With new federal funding, a team of faculty at Virginia Commonwealth University is leading a project to address health disparities by improving access to care and risk reduction services around Alzheimer’s disease and related dementias for low-income older adults in the Richmond area.
The VCU Richmond Brain Health Collaborative has received a new three-year, $1.2 million grant from the Alzheimer’s Disease Programs Initiative of Administration for Community Living, part of the U.S. Department of Health and Human Services. The Alzheimer’s Disease Programs Initiative supports state and community efforts to increase the availability of home- and community-based services and resources for people living with — or at risk for — Alzheimer’s disease and related dementias and their caregivers.
The new funding will allow the program to expand available services in two areas:
- Health coaching in the community to reduce the risk factors associated with developing advanced dementia, and
- Navigation services to connect people and their caregivers to the right resources, both in the community and at VCU Health, and provide support
The VCU faculty are targeting low-income older adults in areas of Richmond where support services are most needed. Their previous research has shown that many of the residents in greatest need for these services are individuals from racial minority populations in the U.S. who have been significantly impacted by health disparities.
Faika Zanjani, Ph.D., the project’s contact principal investigator and one of three co-directors on the project, has studied health disparities related to Alzheimer’s disease and related dementias as the associate director of academic programs and research training at VCU Institute for Inclusion, Inquiry and Innovation (iCubed). This project, she said, is unique in that it provides the opportunity to deliver sustainable solutions for community members and caregivers who often don’t know where to turn when faced with symptoms or a diagnosis of dementia.
“We want to improve their quality of life,” said Zanjani, an associate professor in the Department of Gerontologyat VCU College of Health Professions. “We really want to make each phase of this process easier for the community and the patients that go through it so hopefully they’ll feel better and their health will be better.”
The project stemmed from work Zanjani and project co-director Lana Sargent, Ph.D., assistant professor in the Department of Adult Health and Nursing Systems at VCU School of Nursing and a Geriatric Nurse Practitioner at VCU Health, were doing together through health coaching in the community to reduce the risk of developing Alzheimer’s. “I wanted to see if we could manage risk reduction, and if we could take care of the patients before their dementia gets bad,” Zanjani said.
These community members and their families often were interested in getting more information, Zanjani said. As the idea for a project to bridge gaps in information began to form, the pair connected with Brian Berman, M.D., who joined VCU Health as director of the VCU Parkinson’s and Movement Disorders Center in the fall of 2020. Both he and Sargent see patients who have questions similar to what Sargent and Zanjani were hearing from community members.
“I was just in with a patient today who said, ‘Our primary care doctor asked us to see someone about memory care, and we have no idea where to go or where to start,’ ” said Berman, division chair of Movement Disorders and Behavioral Neurology in the Department of Neurology at VCU School of Medicine. “There is just such a dearth of guidance and information out there, and people really don’t know where to go.”
For those facing dementia, the project will provide added patient navigation services and connect them with existing resources so they understand what’s available to them.
“This is the infrastructure that is really going to help fill a lot of the gaps that we had already been seeing, both on the community-based side and on the clinic side,” said Sargent, who is also a faculty member of iCubed’s Health and Wellness in Aging Populations core alongside Zanjani. “From there, once you build those foundational support services and you make all these community-partner connections that we’re making now, the hope is that you can start building bigger projects things that make an impact, not only in the community, but potentially on the disease itself.”
The team aims to create partnerships with local organizations that work with individuals with Alzheimer’s disease and related dementias. These include the Alzheimer’s Association’s Greater Richmond chapter, Virginia Department for Aging and Rehabilitative Services, No Wrong Door Virginia and Senior Connections, The Capital Area Agency on Aging. The team will continue to work with existing organizations affiliated with VCU, such as the Richmond Health and Wellness Program, which works with high-risk, low-income older adults in the Richmond area. They’ll collaborate with teams at the Riverside Center for Excellence in Aging and Lifelong Health and University of Nebraska at Omaha’s Department of Gerontology to implement the grant.
This project will expand the team’s health coaching work to continue reducing community members’ risk factors associated with dementia. “It’s about making those supported services so that, while we engage them in medical care, they get the services so they can remain safely independent,” said Sargent, an affiliate faculty member at VCU School of Pharmacy.
The effort will also build services for existing patients at VCU Health’s behavioral neurology clinics.
“Patients with dementia often have poor awareness of what’s happening to them and it’s the caregivers and the families who are most impacted by these diagnoses,” said Berman, VCU’s Bemiss Endowed Chair. “What I would love to see is reaching out to these caregivers and families and getting them the support that they need to better take care of the patient when they get home.”
Sargent said the idea around the project is navigating and meeting the specific needs of individual community members and their caregivers, which is at the core of addressing health disparities.
“At VCU and VCU Health, we are proud to support this effort to extend the independence, well-being and health of those at risk for or living with Alzheimer’s and other causes of dementia,” said Art Kellermann, M.D., senior vice president for VCU Health Sciences and CEO of VCU Health. “It is consistent with our mission to serve metro Richmond and the commonwealth. The efforts of these dedicated faculty members across VCU Health Sciences and our health system demonstrate the power of teamwork to reduce and ultimately eliminate health disparities that put vulnerable individuals at greater risk of these diseases.”
The team has previously received pilot funding from the VCU Presidential Research Quest Fund; the Virginia Center on Aging at VCU College of Health Professions’ Alzheimer’s and Related Diseases Research Award Fund and the VCU COVID-19 Rapid Research Funding Opportunity, sponsored by the Office of the Vice President for Research and Innovation and the C. Kenneth and Dianne Wright Center for Clinical and Translational Research. In addition, Zanjani and Sargent earlier this year were awarded one of VCU’s first-ever Community-Engaged Research Health Equity Grants.
Zanjani said each new grant has gone toward work that has improved the team’s understanding of what has the most potential to benefit the community.
“These were all like stepping stones right from the beginning,” Zanjani said. “With each increment, we’ve been able to enhance the project to create this VCU Richmond Brain Health Collaborative and get a better picture of those challenges so we can support the Alzheimer’s disease and related dementia needs of our community.”