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    Clinical Centers of Excellence:
    Diagnosis, treatment of dementia


    Dementia affects about 4 million to 5 million people in the United States. It affects about one percent of people aged 60 to 64 years and as many as 30 percent to 50 percent of those aged more than 85 years. Dementia is a cause of significant morbidity and mortality and is a leading cause of institutionalization. It places a substantial burden on patients and their caregivers.

    Patients with dementia present a significant diagnostic and treatment challenge to primary care physicians. The leading types of irreversible dementia:

    • Alzheimer's disease (about 50 percent of cases),
    • Vascular dementia (about 40 percent of cases), and
    • Lewy body dementia.

    Treatment and caregiver decisions often are based on whether mild, moderate, or severe dementia has been diagnosed in a patient. Primary care physicians may decide in consultation with the patient or patient's caregiver to refer the patient to a center specializing in dementia.

    This month's Clinical Centers of Excellence series features facilities offering comprehensive diagnostic modalities and state-of-the-art treatment modalities including investigational protocols for dementia. The centers also use behavioral interventions and support care.

    The dementia centers were chosen based on a survey of neurologists. Each center was asked to provide patient statistics, research protocol information, and other pertinent dementia management features. We do not rank the centers relative to each other but highlight what makes each one unique. We could not profile them all but have included a list of the other Clinical Centers of Excellence identified by our survey (see the accompanying list).

    Medical Economics' editors also have gathered management and referral tips from the experts associated with the featured centers. These tips may be useful when managing patients with seizure disorders in the primary care setting.

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