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AAIC Press Release

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Alzheimer's Association®  |  Media line: 312.335.4078  |  E-mail: media@alz.org  |
AAIC 2013 press room, July 13-18: 617.954.3414

People with Early-Stage Alzheimer's Mentor Medical Students
to Increase Knowledge and Reduce Stigma

BOSTON, July 17, 2013 – While the global population is aging, and the personal and economic burdens due to Alzheimer's disease and related disorders are skyrocketing, the number of doctors trained to effectively diagnose and treat people with Alzheimer's is already woefully inadequate. Experts in health policy and practice have indicated the need for more comprehensive education for health care professionals in dementia and aging to meet the needs of the growing number of older adults in the United States.

According to the American Geriatrics Society:1

"This is a challenging situation for older individuals, families and our healthcare system," said Maria Carrillo, Ph.D., Alzheimer's Association vice president of medical and scientific relations.

At the same time, a program developed by the Northwestern University Alzheimer's Disease Center in Chicago — and replicated now in Massachusetts, Missouri and New Hampshire — provides opportunities for first-year medical students and persons diagnosed with early stage Alzheimer's to participate together in experiential learning programs. In the Buddy Program, medical students are paired with individuals with dementia, and the "buddies" plan a year of regular meetings around mutually satisfying activities.

These programs are improving medical student knowledge and familiarity with Alzheimer's while also heightening sensitivity and empathy toward people with the disease, according to new data reported today at the Alzheimer's Association International Conference® 2013 (AAIC® 2013) in Boston.

The goals of the Buddy Program are to:

"We want to expand future physicians' knowledge of, interest in and attitudes toward Alzheimer's and dementia in order to increase the number of physicians capable of caring effectively and compassionately for patients with these diseases and their families," said Darby Morhardt, MSW, LCSW, research associate professor in cognitive neurology at the Northwestern University Feinberg School of Medicine.

To date, the Buddy Program has paired 167 medical students and persons with dementia over 16 years. Scores on a Dementia Knowledge Test, created by Morhardt and colleagues in 2000, reveal modest improvement in student knowledge. Analysis of student journal entries, a program requirement following each activity, yield themes that include heightened sensitivity and empathy toward persons with Alzheimer's, increased recognition of remaining strengths and a change in students' preconceptions of dementia.

According to Morhardt, "Many students remark on the comfort and enjoyment they experience with their mentor and for some an increased comfort over the course of the year."

For example, one student wrote, "I feel like my interactions with (my mentor) are becoming more fluid as I begin to ask fewer complex questions and incorporate his viewpoint into my own speech. I also feel more comfortable ‘jumping in' when (my mentor) struggles for too long with a word or sentence without threatening his independence. I understand so much more about (my mentor's) experience than I could even imagine before we met."

First-year medical students are selected based on interest and willingness to commit to these program requirements: 1) attendance at two 90-minute orientation sessions and monthly process meetings; 2) four hours per month in activity with their buddy for one academic year; and 3) submission of a semi-structured journal report following each visit. A pre-/post-dementia knowledge test assesses student's objective learning, and student journal entries are qualitatively analyzed for themes.

Three Successful Replication Programs

The program has been successfully replicated at Boston University (2006), Dartmouth College (2010) and Washington University (2012). Each replicating program has integrated unique modifications while keeping the primary elements in place.

The Boston University program (PAIRS, Partners in Alzheimer's Instruction Research Study) produced several innovations, including the use of a textbook geared toward students and non-specialists; an additional comprehensive dementia knowledge test to better assess students' factual learning; scales to measure attitudes toward Alzheimer's and dementia; measures of physician empathy; and an end-of-the-year reflective essay encompassing students' PAIRS program experiences — including what they have learned throughout the program and how they envision that these experiences will affect their subsequent careers.

"Students in the PAIRS program have consistently demonstrated improvement in factual knowledge, as well as gaining valuable new experiences and perspectives related to caregiver and personal aspects of Alzheimer's disease, such as the frustrations of living with memory loss," said Andrew Budson, M.D., director of the education core at the Boston University Alzheimer's Disease Center. "Students' empathy for patients and caregivers has increased, and they report decreased stigma and negative attitudes toward people with Alzheimer's."

The Dartmouth TALES (The Alzheimer's Learning Experience for Students) program has modified the structure of the Northwestern Buddy Program in the following ways: (1) In addition to first- and second-year medical students, Dartmouth College pre-medical students and master of public health students are permitted to enroll in the program; (2) two students are paired with each person with Alzheimer's and generally visit the person with Alzheimer's together; and (3) students in the program are given a survey of attitudes about Alzheimer's disease before beginning the program and after completing it. Nine medical students, 11 graduate students and 42 undergraduates have enrolled since the program began in 2010.

"While our students typically enter the program with generally positive attitudes toward Alzheimer's disease and those who have it, the experience of being in the program further improves their attitudes on nearly every dimension that we assess," said Robert B. Santulli, M.D., associate professor of psychiatry at the Geisel School of Medicine at Dartmouth.

Modifications to the model by Washington University (DUO, Dementia Understanding Opportunity) include a reduced time requirement to two hours per month and a modified recruitment partnership focusing on students with general geriatric interest, in lieu of neurology students. The DUO Program is midway through its pilot year and has recruited 40 percent more student participants than anticipated with a wait list for interested persons with dementia. In addition to the quantitative measures implemented from the Buddy Program, participant feedback and monthly reflections continue to provide rich data for future qualitative analysis. Several themes for further analysis, such as whether DUO's fewer partner hours can provide the same benefit as the longer hourly requirements of the existing Buddy-inspired programs, have already been identified.

According to the Alzheimer's Association 2013 Alzheimer's Disease Facts and Figures report, more than 5 million Americans are living with Alzheimer's disease. By 2050, the number of people with Alzheimer's could be as much as three times that amount. Yet too many people with Alzheimer's disease are undiagnosed — by some estimates, as many as 50 percent. Alzheimer's disease is the sixth-leading cause of death in the United States and is the only leading cause of death without a way to prevent, cure or even slow its progression.

About AAIC

The Alzheimer's Association International Conference (AAIC) is the world's largest conference of its kind, bringing together researchers from around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer's disease and related disorders. As a part of the Alzheimer's Association's research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community.

About the Alzheimer's Association

The Alzheimer's Association is the world's leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. Visit www.alz.org or call 800.272.3900.

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Dementia Care @ AAIC - Translating Research to Practice
Breakout Five: Volunteering and Mentoring, Wednesday, July 17, 2013, "Reciprocity: The Experience of Medical Students and Persons with Alzheimer's in the Northwestern Buddy Program"

Dementia Patients Mentor Medical Students: A Multi-Site Study

Presenting Author: Darby Morhardt

Darby Morhardt1, Andrew Budson2, Angela Jefferson3, Elizabeth Daube2, Robert Santulli4, Andrea Denny5 1Northwestern University Feinberg School of Medicine; 2Boston University School of Medicine; 3Vanderbilt University Medical Center; 4Geisel School of Medicine at Dartmouth; 5Washington University School of Medicine

The Buddy Program, developed by the Northwestern University Alzheimer's Disease Center (ADC) in 1997, provides opportunities for first-year medical students and persons diagnosed with early dementia to participate in an experiential learning program. Students are paired with diagnosed individuals and the "buddies" plan a year of regular meetings around mutually satisfying activities.

Boston University ADC has successfully replicated the program since 2006 (PAIRS), Dartmouth College began their program in 2010 (TALES) and Washington University ADC began offering the program (DUO) in fall 2012. Each replicating program has integrated unique modifications to the core structure while keeping primary elements in place.

This presentation will begin with a description of the original Buddy Program design, methodology, outcome measures and results.

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Make history at AAIC 2013 • Boston, MA • July 13-18, 2013