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| Memory Disorders |
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Patient Population
Memory disorders in this patient population include Alzheimer's Disease
and patients with dementia. The Toronto Western Hospital Memory Disorders
Clinic evaluates approximately 450 patients annually (150 new consultations),
nearly double the number seen in 1996. The majority of patients are
managed on an ambulatory basis. The Clinic plays a crucial role in the
coordination of patient management and social support, reducing the
frequency of acute care hospital admission for this chronic care patient
population. Annually, more than 300 patients require social work evaluation
and support. Clinic Physicians provide consultation to the Psychogeriatric
Dementia Rehabilitation Unit of Toronto Rehabilitation Institute, evaluating
900 patients per year.
Education
The growing public health problem posed by Alzheimer’s Disease,
as well as increasing awareness and interest, necessitate an increasing
role for the TWH Memory Disorders Clinic in the training of medical graduates
enrolled in post-graduate programs, allied health professional trainees
and the general public.
Each year, more than 50 residents and fellows in Psychiatry, Geriatrics,
Internal Medicine and Neurology undertake core and elective rotations
through the Clinic. International postgraduate trainees and fellows participate
and the Clinic is also available for undergraduate ambulatory activities.
Lay-members of the Alzheimer Association attend to learn about the dementias,
and for guidance in the counseling and referral of patients/families for
medical and social assistance.
Research
This program includes and internationally recognized team which is
working to define the fundamental mechanisms causing AD, with the ultimate
goal of using the information to develop effective therapies and cures.
The TWH Memory Disorders Clinic has been actively involved in several
different types of research which has resulted in 29 lectures and more
than 30 peer-reviewed publications in 1998. Major scientific discoveries
include the mapping of a new Alzheimer’s Disease (AD) gene on chromosome
12.
Patients are recruited into clinical trials for new pharmacotherapies
in dementia including a Phase IV trial of Galantamine (John R. Wherrett).
A pre-clinical trial of a novel therapy for AD in a transgenic model of
AD is being planned. It is anticipated that this will be followed by Phase
I trials later in the year.
The Memory Disorders Clinic will participate in a multi-centre genetic
epidemiology study including Duke University, UCLA, Vanderbilt University
and Boston University.
Research applications have been submitted: 1) to test Vitamin E in Down
Syndrome subjects at risk for Alzheimer's Disease; 2) to develop educational
material for primary care physicians and care-givers; and 3) to develop
measures of quality of life for Alzheimer's Disease patients.
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