A Community Approach to Managing Brain Health

Contributed by: Dennis Fortier, President, Medical Care Corporation

Science is important, but let’s not overlook pragmatism.

As described in this complimentary post, a pragmatic solution to the looming threat of an Alzheimer’s epidemic is more likely to bear fruit than the most progressed scientific solutions.  It is clear that a better-educated public, timelier diagnosis of medical conditions that impair memory, and robust treatment are all achievable endpoints in a successful campaign against this disease. Importantly, each of these can be achieved through pragmatic, community-based efforts to improve knowledge and raise standards of care among primary care physicians. 

Orange County Vital Aging Program - A Community Example
How such a pragmatic program could be implemented in any given community depends largely on the particular make-up of the organizations and healthcare providers in that community.  As a point of reference, the Orange County Vital Aging Program (OCVA) in southern California is already demonstrating this concept with encouraging early results.  That program provides a template for success worthy of further consideration.

The philosophy behind the OCVA is that timely discourse between an educated public and a well-trained physician community can catalyze better care and improved cognitive health on a mass scale.

The program supports a free website where local residents can gather information, view a community calendar of events and lectures, use free tools for risk identification and management, and find physicians who are trained to manage cognitive health.  Local physicians can use the site to register for ongoing CME courses about managing cognitive health, download guidelines for diagnosing and managing conditions that affect cognition, and to learn about community resources that might benefit their patients with memory disorders.

Having accomplished a foundation level of public education and physician training through public lectures and CME courses in its first year, the OCVA program is seeing three community trends:

1)    Patients who are aging normally, but who are worried about perceived declines in their cognition, are raising concerns to their physicians and then being objectively reassured about their good health without an expensive and unnecessary work-up.
2)    Patients with Alzheimer’s disease are being detected in a timely manner and can now benefit from robust intervention while their brains are still relatively healthy.
3)    Patients with other causes of cognitive impairment (depression, stroke, thyroid, sleep disorder, anxiety, etc.) are being diagnosed and treated effectively.

Conclusive evidence demonstrating that the OCVA program improves health and/or lowers costs of care will not be available until longer-term follow-up is complete.  But the early data suggest that the program has engaged the community and is changing the dynamic between patients and their physicians in the primary care channel.

Overall, the looming threat of an Alzheimer’s epidemic is a real problem that may well have painful consequences. We would all like more certainty that scientific efforts will soon thwart the disease, but we cannot yet count on that with high confidence.  In the meantime, a concerted effort to pragmatically implement the scientific advances from the past decade of research will significantly reduce its likely impact.

For more information about the Orange County Vital Aging Program, please visit the OCVA site or download this summary of Year-1 results.

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