particular, banks should have more freedom to intervene if they believe something is amiss. Bankers and algorithms can be deployed to monitor for suspicious changes in activity, but even if a bank suspects there’s a problem, they can still be held liable for not completing a transaction promptly. Removing that threat and encouraging a bank to report signs of abuse or cognitive decline could help. _________________________________________________ Adam Clair is a freelance writer based in Athens, GA.
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Setting the table for an improved Memory Café
Terrence Casey / Penn Memory Center Bob and Molly Freedman, curators of the Jewish Sound Archive of the University of Pennsylvania, conducted a special presentation at September’s café.
by Terrence Casey and Sally Sapega
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emory Café, the monthly pop-up café for Penn Memory Center patients and their caregivers, was already popular as a safe space, but new funding has made each session a can’t-miss social event.
Felicia Greenfield, LCSW, director of clinical research operations and care programs at the PMC, continues to run the monthly cafes with Assistant Director of Care Programs Alison Lynn, MSW, LSW, and MSW interns.
Supported by a new grant from Christ Church Neighborhood House, the Penn Memory Center has been able to invite local artists to perform at each month’s café. Upcoming performances include Svitanya — a women’s vocal ensemble singing Eastern European Folk Music — and Pakistani singer/songwriter Umer Piracha.
“It offers a stable and safe environment,” Ilg said. But it’s not a support group, she stressed. “The participants are socializing with each other. While they acknowledge and understand that everyone is there for a similar purpose, they come mostly to hang out. It’s a unifying experience.”
Additionally, guests will have an improved “café experience” through a set of new café tables and entertainment options such as adult coloring books, said Christ Church Neighborhood House Program Director Abigail Guay. A wider selection of coffee and snacks — previously donated from Kitchen Gia — will be purchased from local vendors.
“There’s an acceptance,” said Diane Cagan, who attends with her husband, Paul. “In other social situations, you feel like people are watching you. And you’re watching [the patient] — is he embarrassing himself? But you know that won’t happen at the café. That’s the core reason I go.”
Dutch psychiatrist Bere Miesen created the first memory cafés in the Netherlands in 1997. The concept quickly spread throughout Europe and crossed the Atlantic Ocean in 2008. Today there are more than 100 memory cafés in this country but Penn’s is the only one in Philadelphia. PMC’s goal is to get patients and caregivers out of the house and “re-establish social connections and friendships,” said Genevieve Ilg, MSW, LSW, who proposed the idea when she was a PMC intern while working on her master’s degree at Penn’s School of Social Policy and Practice. INSIGHT
Susan Jewett, who comes with her husband Carl, loves the “intimacy” of the café and the cultural activities that accompany the socializing part of the café. To learn more about Memory Café, contact social work intern Kelsey Fleming at 215-360-0274. _________________________________________________ Terrence Casey is the Penn Memory Center communications coordinator. He can be reached at (215) 898-9979 or terrence. casey@uphs.upenn.edu. Sally Sapega is editor of Penn Medicine’s HUPdate and System News.
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‘The Caring Difference’ at PMC Meet the Team Felicia Greenfield, MSW, LCSW Director, Clinical Research Operations and Care Programs 215-662-4523 felicia.greenfield@uphs.upenn.edu
Alison Lynn, MSW, LSW Assistant Director of Care Programs 215-360-0257 alison.lynn@uphs.upenn.edu
Kelsey Fleming Social Work Intern 215-360-0274 kelsey.fleming@uphs.upenn.edu
Dear valued member of the PMC community, I am proud to lead a team of talented counselors to enhance your clinical experience at Penn Memory Center. Every family seen at PMC has access to services beyond medical care, including education, emotional support, and programs to promote patient and caregiver well-being. Under my supervision, my team works with families of the PMC to provide supportive services. The standard of care at the PMC, we call our suite of programs “The Caring Difference.” This approach to family support is unique to the PMC and we are delighted to bring this to our families, thanks to a generous gift from the Julius H. Caplan Charity Foundation (we’ll have more details on this in the next edition of InSight). Please feel free to reach out if any of the following programs may be of interest to you or your loved ones.
Sincerely,
Felicia Greenfield, MSW, LCSW
Megan Fucci Social Work Intern 215-614-7612 megan.fucci@uphs.upenn.edu
What we offer:
Deirdre MacFarlane Social Work Intern 215-360-0254 deirdre.macfarlane@uphs.upenn.edu
When a family returns to PMC to receive a diagnosis from the doctor, patients and their care partners have the opportunity to meet with a counselor. At this meeting, families learn more about the patient’s diagnosis and how to begin planning for the future while customizing the ways they can support their loved one. Families maintain access to their counselor while under the care of the PMC.
Lauren Tempesta Social Work Intern 215-614-7611 lauren.tempesta@uphs.upenn.edu
INSIGHT
Patient and Family Education
Individual Psychotherapy
Receiving a diagnosis of mild cognitive impairment (MCI) or dementia can cause increased anxiety and/or depression. Caring for a spouse or parent can be emotionally painful. Clinical social workers provide individual therapy for those newly diagnosed with MCI or family
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member adjusting to the changes and challenges they experience as caregivers. We work on setting goals and help individuals enhance their quality of life given the emotional difficulties that are common when living with or caring for someone with memory impairment.
Caregiver Education
When caregivers are looking for strategies to improve their own self-care and hone their caregiving skills, we offer “Caring for the Caregiver,” a six-week class for spouses of a person with dementia or adult children caring for a parent with dementia, twice each year. Classes are offered every October and March.
Caregiver Support
Graduates of “Caring for the Caregiver” are invited to join an ongoing monthly caregiver support group.
Memory Cafés
People affected by Alzheimer’s disease and other dementias, and their caregivers, are at risk of social isolation. In an effort to combat this, we offer monthly Memory Cafés (see page 7) designed to promote social engagement and new friendships. From time to time, we invite a featured artist or performer to provide stimulation and entertainment.
Curtis at Home
Music can be an uplifting and effective way to engage older adults with Alzheimer’s disease and other disorders. Rimbo Wong, an ArtistYear Fellow from the Curtis Institute of Music, will bring classical viola music to PMC patients. If you live in Philadelphia, Rimbo can make a home visit to perform her beautiful music for one-hour sessions (Tuesdays only).
Cognitive Comedy
Laughter is the best medicine. A local improv actor, Leah Lawler, leads workshops on improvisation and concludes with an improv performance. This confidence-building activity is sure to stimulate cognition while having a few laughs with new friends.
Learn more about these programs at www.pennmemorycenter.org /programs-services. INSIGHT
Volunteer Opportunities
Do you like kids? Would you like to connect with and give back to the Philadelphia community? If so, consider volunteering for the Children’s Hospital of Philadelphia (CHOP) through PMC’s intergenerational volunteer program, designed to provide enriching experiences with an emphasis on literacy. Read and interact with children at the state-of-the-art Community Health and Literacy Center in South Philadelphia.
Music Therapy
MSW intern Deirdre MacFarlane is a certified music therapist. In early 2017, Deirdre will organize a music therapy group to individuals with a diagnosis of mild cognitive impairment or mild-to-moderate Alzheimer’s disease and their family caregivers. The group, which will meet at the Ralston Center on Tuesdays from Feb. 7 to March 28, is open to PMC patients and their caregivers and will use different forms of music to help promote socialization, emotional expression and create community among the group members. The group is open to all types of music lovers with no prior musical experience or knowledge needed. ___________________________________
Cognitive Fitness Programs: Dawn Mechanic-Hamilton, Ph.D., and her neuropsychology graduate students offer two group interventions for patients with MCI:
Psychotherapy Group
This group is for individuals with a diagnosis of MCI or subjective cognitive change, who are also experiencing symptoms of anxiety or depression related to change in cognition. The group uses an Acceptance and Commitment Therapy (ACT) approach to address emotional wellness. This group meets weekly for 8 to 10 weeks.
Compensatory Strategy Group
This group is for individuals with a diagnosis of MCI who are interested in learning new strategies and reinforcing good habits to support areas of weakness in memory and organization. This group meets weekly for 8 to 10 weeks.
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Penn Memory Center Staff News
Dr. Wolk named AIC chairman
After 10 years, Mesa says goodbye
Penn Memory Center Co-Director Dr. David Wolk has been selected as chairman of the 2017 Alzheimer’s Imaging Consortium (AIC), a preconference to the Alzheimer’s Association International Conference.
Wolk
AIC focuses on the clinical application and methodological development of neuroimaging such as MRI and PET to Alzheimer’s disease, other dementias, and normal brain aging. Wolk was vice chairman for the 2016 consortium held in Toronto.
NAPSA honors Dr. Karlawish with elder protection award Penn Memory Center Co-Director Dr. Jason Karlawish is the 2016 recipient of the Rosalie S. Wolf Memorial Award, given to a researcher or someone involved in research “in recognition of a significant contribution to the knowledge and development in the fields of abuse of elders or persons with disabilities or Adult Protective Services.” The National Adult Protective Services Association (NAPSA) Conference Awards Committee selected Karlawish for his “extraordinary” contributions to the field. “Jason is an internationally known expert in the field of cognitive aging and financial capacity,” Karlawish said NAPSA Assistant Director Andrew Capehart. “Jason has been published extensively in various publications and recently coined the term ‘Whealthcare’ to highlight the need for the financial services and health care systems to cooperate in order to promote both health and conservation of assets in old age.”
Ivy Mesa, who had been managing patient coordination at the Penn Memory Center for slightly more than a decade, said goodbye in October.
Mesa
Intern Lynn hired full-time Alison Lynn, who had interned under Felicia Greenfield during the 2015-2016 academic year, was hired to join the Penn Memory Center team full-time after successfully completing the University of Pennsylvania’s Master of Social Work program. Lynn is now the assistant director of care programs at PMC.
“The Penn Memory Center and the Penn Health Brain Research Center take great pride in Tigist Hailu receiving her master’s in public health from the University of Pennsylvania,” said Dr. Jason Karlawish, co-director of the Penn Memory Center. “She’s learned skills and talents that are accelerating Hailu and expanding the Centers’ efforts to raise awareness and improve the cognitive health and wellbeing of older adults and their families. She’s an inspiration.”
Lynn
Dr. Hamilton named CNST director Dr. Roy Hamilton, a neurologist at the Penn Memory Center, has been named director of Perelman School of Medicine’s Clinical Neuroscience Training program. The goal of the CNST is to train clinical neuroscience specialists who will participate at the forefront of clinical and academic practice, and disease oriented research. Hamilton was also named recently named a Hamilton fellow of the American Academy of Neurology.
Interns added to editorial team
Hailu earns Master of Public Health Tigist Hailu, Penn Memory Center coordinator for diversity in research and education, has successfully graduated from the University of Pennsylvania’s Master of Public Health (MPH) Program.
Mesa had crossed paths with hundreds, if not thousands, of PMC patients and research participants since coming on board in 2006. We wish her luck in her new adventure.
Marx
Darby Marx and David Ney, two undergraduate students at the University of Pennsylvania, have been added to the PMC team as editorial interns. Their work can be found at www.pennmemorycenter.org and www.makingsenseofalzheimers.org.
Ney
New coordinator for NACC study Joseph Harrison joined the Penn Memory Center in 2016 as a clinical research coordinator. Before joining PMC, he was a clinical research assistant with the Center for Interdisciplinary Research on Nicotine Addiction in Penn Behavioral Health. Harrison received his BS in interdisciplinary health services with minors in biology and health care ethics from Saint Joseph’s University. He is also a post-baccalaureate student at Penn. At PMC, he coordinates the NACC study.
Harrison
Task force, PMC jointly tackle elder abuse By Darby Marx
E
mily Cardin was suspicious the moment she first learned about “Richard.” Her mother thought he was “The One.” The wealthy British businessman on Match.com was deeply religious, courteous, and gentlemanly. He also promised that he could care for her financially after his trip to Africa. It didn’t sit well with Cardin, who warned her mother that it could be a scam. Despite Cardin’s warnings, her mother sent more than $60,000 to Richard for his hospital bills. But Richard was not in the hospital, nor was he on Terrence Casey / Penn Memory Center vacation. He was nothing more than a character Speakers, including Dr. Jason Karlawish (top left) Joe Snyder (top right), and Emily Carinvented by a group of Nigerian scam artists. din (center front), at World Elder Abuse Awareness Day June 15, 2016.
As adults age, they begin to lose what is called fluid intelligence, making it more difficult to manage finances. This also makes them more susceptible to scams that might seem obvious to other people. Cardin’s mother continued to ignore warnings and gave her personal funds to a variety of foreign scammers, eventually losing her home and all savings. She since has been diagnosed with dementia and has moved in with Cardin, who began managing her finances and had taken away computer access. “It’s still hard to talk about and believe it happened,” said Emily, who shared her mother’s story in June at a World Elder Abuse Awareness Day (WEAAD) educational forum organized by the Financial Exploitation Prevention Task Force. This task force — a team of lawyers, social workers, physicians, and representatives from financial institutions, the Philadelphia police department, and the district attorney’s office — routinely holds these types of events to help prevent the financial exploitation of elders like Cardin’s mother. “Unfortunately, the damage is already done when we hear about a case,” said Joe Snyder, who leads the task force. “We want to try to prevent this from happening altogether.” As the public policy chair and past president of the National Adult Protective Services Agency, Snyder has extensive experience in this field. In the early 2000s, he worked with then-Wachovia Vice President of Loss Prevention Linda Mill to form a Fraud Prevention Program used as a national model to save more than $62 million in assets. Snyder and Mill then worked with Mayor Michael Nutter’s adminisINSIGHT
tration to organize a meeting with the CEOs of the major financial institutions in the Philadelphia region to discuss financial exploitation. Following the success of this event, Snyder organized the task force, which has developed into an interdisciplinary team that has made great strides in educating not only the public about the risks of financial exploitation, but also each other. Because the task force has representatives from a wide range of disciplines, the monthly meetings serve as a space for people from different backgrounds to share knowledge and build relationships. When Snyder met Penn Memory Center (PMC) Co-Director Dr. Jason Karlawish, he knew that “PMC would be a natural fit on the interdisciplinary team.” As an Alzheimer’s physician and researcher, Karlawish offered a perspective on how the aging brain makes certain individuals susceptible to the financial exploitation that the task force aims to prevent. Today, PMC is represented at the meetings by Tigist Hailu, PMC’s coordinator for diversity in research and education. She continues to promote “whealthcare,” a concept designed by Karlawish to encourage collaboration between the healthcare industry and financial institutions to care for the nation’s aging population and its savings. “Our collaboration with the task force allows us to enforce the concept of whealthcare using public health-based strategies,” said Hailu. Learn more at www.whealthcare.org. _________________________________________________ Darby Marx is a senior at the University of Pennsylvania and is a communications intern with the Penn Memory Center.
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Giving Voice to the Voiceless in a New Zine Editor’s Note: This article was originally published on Making Sense of Alzheimer’s and has been edited for print. Find the complete article and more like it at www.makingsenseofalzheimers.org. By Dutch Godshalk
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ndreas Lazaris has a lot on his mind, perhaps more than the average 24-year-old American male. If you need proof of this, just have a twohour conversation with him; it can be a fascinating and slightly overwhelming thing. He’s knowledgeable and articulate, enthusiastic and loquacious. He’s a walking, talking glossary of cognitive neuroscience. And he speaks in streams. Wind him up, let him go. It’s understandable that Lazaris has so much to talk about. After all, the UC Berkeley graduate has spent much of his life tackling some pretty heady subjects. For years, he’s been pondering the life of the mind, a pursuit that eventually led him to also ponder the death of the mind. Memory. Aging. Dementia. Throughout college, Lazaris worked at UCB’s Alzheimer’s disease neuroimaging lab. He served as the vice chair on the City of Berkeley’s commission on aging, a position he held for two years. Post college, he worked at the University of California, San Francisco’s Memory and Aging Center. For most of his life, it seems that Lazaris’ interest in memory and aging was purely scientific. In 2014, that changed. That’s the year Lazaris founded the zine “If you’d like to hear it // I can sing it for you,” which focused on the experience of aging in America. It’s a unique publication, something of a DIY literary magazine, printed on standard computer paper and stapled together by hand. It’s a passion project for Lazaris, who edits the content and designs each page himself. In so many words, “If you’d like to hear it” is a publication that aims to give a voice to people who Lazaris says don’t always have one: the elderly, the dying. Or INSIGHT
maybe someone suffering from Alzheimer’s disease. “An Alzheimer’s patient does not necessarily have the ability to advocate for his or her self. Other folks advocate on their behalf,” Lazaris says. “There is this need to hear from people themselves. And that idea kind of gave rise to the zine.” The zine’s pages comprise essays, poems, and artwork submitted by people all over the country. Some are people who have experienced aging, dementia, or sickness firsthand. Some are the relatives, friends, and caretakers of those people. Different voices, different experiences. “The way that I think about the zine is: you have these pages which are from different people who have never met each other, from different states, from different cities. And they’re all in this physical text. In a lot of ways, they’re all in conversation with each other,” Lazaris says. Given the zine’s focus, many of the stories are woeful, even moribund. Children recount the moments their parents succumbed to cancer. Men and women describe the onset of dementia. It’s a tableau of death, consistently powerful and assiduously difficult to grapple with. But that’s kind of the point, as Lazaris writes in the first issue. “In these pages, we seek to understand the struggle of aging // to affirm it through inter-generational conversation. We don’t aim to busy ourselves in fabricated models of ‘productive’ aging that conceal its realities …” His aim is to offer a glimpse of the reality of aging, not some sanitized version. Over the phone, he adds, “although something may be dark and something may be morbid or really challenging in terms of the sociological issues that it approaches and the personal and emotional issues that it approaches, I think the more difficult that it is, the more important it becomes.” And, more than anything, he says, the zine “was created to become a space for people to be able to put things in writing and make sense of them themselves,” as an act of healing or reckoning.
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The zine offers “a way to really express these things and send them out into the ether,” Lazaris says. “And someone might read them. Someone might not. But it becomes a little more cathartic, it seems, for some people to just send it out and to not really think about what happens to it.” Think of the zine as a message in a bottle, cast out in a sea of libraries and independent bookstores. “It gives people a lot more freedom to be as open as they need to be or as they want to be, in a way that they themselves and the role that they hold in the world [aren’t] attached to the story,” he says. “If you’d like to hear it” has its benefits for Lazaris as well. For one, he shares some of his own experiences in the zine, most notably the death of his grandfather, who passed away a decade ago.
of the aging, insight he’ll be able to apply during his career as he intends to be a geriatrician. “[The zine] helps me to think about these issues even more,” he says. “Because I’ve had a certain set of experiences within aging and caring for people, both family members and patients in the various places that I’ve spent time in. But those are just my experiences.” Working on the zine “really gets me to think about my life and my place in this work and in this field.” For more information on “If you’d like to hear it // I can sing it for you,” visit www.agingzine.tumblr.com.
_________________________________________________ Dutch Godshalk is a freelance writer based in Philadelphia, PA.
His grandfather’s passing “was the first time that a death affected me the way it did, because it was a person who was so close to me and it was the first of the grandparents, the first of the elders of the family to go,” Lazaris says. “And I think that being the first, it was an impactful moment, and it influenced the way that I thought about [how] elders should be treated and interacted with in our society.” He felt it was important to place some of his own writing in the zine, as an act of harmony. “By including a personal story and a personal reflection and opening up that part of myself, it was kind of in solidarity with the rest of the contributors who open up a part of themselves,” he says. “I think it would be unfair to say, ‘I’m the curator … but I won’t open myself up to uncover the same burdens that these contributors have.’ ” Professionally, the zine offers Lazaris invaluable insight into the lives INSIGHT
Recent copies of “If you’d like to hear it // I can sing it for you” are on display.
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A closer l
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Arun Pilania / Penn Memory Center Tigist Hailu, Penn Memory Center coordinator for diversity in research and education, leads a focus group on one of the proposed messages.
The Public Health Communications Study At the Penn Memory Center and at Alzheimer’s research centers across the nation, patients are asked to visit with a “knowledgeable informant,” or an adult who sees the patient regularly and would be able to identify changes in the patient’s memory or daily function. Often, the informant plays a critical role in getting his or her loved one to see a memory specialist in the first place. To determine the best way to target potential knowledgeable informants, PMC Co-Director Dr. Jason Karlawish joined forces with Professor of Communications Amy Jordan in a Centers for Disease Control and Prevention Special Interest Project called “Public Health Communications: Culturally Relevant Messages and Strategies to Promote Awareness about Dementia, including Alzheimer’s Disease.” The goal was to study the kinds of messages that would motivate individuals from diverse backgrounds to accompany a parent or parent-in-law on their trips to a memory specialist. As co-principal investigators of this INSIGHT
study, Karlawish and Jordan hoped to “change the attitudes and views around Alzheimer’s Disease” and create meaningful messages that would resonate with a wide range of potential knowledgeable informants, Karlawish said. In the project’s first phase, researchers sought to determine the beliefs, attitudes, norms and barriers that different communities face in trying to bring a loved one to a memory specialist. Sixty one-on-one interviews and about 600 telephone surveys were conducted with participants of different genders and races. Karlawish and Jordan then worked with a graphic designer to create posters featuring different messages. The posters were subsequently tested in focus groups, where participants shared whether these posters would motivate them to take an elderly loved one to a memory specialist. While only minor differences were found in the kinds of messages that resonated with African-American or white adult children in focus groups, gender of the parent did matter in the survey phase. Researchers are now looking for a partner who would be interested in using the messages.
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at our research The Biogen Study In September, a pre-clinical research study published in the science journal Nature suggested that human antibody aducanumab may slow cognitive impairment in patients with Alzheimer’s disease of other related cognitive impairments. Aducanumab is a human antibody thought to target and eliminate beta-amyloid protein, which forms plaques in patients with Alzheimer’s disease. Following these results, the Penn Memory Center is working with biotechnology company Biogen for Phase III trials of different versions of the drug, now called Engage and Emerge, to test whether it slows cognitive and functional decline in a larger group of patients. “While these results are promising, the drug was initially tested in a small pool of participants and needs to be replicated in larger studies,” said Grace Stockbower, research coordinator for the Biogen Study at PMC. “That is precisely what these Phase III trials will do.” PMC is just one of more than 300 registered sites in 21 countries participating in this phase of testing. PMC Co-Director Dr. David Wolk is the principal investigator of the trial at Penn. Individuals 50 to 85 years old with a diagnosis of mild cognitive impairment may be eligible for this study.
The Generation Study With the click of a button and a swab of your cheek, you can help Alzheimer’s researchers through the GeneMatch program. GeneMatch, run by the Alzheimer’s Prevention Registry, collects and safely stores the genetic information of individuals in the U.S. who have not been diagnosed with a cognitive impairment and are between the ages of 55 and 75. This program is unique in that it is a database of genetic information used in a wide range of studies aiming to prevent or slow Alzheimer’s disease. At PMC, the Generation Study, a phase II/III clinical trial, uses GeneMatch to recruit research participants. The first phase of Generation involves selecting a pool of individuals from the GeneMatch database and asking them to participate in genetic disclosure. During this phase, individuals find out their genetic status for the APOE gene, which has been implicated in Alzheimer’s disease. In particular, those with two copies of the APOE4 allele have an increased risk of developing Alzheimer’s disease.
Research participants who are eligible and consent will receive injections of aducanumab on a monthly basis, and the results of their assessments will be analyzed as part of the larger study.
Individuals in this “high-risk” category are then invited to participate in the drug phase, where they will receive one of two investigational drugs or a placebo. Throughout the trial, memory tests and other cognitive tasks will be used to assess whether these interventions are preventing or delaying cognitive impairment in these healthy individuals.
Learn more about the Biogen Study by visiting www.pennadc.org/study/biogen or contacting Grace Stockbower at 215-746-3949 or grace.stockbower@uphs.upenn.edu.
To learn more about the Generation Study or GeneMatch, please visit www.endalznow.org/genematch or contact PMC research coordinator Shira Blady at 215-615-3133 or shira.blady@uphs.upenn.edu.
INSIGHT
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Alzheimer’s Doctor Reveals His Most Powerful Technology Editor’s Note: This is an edited edition of a column originally published on www.forbes.com/sites/ jasonkarlawish, where PMC Co-Director Dr. Jason Karlawish is a contributor.
I
am an Alzheimer’s doctor. I practice at a “university-based memory center.” I care for patients with failing brains, and I also care for their families, because you cannot have one without the other. Technology surrounds me. Beneath me, in a basement encased in concrete, a 220-ton cyclotron spins hydrogen atoms to near light speed, creating a beam of protons to shoot at a cancer. Around me, infusions suites house intravenous pumps delivering powerful medications. There are devices to monitor, pace and even resuscitate hearts. The building itself testifies to invention, a multi-storied glass-and-steel-framed atrium, a kind of crystal palace. Technology surrounds me, but my exam rooms are barren. My technology is limited, almost pre-modern. In fact, a better word to describe what I use is “tools.” A clipboard with plain white paper, a pen for me, a pencil for the patient, a box of tissues. I’ve come to see that my most powerful technology is not technology in the strict sense of that word. My most powerful technology is a four-word question : “What’s a typical day?” “What’s a typical day?” inaugurates a conversation that achieves several important diagnostic and therapeutic goals. The stories of day-to-day life are real-world, detailed accounts of brains in the world, or, in a word, the mind. They tell me the severity of memory problems and so guide me to a diagnosis. Even more fundamentally, a family member’s ability to answer the question is data as well. The more detailed and vivid the story, the more confidence I have that the history I gather is accurate because I know someone else knows what’s going on. The question is also transformative. A family member INSIGHT
answering this question is among the earliest enactments of a new and important role she is about to take on, a role we call the “knowledgeable informant.” This is the person who reports on the health and well-being of a patient with cognitive impairment. It is among the roles that collectively create “the caregiver.” Caregivers are of course critical to making the case for the size and scope of the problem of Alzheimer’s in America. Eighty-four percent of the disease’s $215 billion-a-year costs are attributed to caregiving. If there were no caregivers to label, count and ask questions to, Alzheimer’s wouldn’t be so costly. The stories of what’s a typical day as told by the patient and by their informant provide a personalized narrative that opens up a precise assessment of the patient’s quality of life. A day that is busy, engaged and safe is arguably better than one that begins and ends with sitting on a couch before a TV, punctuated only by three meals, a snack and a nap. My profession is not simply engaged in diagnosing diseases of the brain. We’re dedicated to measuring a problem of the mind and to help patients and their families reconcile differences over what this problem is and how they are going to live with it. The histories of the other killers of 20th century America are war stories. A massive therapeutic armamentarium is deployed. The walk to my memory center takes my patients and their families past well-endowed cancer and cardiovascular centers, endowments that testify to the value society places in their centers where patients do brave battle with the 20th century’s great killers. My colleagues arm their patients with powerful technologies–pacemakers, implanted defibrilla-
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The stories of day-to-day life are real-world, detailed accounts of brains in the world, or, in a word, the mind.
Samantha Ing/Flickr
tors, portable catheters into which drugs are infused, some so powerful they turn people hairless, yellow and bloated, or pink and shiny. And I sit in my exam room with my pen and clipboard, pressing a daughter for details about the movies her mother watches and whether her mother really follows the plot or merely sits and watches. The history of my profession’s efforts to discover treatments for Alzheimer’s disease is a history of decades of failed experiments. Our few successes discovered drugs that increased the level of cholinergic neurotransmitters. Their modest effects on symptoms created the cholinergic hypothesis of Alzheimer’s and so a business model to promote the disease, but then the drugs’ patents began to expire and so the field looked up to scan the event horizon for better treatments. And we need them. The promise of our current experiments is that brain scans and genetic tests will more precisely label the disease and drugs will treat the underlying pathologies that cause cognitive decline. Colleagues speak of the coming of “Alzheimer’s infusion centers,” reflecting how many of the drugs under study are delivered by intravenous infusion. INSIGHT
These centers will be a welcome addition to memory centers, but I fear the unintended consequences of the technologies they’ll house. Technologies don’t just do things, they change things. Look at how the car, electric light bulb and cell phone have changed the American family. The coming Alzheimer’s technologies will arguably change my profession as technologies have changed fields like oncology and cardiology. Alzheimer’s doctors will pass less time talking with the patient and family about the patient and how they’re living with and making sense of the disease, and more time talking about the technologies. The Alzheimer’s doctors who run the centers will not be doctors like me who like to ask questions to write vivid narratives about a typical day. I’ll be replaced by different and probably younger doctors who like talking about the scans and the drugs. I fear one side effect of these technologies is that we’ll stop caring about our patients’ days. ___________________________________________ Jason Karlawish is a Professor of Medicine, Medical Ethics and Health Policy, and Neurology at the University of Pennsylvania.
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With gratitude, we recognize these recent donors Gifts received in 2016 up to November 1.
Gifts of $5,000
In honor of Janet Caplan Ms. Dolores Miller In memory of Inge A. Grohn American Turners Jahn Education Fund In memory of Patrick F. Kennedy Mr. Steven Chen
Mr. and Mrs. Michael D. Fishbein
Gifts of $2,500
In honor of Roy Hamilton, MD and James D. Lewis, MD, MSCE Mr. and Mrs. Martin Krimsky
Gifts of $1,000
Mr. John S. Buzby, Sr. Mr. Steve Downing Mr. and Mrs. Lawrence A. Marcus Verizon Communications
Gifts of $200-499 American Endowment Foundation Mr. Daniel Criel Mrs. Marianne S. Rhoads
In memory of Joseph F. Campbell Ms. Barbara E. DeSanctis Mr. and Mrs. Harry S. Forst
In honor of Eli and Janet Caplan Ms. Pamela Rosenau
In honor of Eli and Janet Caplan Mr. and Mrs. Eli Caplan Mr. and Mrs. Joseph Zuritsky
In memory of Patrick F. Kennedy Balson Family Foundation
In memory of Inge A. Grohn Mr. and Mrs. Edmund L. Scherer
In memory of Rella Seidenfeld Mr. Gregg A. Geffen
In memory of Patrick F. Kennedy Mr. John E. Elicker, Jr.
Gifts of $700
In memory of George Ulmer, Jr. Mr. and Mrs. Erich F. Lukas, Jr. Dr. Sara Missett Mr. Charles Schmidt Midnight Graphics
In memory of Helen Felsenthal Mrs. Danielle Smiley
Gifts of $500 Mr. Harry R. Hicks
In memory of Charles Bolling and Lea H. Bolling Mr. Jay Badgley and Mr. Stevens H. Harrison
In honor of Ms. Marianne Watson Mr. John E. McDowell
In honor of Eli Caplan Ms. Dolores Miller Mr. Murray Spain
Mr. and Mrs. James C. Catrickes Mr. Dave Cronomiz Mr. Chester Cyzio and Mrs. Helen McElroy-Cyzio
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Gifts of $100-199
Ms. Vivian Golden Mr. and Mrs. Thomas Potts Mr. John N. Rudolph, Jr. Mr. and Mrs. Carl S. Viola In memory of Joseph F. Campbell Mrs. Margaret M. Campbell In honor of Mrs. Mona Cheung Mr. Jeffrey T. H. Cheung In memory of Helen Felsenthal Ms. Kristin Mirek In memory of Jacquelynne Gano Mr. Duen Li Kao In honor of Roy H. Hamilton, MD Mr. Robert Klein In memory of Doris S. Keating Mr. John J. Keating In memory of Patrick F. Kennedy Ms. Astra B. Czerny Mr. and Mrs. Donald M. Detwiler Ms. Vicki Townend In memory of Patricia Kind Nadine Flexer In memory of Norman Kitchen Ms. Drusilla Barmby Mr. Volkan Goren Mrs. Renate C. Impicciatore In memory of Shirley J. Klinck Mr. Ronan M. Sheil In memory of Francine Ost Ms. Nadine Flexer In honor of Lillian M. Ludwig Ms. Patricia J. Ludwig
newsletter of the penn memory center
In memory of Lorraine Rosenberg Ms. Stefani L. Ash Mrs. Marcy Debson Mrs. Jessica L. Koch Mrs. Paulette Koch Mr. Timothy Moran In honor of Joanne Ruser Ms. Margaret Russell In memory of Edith Tucker Mrs. Barbara A. Reeves In memory of George Ulmer, Jr. Mr. and Mrs. Richard A. Bailey Mr. and Mrs. Robert F. Brumbaugh Mr. and Mrs. Kevin C. Fillmore Mr. and Mrs. William E. Kott Mr. and Mrs. George Kugler Friends of Penn’s 5K for the IOA Ms. Gertrudis L. Quinn Mr. and Mrs. Walter L. Reichner Mr. and Mrs. Charles W. Samph Mr. and Mrs. L. Russell Schenck Mr. and Mrs. Richard Daniel Soltan Mr. and Mrs. Arthur P. Stevens Mr. and Mrs. Donald H. Stock Mr. and Mrs. Edward E. Ulmer Mrs. Elizabeth P. Ulmer Mr. and Mrs. Allen R. Werner In memory of Albina Wallis Dr. George T. Furst
Gifts up to $99
Ms. Marci Alborghetti Mr. and Mrs. Alfred F. Beers Mr. and Mrs. David C. Brubaker
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Make a gift online Visit www.pennmemorycenter.org/gifts. In memory of Joseph DeSouza Ms. Nadine Flexer
Mr. Dave Cronomiz Mr. and Mrs. Sheldon Faktorow Mr. and Mrs. Gregory N. Hall Ms. Ruth M. Helm Ms. Almeda Henry IBM Corporation Mr. and Mrs. Edward J. Jankowsky Joseph D. Lubin, MD and Mrs. Dolores A. Lubin Mr. and Mrs. George Maalouf Ms. Margaret Mcnally Mr. Victor Kodzo Ofori Mr. and Mrs. Philip J. Matilla Dr. and Mrs. Michael F. Schwartz Mr. and Mrs. Lloyd C. Whittaker
In memory of Marty Dimmerman Ms. Nadine Flexer In memory of Patricia Emore Mr. and Mrs. Daniel D. Bones Ms. Jacqueline Bretz Ms. Dorothy Fritsch Mr. Joseph O’Keefe Ms. Loretta M. Schoen In memory of Helen Felsenthal Ms. Kara Lombard In memory of Inge A. Grohn Mrs. Lidia T. Kawecki Mrs. Vicki Lambros Mr. Joseph M. Nicoletti Mr. Frank C. Wedl Ms. Donna R. Weinstein
In memory of Murray Borrenstein Mr. and Mrs. Gary M. Survis Quest Diagnostics In memory of Calvin Bowers Mr. and Mrs. F. J. Tripodi In memory of Joseph Burke Mr. and Mrs. Paschal C. Gazzillo In memory of Robert Burke Mr. William J. Hurley In memory of Joseph F. Campbell Mr. and Mrs. Albert Cupo Mr. Marty Milligan In memory of Eloise Cummins Ms. Laurie Foster
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In memory of James Bennington Irvine Ms. Margaret M. Frederick In memory of Robert Allen Kear Ms. Marilyn I. Rector In memory of Patrick F. Kennedy Mrs. Denise Koenig Ms. Sara Levine Mr. and Mrs. Edward Magil Mr. James J. Meehan Mr. Robert A. O’Connell Dr. Gail Coffey Reichle Mr. and Mrs. Stanley G. Rodefeld Mr. Thomas Southmayd Mr. and Mrs. Francis J. Sullivan
In memory of Akram Ali Khan Mr. Zeeshan R. Khan
In memory of Salvatore Simonetta Ms. Karen V. Paulus
In memory of Norman R. Kitchen Ms. Marilyn Dale Mr. and Mrs. Thomas R. Lettieri Ms. Marybeth O’Malley Ms. Joe-Anne Roberts
In memory of George Ulmer, Jr. Mr. and Mrs. Edwin F. Bates, Jr. Ms. Heather J. Bech Ms. Susan Calhoun Ms. Janet Carter Mr. and Mrs. Charles Christian Mrs. Patti Clifford Mr. and Mrs. Paul Conroy Mr. and Mrs. Gary R. Ebling Ms. Jeanne H. Gaertner Mr. David J. Hamburg Ms. Rosemary Hargreaves Ms. Esther D. Kraeer Ms. Frances Marchesani-Oppman Mr. and Mrs. George Matysik Mr. and Mrs. James S. Murray Dr. and Mrs. Alan Nathanson Mr. Dennis Joseph O’Leary, Sr. Mr. and Mrs. J. Patrick O’Mara Mr. and Mrs. Charles Ott Ms. Janice Rae Mr. Robert Reiff Mr. and Mrs. Stanley G. Rodefeld Ms. Lorna Rosenberg Mr. Paul C. Rusch Mr. John R. Sharpe Ms. Dorothy H. Smith Mrs. Barbara A. Sollberger Ms. Bette Tokar Ms. Rosemary Trombetta Ms. Joyce B. Wyeth
In memory of Shirley J. Klinck Ms. Julianne Hill Ms. Angela N. McMichael Mr. Jason Seta In memory of Dean Mason Mrs. Susan M. Reisbord In memory of Donald Metzger Nadine Flexer In memory of Lorraine Rosenberg Mr. and Mrs. Donald Albert Mrs. Miiriam Axelrod Ms. Eileen Campbell Ms. Joanne Fishman Ms. Hannah Gibson Mrs. Julie V. Goldman Dr. and Mrs. Peter R. Heisen Ms. Lynda Miller Mr. Saul Victor and Mrs. Beverly A. Siegel Ms. Lisa Simon Mrs. Carol A. Simpson Ms. Judith Slagoff Mrs. Jacqueline Swartz Ms. Maxine Temkin Mrs. Ellen B. Turk In memory of Alice Rothschild Ms. Helen C. Aster In memory of Angelina Rubinstein Dr. Beth W. Nalitt and Peter N. Nalitt, Esq.
newsletter of the penn memory center
In memory of Aaron Wishnoff Ms. Helen C. Aster In memory of Ronald Yost Ms. Marianne Antczak Ms. Jean L. Harle Mr. and Mrs. Thomas R. Rapa
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On people and efforts that bring the knowledge we seek on Alzheimer’s disease and lifelong brain health ever closer in sight.
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American, Cuban researchers ‘speaking the same language’
PUBLISHER Jason Karlawish jason.karlawish@uphs.upenn.edu EDITOR Terrence Casey terrence.casey@uphs.upenn.edu 215-898-9979 CONTRIBUTORS Adam Clair Dutch Godshalk Darby Marx David Ney OFFICE 3615 Chestnut Street Philadelphia, PA 19104 www.pennadc.org www.makingsenseofalzheimers.org Follow us on Facebook https://www.facebook.com/ PennMemoryCenter l The Penn Memory Center is a National Institute on Agingdesignated Alzheimer’s Disease Center (ADC), one of only 29 such centers in the United States, and the only one in our tri-state region. l Our staff and programs are dedicated to research in Alzheimer’s disease, age-related cognitive problems, lifelong brain health and improving the well-being of our patients and their families. l Produced by the Penn Memory Center, part of Penn Medicine. We welcome and encourage your questions, comments, suggestions and gifts. PRINTING Fort Nassau Graphics http://fortnassaugraphics.net/
Courtesy of Dr. David Wolk Above: Dr. David Wolk rides in a Havana cab to the 18th International Organization of Psychphysiology Congress. Below: La Plaza de San Francisco in Havana, Cuba.
Cuban researchers are excited about the new opportunity to collaborate with their American peers following normalization of relations after a 54-year divorce. That was Penn Memory Center CoDirector Dr. David Wolk’s takeaway from the 18th International Organization of Psychophysiology Congress, held in Havana, Cuba this past August. In the communist state of Cuba, scientists are paid poorly and have a fraction of the resources available to US organizations like the Penn Memory Center. But Cuban researchers are “speaking the same language” as their American counterparts, Wolk said. “They’re asking the same questions, but using different tools,” said Wolk, who
noted that Cuban research was “sophisticated” in its own right. Presidents Barack Obama and Raul Castro announced the beginning of the process of normalizing relations between the nations in December 2014.