Alzheimer's disease (AD) is the most common cause of dementia, a general term for memory loss and information processing challenges that make daily life harder. As in other areas of healthcare, Wisconsin faces a critical shortage of geriatricians, whose work often focuses on this age-related disease, because there are too few care providers serving the state’s older patients. As the senior population grows, the workforce will need a 58% increase in geriatric specialists, especially in rural areas, to meet the demand for dementia and other care by 2050. The Advancing a Healthier Wisconsin Endowment is helping address this gap by funding a wide range of projects that tackle the challenges of Alzheimer’s disease from several angles
Age is the biggest risk factor for Alzheimer’s disease, with 10.6% of adults, or 110,900 people, aged 65 and older having the disease in Wisconsin. Other factors can raise the risk of cognitive decline, including high blood pressure, physical inactivity, midlife obesity, diabetes, smoking, and poor sleep. However, health inequities play a role in diagnosis and care – access to providers who understand patients' cultural backgrounds is limited, and stigma is a barrier for LGBTQ older adults and people with developmental disabilities seeking care.
An AHW-funded project led by Medical College of Wisconsin (MCW) Associate Professor of Neurology, Biophysics, and Biomedical Engineering, Leonardo Fernandino, PhD, sought to test patterns of brain activity to understand how the brain stores word meanings and to lay the groundwork for identifying precise biomarkers and, ultimately, earlier signs of AD.
Since mild cognitive impairment (MCI), a stage between normal aging and dementia that can include trouble finding or understanding words, the team believes that finding Alzheimer's earlier could help the future understanding and diagnosis of AD. They used functional magnetic resonance imaging (fMRI), a scan that shows which parts of the brain are active, at the Center for Imaging Research at MCW to measure activity during word-reading tasks, or semantic word processing, to identify patterns of brain activity.
Eleven people with amnestic MCI, a type of cognitive impairment that mainly affects memory, completed two fMRI scans one week apart. The team compared those findings with those of participants with no history of neurological or reading disorders. The result of this project was a complete process for studying how brains interpret word meanings, which can be applied to larger studies down the road and could build the models needed to someday aid early detection of Alzheimer’s disease.
Using AI for Brain Mapping
An AHW-funded project led by MCW Assistant Professor of Neurology Andrew Anderson, PhD, also aimed to improve dementia forecasting through brain scans and word meaning. This work leveraged a team of cognition experts using AI tools to interpret brain scans.
The project team compared AI’s understanding of a story to brain scans of older adults with and without MCI. While in fMRI machines, participants listened to 45 minutes of “The Old Man and the Sea” by Ernest Hemingway, with breaks for comprehension. The AI program, GPT-2, turned each word of the story into a list of numbers that captures its meaning.
The team lined those numbers up with the moment each word was spoken and checked how closely the AI's numbers matched activity in each part of the brain. A close match suggested that area is processing meaning clearly, and a weak match suggested it may be struggling. At the end of the project, the team submitted a scientific paper and continued research on AI language models.
Diagnosing Alzheimer's disease early is one component of optimizing treatment. Supporting the people who care for someone with the disease is another. Another project funded by AHW aimed to give caregivers of individuals with AD opportunities to build networks and participate in helpful programming . The effects of AD reach well beyond patients: more than 1 in 5 Wisconsin caregivers provide care for someone with Alzheimer's or another form of dementia. Many are unpaid, report high emotional stress, care for a child, or even have health problems of their own.
To relieve stressed caregivers, TimeSlips, along with MCW Associate Professor of Family and Community Medicine, Leslie Ruffalo, PhD, MS, wanted to use memory cafes as an antidote to the lack of support and isolation many caregivers may feel in that role. TimeSlips is a community organization that uses evidence-based communication and storytelling approaches to have a deeper impact on people with dementia and their caregivers.
Memory cafes offer an opportunity for connection and regular social gathering, allowing caregivers to share stories and find support with peers in similar situations. Memory cafes can take many forms, in person or virtually, and can be hosted through resource centers, public health departments, or community organizations.
With funding support from AHW, TimeSlips, Dr. Ruffalo, and team raised awareness of memory cafes and created a catalog of 139 cafe locations across Wisconsin via an Excel database. They also connected with Dementia Friendly America to add their catalog to the national memory cafe directory, providing Wisconsinites with a user-friendly, searchable database of these critical resources. Beyond the directory, the team interviewed healthcare staff, hosts, and senior service groups to track awareness of programs and gather perspectives.
Each of these projects gathered early data and tested ideas that can be built upon for new, longitudinal cognitive studies and larger initiatives that may improve the diagnosis and care for AD patients in the future.
Advancing a Healthier Wisconsin is proud to support this work to maximize the health of all Wisconsinites. To learn more about these and other projects we fund, visit our funded projects page.