KU School of Medicine-Wichita

Moderately Severe Decline While they can probably still take care of personal needs (such as using the toilet), they could find it dicult to dress appropriately or be unable to remember simple facts about themselves. This stage can last around 1.5 years. Moderate Decline Your loved one may find it dicult to manage money, or remember what they had for breakfast. If they undergo mental status testing, it's likely that they will be diagnosed with dementia. The average length of this stage is around two years. Mild Decline As dementia worsens, you may notice subtle changes and signs that something "isn't quite right." They might be frequently losing their purse, or forgetting appointments. This stage can last up to seven years. 20 "It's not what we think we know, it's truly what patients are experiencing. This really gives us a feel for their day-to-day struggles. You actually embody the person who has the medical condition." — Tiany Schwasinger-Schmidt, M.D., Ph.D., FACP, associate professor, director, Internal Medicine, Center for Clinical Research aspects of memory, attention span, higher-order problem solving abilities, verbal abilities, visual-spatial abilities and more. The examiner then compares the patient's current functioning to normative data as well as to estimates of the patient's lifelong functioning to determine the presence, degree and nature of cognitive decline. Results from neuropsychological testing, along with the patient's symptom and medical histories, can help determine what, if any, kind of dementia a patient has. In people with Alzheimer's disease, for instance, "they might have good memory of the remote past but have trouble remembering a conversation that occurred several minutes before," Martin said. In frontotemporal dementia, which is more common in people under 65, personality, behavior and skills in language and executive functioning (higher order cognitive skills important to daily functioning) are impacted. Some patients are found to be experiencing normal changes associated with aging or perhaps cognitive diculties due to other conditions, such as depression or anxiety. While a dementia diagnosis is never good news, early detection can be helpful in starting treatment and relieving the anxiety of the unknown. After diagnosis, neuropsychologists meet with family members to oer guidance in setting up an advanced care plan, access community Alzheimer's or Lewy body dementia with Parkinsonian features. The program simulates the confusion, fear, trembling and other physical and emotional manifestations the diseases produce as well as the reaction of others with whom the simulated patient interacts. The goal: Increased empathy and understanding of a condition the students have not personally experienced that they can draw on during their medical careers. During the same clerkship, students spend time with residents of memory care homes operated by ComfortCare Homes, one of the city's largest providers of that care. Detecting dementia Phillip Martin, Ph.D., ABPP-CN, a neuropsychologist and associate professor, conducts neuropsychological assessments of adults and older adults. The evaluations include an interview of patients and family members, as well as an administration of a neuropsychological test battery. Martin said a battery of cognitive testing typically takes a couple hours and assesses various In a more basic form of research, the school, in conjunction with KU's Alzheimer's Disease Research Center in Kansas City, is contributing to a national database of information about people with memory impairment. It's hoped that the repository of cognitive tests, blood samples, brain scans and other data will help researchers identify biomarkers of the disease and advance care. And for participants, Schwasinger- Schmidt noted, "It's a really great opportunity to gain a lot of information" about themselves. Virtual and in-person experience In addition to research initiatives conducted at the Center for Clinical Research, educational initiatives are underway to better prepare the next generation of physicians. In 2020, KU Wichita medical students in their third-year neurological clerkship class started using virtual reality headsets to simulate what it's like to have Phillip Martin, Ph.D., ABPP-CN, associate professor Psychiatry & Behavioral Sciences

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