Mission & Introduction

History
In 1998, Dr. Bruce Miller, Dr. Joel Kramer, Dr. Kristine Yaffe, and Rosalie Gearhart started the Memory and Aging Center. There are approximately 1500 clinic appointments per year (500 new patient and 1000 follow-up visits) . There are 300-500 individuals participating in the center’s research projects per year.

New diagnostic and treatment approaches to Alzheimer’s disease (AD) and non-AD dementias, including Frontotemporal Dementia, Creutzfeldt-Jakob disease, and Mild Cognitive Impairment have been established at UCSF.

The two main components are:

• CLINICAL SERVICES
  Clinic locations are:
  
  • Memory and Aging Center (directed by Bruce Miller, MD)
    at UCSF Parnassus Campus
  • Memory Disorders Center (directed by Kristine Yaffe, MD, MP)
    at the San Francisco Veterans Administration Medical Center
  
  Outreach locations are:

• Self Help for the Elderly
• Chinatown Public Health Center
• Laguna Honda Hospital

• RESEARCH PROGRAMS (more about the Research)

Funding
The following organizations provide a majority of the funds that support research at the Memory and Aging Center:

• National Institutes of Health (NIH)
• National Institute on Aging (NIA)
• Department of Health Services (DHS), State of California
• Larry L. Hillblom Foundation
• John Douglas French Alzheimer’s Foundation
• Koret Family Foundation
• McBean Family Foundation

UCSF Alzheimer's Disease Research Center

In April 2004, the UCSF was designated as a national Alzheimer’s Disease Research Center (ADRC). The Memory and Aging Center, is the central coordinating site for the ADRC. Funded by the NIH, this large collaborative project involves multiple institutions and locations. It is designed to integrate basic science and clinical resources in order to investigate the clinical, molecular, neuropathological and neuroimaging features of Alzheimer’s disease (AD), non-AD dementias, and mild cognitive impairment (MCI). The ADRC has two overarching aims:

• To bridge the gap between laboratory and clinical studies in dementia and aging
• To explore the unique and overlapping symptoms seen in various neurodegenerative diseases

The ADRC uses standardized and novel methods to examine patients and biological specimens, so that new hypotheses can be tested regarding the pathogenesis, diagnosis, and treatment of dementia. The ADRC brings together investigators who are leaders in basic science and clinical research related to dementia.

The goals of the ADRC are to:

• Maintain large groups of reliably diagnosed dementia patients using novel approaches.
• Improve the diagnosis and treatment of patients by providing education to patients and their families for AD and non-AD dementias.
• Provide outreach to the Asian and Pacific-Islander population in San Francisco.
• Integrate UCSF’s novel diagnostic, imaging, and treatment approaches to AD and non-AD dementias into the national AD research community.

The ADRC is composed of several organizational units called “Cores”. Each Core has specific responsibilities and together support the research Projects. The ADRC blends the research efforts of various centers which support the Cores. The Cores and Projects are at the following sites:

• UCSF Memory and Aging Center
• Institute for Health and Aging
• San Francisco VA Medical Center
• Institute for Neurodegenerative Diseases
• Gladstone Institute of Neurological Disease

UCSF Memory and Aging Center
(primary location is UCSF Medical Center, other locations include UCSF Mt. Zion Hospital, San Francisco VA Medical Center, and San Francisco General Hospital)

Administrative, Education, and Outreach Core (Led by Drs. Bruce Miller, Lennart Mucke, Howard Rosen, and Craig Hou)
The Administrative division of this core provides overall management of all of the cores, projects, training, and minority outreach. The Education program engages UCSF departments in conferences, lectures, retreats, and web-based teaching with the goal of improving knowledge about AD and non-AD dementia and training future experts in the field. With the assistance of the Alzheimer’s Association and the Family Caregiver Alliance, caregiver education will be accomplished through national conferences for clinicians and caregivers focusing on AD, FTLD, and related disorders. The Outreach program develops material written in other languages, recruits for research projects, and collaborates with community-based organizations and health-care professionals that serve minority groups in order to spread information and encourage referral of minority individuals.

Clinical Core (Led by Drs. Bruce Miller and Joel Kramer, Kristine Yaffe, and Howard Rosen)
The Clinical Core focuses on the range of dementia-causing disorders and brain-behavior relationships. Dr. Miller is devoted to clinical research and patient care and wishes to facilitate recruitment, maintenance, and accurate diagnosis of patients in the core. The core maintains well-characterized cohorts of patients with Alzheimer’s disease (AD), frontotemporal lobar degeneration (FTLD), FTLD with amyotrophic lateral sclerosis (ALS), progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), Creutzfeldt-Jakob disease (CJD), and mild cognitive impairment (MCI). The variety of presenting symptoms in AD and MCI will be studied, with special emphasis on patients presenting with isolated language or executive/behavioral symptoms. Possible genetic factors will be studied by screening patients for specific genetic mutations. Information collected in the Clinical Core will be linked to data from the Imaging Core, Neuropathology Core, and the “Molecular Indicators of Dementia Related Deficits” project .

Institute for Health and Aging & UCSF Memory and Aging Center
Data Management and Biostatistical Core (Led by Dr. Patrick Fox, John Neuhaus, Leslie Ross, Joe Hesse)
The Data Management and Biostatistical Core ensures uniform and accurate collection of data. This core is based upong ongoing collaborations between UCSF’s Institute of Health and Aging and the UCSF Memory and Aging Center. Protecting data confidentiality and meeting HIPAA (Healthcare Information Protection and Accountability Act) guidelines are critical functions of this core.

UCSF Neuropathology Research Laboratory Neuropathology Core (Led by Drs. Stephen DeArmond, Eric Huang, and John Trojanowski)
The Neuropathology Core analyzes brain tissue collected in autopsies of individuals seen in the Clinical Core. The tissue samples are used by other UCSF ADRC investigators to study the relationship between the diagnosis, brain regions, pathology, behavior, and cognition.

San Francisco VA Medical Center
Imaging Core (Led by Dr. Michael Weiner)
Patients from the Clinical Care are scanned using a MRI through the Imaging Core. FTLD, AD, MCI and healthy volunteers are studied. This core provides one of the first comprehensive dementia studies using MRI at high fields and produces novel structural, chemical and physiological data. The scans and data are used to study brain-behavior relationships and the role of MRI in diagnosing disorders that cause dementia.

Institute for Neurodegenerative Diseases
PrP Sc Specific Interaction with Novel PrP-Fc Fusion Proteins (Led by Dr. Stanley Prusiner)
In order to study the structure of prion molecules (both normally-occuring and disease-causing), new proteins will be created from portions of disease-causing prion molecules and immunoglobulin proteins. This project will also explore the ability of these proteins to detect disease-causing prion in infected mice.

Gladstone Institute of Neurological Disease
Molecular Indicators of Dementia Related Deficits (Led by Dr. Lennart Mucke)
This project evaluates the relationship between cognitive deficits and calcium-dependent proteins in brain regions critical for memory. Advanced genetic and protein technology will be used to search for other molecules obtained from mouse models of AD that might indicate or contribute to cognitive deficits.