Research Areas & Featured Projects

Project: Advancing Our Understanding of Lucidity in Dementia

People living with Alzheimer’s disease and related dementias experience progressive losses in memory and thinking abilities. Yet, lucid episodes, described as periods of a remarkable return to previous abilities and awareness, have been reported by family members and health care providers. The project is one of a handful being funded by the agency to accelerate scientific discoveries in this area. Unfortunately, our understanding of this phenomena is extremely limited, and no large-scale studies have attempted to prospectively identify and characterize these events. A better understanding of lucid episodes, particularly in advanced stages of dementia, has important implications for our understanding of disease progression, retained abilities, and care. Our team will lead one of the first large scale studies focused on lucidity in dementia, with the goal of advancing observational and computational linguistic approaches for capturing and characterizing these events and their distinguishing features.  Funding: National Institue on Aging

Project: The Personalized Approach and Targeted Interventions (PROACTIVE) Treatment Approach

Neuropsychiatric symptoms (such as agitation) are common and persistent for persons with dementia and often increase in number and severity during hospitalization. To address the need for interventional approaches to managing neuropsychiatric symptoms in the acute care environment, we partnered with clinicians to develop, pilot, and evaluate the Personalized Approach and Targeted Interventions (PROACTIVE) Treatment Approach– a low-cost, multi-faceted, nurse-led intervention designed to improve prevention and management of dementia-related neuropsychiatric symptoms in acute care. An initial pilot evaluation of PROACTIVE Treatment Approach on an inpatient medical unit in a VHA hospital setting demonstrated decreases in prolonged use of antipsychotics, shorter lengths of stay, shorter duration of 1:1 observation, and greater confidence among nursing staff in managing neuropsychiatric symptoms. The PROACTIVE Treatment Approach has been sustained on this unit and is now being implemented on other units in the intervention hospital. Funding: National Institute on Aging

Project: The Stakeholders Understanding of Prevention Protection & Opportunities to Reduce Frequent Hospitalizations (SUPPORT) Study

The SUPPORT Study (Stakeholders Understanding of Prevention Protection & Opportunities to Reduce FrequenT Hospitalizations) is a multi-site qualitative study aimed at understanding diverse stakeholders perspectives regarding preventable hospitalization and re-hospitalization events among people with dementia. This study is one part of a broader nation-wide effort to inform and improve national re-hospitalization policies, and identify effective community and caregiver-responsive strategies for bolstering resilience and supports that are protective against hospitalization. Funding: National Institute on Minority Health and Health Disparities

Project: HelpCareConnect (HCC)

We partner with the Werner Lab at UW-Madison, led by Dr. Nicole Werner, to support the development of a scalable caregiver learning health system, HelpCareConnect (HCC). HCC adopts a human factors approach to understanding caregiving teams by systematically addressing information sharing, taskload distribution, communication, and ongoing adaptation of caregiving strategies through a mobile health information technology (Health IT) application. This work centers the design needs of caregivers of people with dementia throughout the development process. Funding: National Science Foundation, National Institute on Aging, Institute for Clinical and Translational Research (Werner)

Project: Care Coordination Following Acute Illness Care

People with dementia experience frequent transitions in care that are often poorly managed and have disproportionately higher utilization rates of unscheduled acute care, which is associated with various negative outcomes. To mitigate these risks and outcomes, comprehensively addressing the transitional care needs of people with dementia during the post-acute care period is critical. Drawing from end-user input, electronic health record data, and Medicare claims data sources, we identify and evaluate coordination and communication of important care needs surrounding and following acute illness care episodes. Major areas of foci for this work have included: transitional care needs and communication during hospital to skilled nursing facility transitions, discharge communication quality regarding high-risk care needs (follow-up care specification, high-risk medications), pain management, and coordination related to dementia-specific care needs (neuropsychiatric symptoms). Funding: National Hartford Center of Gerontological Nursing Excellence, Mayday Fund

Project: Electronic Health Record-Based Phenotyping for Cognitive Impairment

Dementia and cognitive impairment are under-recognized during hospitalization, limiting opportunities to improve detection, diagnosis, and connection to appropriate care and services for cognitively vulnerable populations. Automated electronic health record (EHR) driven approaches hold promise for improving detection and supporting clinicians in recognition of potential cognitive impairment. Yet, these algorithms rely heavily on structured data sources (i.e. ICD codes, medication events) which limit utility among underrepresented populations who are systematically less likely to receive care, diagnosis, and treatment. Our team has derived an electronic health record-based phenotype definition for identifying potential cognitive impairment during acute illness care harnessing unstructured (free text) notes in the electronic health record. We are now leading validation of this and other phenotype models in community based and longitudinal cohorts. Funding: National Institute on Aging

Project: Brain Health Community Registry

Existing paradigms and practices around dementia research recruitment often do not recognize or respond to priorities, concerns, and constraints relevant to participants from diverse backgrounds. To address these gaps, we have developed and applied a research recruitment and engagement model and registry that centers and prioritizes research participant needs. Funding: Wisconsin Alzheimer’s Disease Research Center REC Scholars Program, University of Wisconsin-Madison Vilas Award, NACC