Thursday, March 27, 2014

Telemedicine can help delay Alzheimer's, especially in rural areas, where it starts sooner, Appalachian health conference is told

By Melissa Landon
Kentucky Health News

Telemedicine is a strategy that can be used to help prevent and treat Alzheimer's disease, especially in rural areas, where the disease comes sooner in life, Dr. Gregory Jicha, clinical-core director of the University of Kentucky's Disease Center, said today at the fourth annual Appalachian Translational Research Network Summit in Lexington.

Dr. Gregory Jicha
While mortality rates for prostate cancer, breast cancer, heart disease and HIV are going down, the rates for Alzheimer's are going up, and by 2020, it is estimated that 5.6 million Americans could be affected by it. Rural areas have higher incidents of the condition, and the onset of dementia averages four years younger in rural areas than in urban areas, Jicha said.

The university's Telemedicine Cognition Clinic offers appointments that involve video interaction with patients and caregivers in remote areas. In rural areas in general, telemedicine can be particularly helpful for patients who live great distances from the nearest specialist. "I cannot drive to Paducah and fill an entire clinic every week," Jicha said. But he explained that he can "travel" to a different city every hour and provide care to patients. "Telemedicine really is the wave of the future," he said. 

During telemedicine appointments, medical experts can talk about the patients' history, administer cognitive tests, and even observe patients walking or performing tasks to diagnose them. The goal of the program is to provide high level care and cognitive evaluations in rural areas by partnering with primary care physicians and clinics in rural areas, Jicha said.

Another important aspect of the growing program is education, both for patients and for physicians. Alzheimer's disease has no sure, but some risk factors associated with it—such as hypertension, alcohol use and depression—are treatable. If rural residents had better access to specialists who can detect the early symptoms of the disease, its onset could be delayed.

The conference was a forum for hundreds of research efforts. Among the topics discussed during the conference were the connection between physical fitness and academic performance in children, and environmental enrichment to promote healthy aging brains.

Todd Gress, a professor at Marshall University in Huntington, W.Va., presented a study about a pilot test of a text-message reminder system to advance diabetes awareness, compliance, and education—particularly in remote areas where cell phone service might be unreliable.

The advancing telemedicine strategy and these other research agendas should serve as a reminder that gifted researchers are searching for ways to improve rural health.

Such conferences "represent the best of what's happening out there in the world of universities and the world of communities," UK Provost Christine Rirodan told one session. She said the Appalachian gathering "represents the passion of people who are dedicated to solving these problems" in the region, "which require a great deal of collaboration to solve. . . . They're not small problems."

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