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In 2004,
the Virginia Alzheimer’s Disease and
Related Disorders Commission has
created a statewide “Virtual Alzheimer’s
Disease Center.” To date, this work has
received financial support from a federal
grant obtained by the Virginia Department of
Aging (The Alzheimer's Disease Demonstration
Grants to States Program).
In 2006, however,
the Commission has refined this effort so
that over the long term it will create a
centralized mechanism for ascertaining
patient needs and mounting coordinated
responses to those needs before they reach
crisis proportions. This effort has been
formally titled the “Virginia Alzheimer’s
Disease AlzPossible Initiative” (VACAPI).
VACAPI is established as a
virtual center or a center
without walls. The virtual
center concept is a
hybrid organization
designed to leverage intellectual assets,
rather than physical assets, to
attain its corporate objectives.
ASSUMPTIONS
The fundamental philosophy of
the virtual center concept is to create a
vibrant environment for discovery of
knowledge by assembling a critical mass of
talented and highly motivated professionals
with different skills and perspectives.
The operational ethic is cross-disciplinary,
involving experts and professionals from
different disciplines and/or institutions
working together on a common problem. The
research philosophy is based on a systems
approach to the solution of complex
problems, where the emphasis is on building
a multidisciplinary team of experts who
individually have an in-depth knowledge of
different parts of the problem. VACAPI will serve as a
facilitator or a spawning ground for new
ideas for solving specific problems. By
establishing an efficient management
organization, VACAPI expects to accelerate the process of
discovering effective interventions and new
methods of care aimed at reducing disability
and extending independent functioning.
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BACKGROUND AND RATIONALE
Life expectancy of the oldest-old is
increasing, while the prevalence of dementia
increases nearly exponentially beyond age
65. The number of people being affected by
Alzheimer’s disease (AD), the most prevalent
form of dementia, is growing at a faster
rate than the progress being made in
discovering the means to cope with the
emerging epidemic. In other words, the pace
of developing interventions to delay the
symptoms of disease is not adequate to
overcome the demographic forces, which are
increasing the total number of affected
individuals. The approaching crisis in the
national health care system stems from not
only the growing number of older people at
risk for prolonged disabilities such as
cognitive impairment due to dementia but
also the rising cost of labor intensive
care. Neither the general public nor its
policy makers appreciates the magnitude of
the pending public health disaster.
Alzheimer’s
disease, the most prevalent form of
dementia, currently costs nearly $100
billion a year, reflecting medical charges,
institutionalization, and informal care
costs. The average annual cost of
care is estimated to be between $40,000 to
$60,000 per patient, per year, with nearly
500,000 new patients every year.
By the year 2050, more than 14 million
individuals, up from four million today, may
be affected by Alzheimer’s disease and may
require medical care and
institutionalization.
The patterns of
demographic, economic,
and sociologic changes in society are going
to effect profoundly how care is provided
for people with Alzheimer’s disease. These
patterns will have their full impact as the
“baby-boom” generation ages into late life
20 to 30 years from now. These trends, which
foretell the devastating toll of dementia,
have already begun to shape the future
strategic plans of many public and private
organizations. Not only the families of the
people with the disease but also the whole
population of the Commonwealth of Virginia,
and the country as a whole will feel the
projected changes.
At the same time, remarkable
progress has been made since 1978 in
understanding Alzheimer’s disease. Now the
field has access to a rich array of
talents, tools, ideas, knowledge, and
experiences from diverse disciplines,
providing unique
opportunities for quantum leaps in
uncovering cause(s), early detection,
treatments, and new models of care.
New discoveries and leads have begun to
provide some measure of hope for
interventions that could
delay the onset of disabling
symptoms and enable patients to continue
functioning independently for longer
periods. It is estimated that a modest
delay in the onset of symptoms by five years
for all age groups over 65 would reduce
nearly half the total number of individuals
with the disease.
Therefore, the time is ripe
to launch a well-coordinated initiative
within the Commonwealth of Virginia to
capitalize on existing knowledge and
accelerate the process of translating new
knowledge into practical applications. The
success of such a venture is virtually
assured because the Commonwealth is
fortunate to have all of the essential
elements in place: a) the necessary human
capital, b) a very good network of social
services providers, c) a rich scientific
infrastructure, and d) a wealth of
exceptional medical, scientific, and
technical expertise.
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MISSION OF VACAPI
The mission of VACAPI is to promote the development
of a broad range of well-integrated
programs, services and research designed to
reduce the burden of the disease for the
citizens of the Commonwealth of Virginia.
The goal is to develop effective
interventions to maintain and/or extend the
independent functioning of people with the
disease. In short, the Comprehensive
Virtual Center shares the Alzheimer’s
Association’s vision which calls for the
creation of "A World without Alzheimer's
Disease" in the 21st century. The
Center will strive to establish a prototype
for the Nation to follow by creating “A
Commonwealth without Alzheimer’s disease”!
The primary objective of VACAPI is to provide a
framework for a “Systems Approach” in
attempting to find cost-effective solutions
to several problems with complex
interactions. This approach to
problem-solving is similar to that used in
the federal government’s “Manhattan Project”
and “Man in Space” program where great
emphasis is placed on coordination and
efficient use of existing resources,
services, technology-transfer/educational
and research activities and the
technical/scientific/professional expertise
within the Commonwealth of Virginia.
VACAPI,
when fully established, will integrate all
relevant programs, services and other
bench-to-bedsides activities to leverage as
much added value as possible from what is
already in place in Commonwealth of Virginia.
The ultimate aim is to create a national
resource that would be a magnet for major
grants and contracts and the repository of
additional research and development (R & D)
resources generated by participating
Virginia institutions from various outside
sources. Potentially, within a short
period, the Comprehensive Virtual Center
would be able to generate
multi-component/multi-disciplinary research
grant applications, such as the P30
Alzheimer’s Disease Core Center grant
proposal to the National Institute on Aging
(NIA) within the National Institutes of
Health (NIH), as well as additional R&D
contracts.
The quantity and the quality of research at
the academic and medical institutions within
the Commonwealth of Virginia are, indeed,
impressive. The productivity and competence
of investigators in the Commonwealth of
Virginia being well known nationally, the
center will enhance their collective
capabilities by facilitating collaborations
and cooperation. It is conceivable that
after the initial capitalization, priming
the pump, VACAPI
could become budget neutral by generating
the necessary funds from external sources
such as national foundations, federal
funding agencies, industry contracts,
venture capital investment or other
channels.
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SPECIFIC CHALLENGES TO BE ADDRESSED
The Virginia Alzheimer’s Disease and
Related Disorders Commission has formed several
cores to: 1) address strategic problem
areas as high priority targets in need of
new initiatives and/or further development
and 2) help develop a strategic business
plan for a virtual statewide initiative. The
cores are
organized to identify some of the broadly
defined generic challenges, problems, and
opportunities related to capacity-building,
services, social, financial, and scientific
research issues that the Commonwealth of
Virginia must address in order to avert the
pending public health catastrophe due to the
rapidly increasing numbers of people with
Alzheimer's disease. The present roster of
cores includes:
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ABOUT THE PROJECT