New Thinking ABOUT THINKING - Keep Memory Alive
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
NewThinking
SPRING 2023
A BOU T T HINK ING
JOHN PAUL DE JORIA
DAVID HUMM
TAL RONNEN
WOLFGANG PUCK
DIRECTOR’S MESSAGE
Since opening in 2009, Cleveland Clinic (see page 11). Our aim is to understand our
Lou Ruvo Center for Brain Health has patients and the sources of their suffering, and
facilitated more than 246,000 patient to integrate compassionate transdisciplinary
appointments with our providers. More treatment and research to improve the lives of
than 5,565 lives are currently in our care, today’s patients while we prepare trainees to
representing a total of more than 26,000 visits care for tomorrow’s patients, and drive research
in 2021 as we await the final tally for 2022. to hasten the day when there are no more
patients (see page 21).
The number of families we've served is
impressive, but their importance lies not in that In 2023, we celebrate our 26th annual
number; rather, it is in the extraordinarily deep Power of Love® gala. This year will be different
knowledge we have been able to gain about without our original caregiver, Angie Ruvo, who
what brain degeneration means. spurred her son Larry to turn pain into purpose,
raising millions to relieve the suffering of other
Yes, we have gained insight into proteins, families. On February 18, the anniversary
inflammation and neuroimaging (see page 9). of the death of her husband, Lou — the
Dylan Wint, MD More fundamentally, we are developing a better eponymous inspiration for a “one-stop shop”
Center Director understanding of how the biology of disease to reduce the burden on other families — we
and its related symptoms impact interpersonal kick off the next quarter-century of fundraising.
Camille and Larry Ruvo
Chair for Brain Health relationships, particularly family dynamics We will present our Community Leadership
(see page 25). For example we have assembled Award to John Paul DeJoria, the man who
Director, Education
a team of experts to help families consider serendipitously handed the very first check
Las Vegas Legacy
the benefits and burdens of testing for the to Larry to “do something about Alzheimer’s
Chair for Neuroscience
Education hereditary condition Huntington’s disease disease in Lou’s honor" (see page 3).
(see page 15).
Cleveland Clinic
Lou Ruvo Center for Please join me and 25 years of supporters
Brain Health Our team continues to stretch their own at our Power of Love gala and build upon
brains in pursuit of advanced specialization the legacy of Angie and Lou Ruvo, sustaining
(see page 13). We are actively pursuing deeper the family’s dream of a future without
understanding of how social determinants in brain degeneration.
communities outside Nevada’s urban cores
affect the prevalence and impact of dementia See you on Saturday, February 18.
1 New Thinking About Thinking Spring 2023
NewThinking
SPRING 2023 Cleveland Clinic Nevada
702.483.6000 | clevelandclinic.org/Nevada
Research, treatment and education for patients and
families living with brain disorders
A BOU T T HINK ING ALZHEIMER’S DISEASE PARKINSON’S DISEASE
FRONTOTEMPORAL DEMENTIA MULTIPLE SYSTEM ATROPHY
LEWY BODY DEMENTIA MULTIPLE SCLEROSIS
HUNTINGTON’S DISEASE
CONTENTS
FE AT URE S
3 Serving Up a Recipe for Better Neurological Care
5 25 Years of Impactful Giving: Celebrating the Power of Love®
7 Remembering David Humm, the Original Las Vegas Raider
C L INI C A L RE SE A R C H UPDAT E
9 Research Studies Drive Advances in Quest to Unlock the Mystery of AD
11 In Rural Nevada, an Urgent Need to Reduce Dementia Disparities
12 Retired Fighters Gain Improvement in Cognitive Function, Study Shows
13 Specialty Certifications Affirm Center’s Exceptionalism
5 WO RL D C L A S S C L INI C A L C A RE
15 In Families With Huntington’s Disease, an Agonizing Decision for Every Member
16 Wondering About Wandering?
17 Can You “Dual Task”? Physical and Cognitive Tasks Work Body and Brain
18 “Microhabits” Yield Macro Results in Personal Health
19 Dementia: It’s Time to Talk
PHIL A N T HRO P Y AT WO RK
20 New Research Highlights Women’s Cognitive Health Risks
21 An Approach That Serves Patients and Providers Well
11
22 2.0: Volunteer Program Gets a Reboot
23 Public-Private Funding Changes Nevada’s Neuroscience Landscape
C A RIN G FO R C A RE PA R T NE RS
22 25 Guilt: A Constant Companion in Care Relationships
O N T HE S C E NE
30 All In for Brain Health
31 Visitor Photo Gallery
32 Month of Memories
Be a lobby
7 volunteer!
33 Creative Collaborators Host Events to Support Brain Health
34 Recognized for Excellence
clevelandclinic.org/Nevada 2
FE ATURES
The Ruvo family arrives
in Las Vegas
Serving Up a Recipe for
Better Neurological Care
So an energetic maître d’ and a chef walk Alzheimer’s: An Uninvited Guest
into a neurology desert… But make no
Fast forward to 1991 and changes in
mistake: This isn’t the beginning of one
Lou’s memory had become undeniable.
of “those” jokes. Rather, it was the
The desert town that had been a great
beginning of one family’s legacy that has
venue for growing a business and raising
impacted a city of more than 2 million.
a son didn’t have the healthcare
And we’re deadly serious.
resources the Ruvo family needed.
When Angie and Lou Ruvo relocated
After visiting numerous doctors in search
from Buffalo, New York, to Las Vegas
of an explanation for the changes friends
in 1955 with their son, Larry, age 9,
and family had noticed in Lou, Angie Ruvo
they opened the Venetian Ristorante.
met Leon Thal, MD, in San Diego. The
It was the “see and be seen” dining
renowned researcher put his hand on
experience in town, attracting celebrities
her shoulder and said, “Mrs. Ruvo, you
and locals alike. Angie was widely
have a 24-hour-a-day job here. Lou
regarded as Las Vegas’ first celebrity
has Alzheimer’s.”
chef. Lou never forgot a face, and would
greet guests with a question about a Less than three years later, on February
mutual friend or the continuation of 18, 1994, Angie found Lou dead on their
a previous conversation. bedroom floor from a heart attack.
THE MOST WELCOME OF GUESTS: Enter John Paul DeJoria
“It was February 1995 and I was hosting given a check, others began opening their
a dinner at Spago for my company during a wallets; $35,000 had been raised by
hair convention,” John Paul DeJoria recalls. evening’s end. Camille and Larry Ruvo went
“When I arrived, the maître d’ said, ‘JP, did home that night with a new family mission:
you know your friend Larry Ruvo is here They would continue to keep Lou Ruvo’s
holding a dinner in memory of his dad?’” memory alive by doing something to change
the trajectory of Alzheimer’s disease.
About 35 people had gathered at Chef
Wolfgang Puck’s flagship Las Vegas A self-made man who emerged from
restaurant, Spago, on what is now an homelessness to co-found John Paul
historic night to pay tribute to Lou. Mitchell Systems and Patron Tequila,
John Paul lives by the motto “Success
“In appreciation of our friendship, I wrote
unshared is failure.” If he hadn’t shared his
Larry a check for $5,000 and said, ‘Put this
success with us, the Lou Ruvo Center for
toward something to change Alzheimer’s.’”
Brain Health wouldn’t exist. And so, we’re
Larry never envisioned the memorial dinner presenting John Paul with the Community
would become a fundraising event but, when Leadership Award at the 26th annual
he announced to guests that John Paul had Power of Love® gala (see page 5). John Paul DeJoria takes the
microphone at the gala in 2012
3 New Thinking About Thinking Spring 2023
FE ATURES
The Rise of Ruvo: World-Class Neurology
Care Emerges from the Desert Dust
Camille and Larry Ruvo set about to deliver
to Nevada families living with Alzheimer’s
disease the reassurance that a firm
diagnosis and ongoing education and
Larry Ruvo, with his mother,
support can offer. In 2007 they broke Angie, at the 2019 gala
ground on a Frank Gehry-designed structure
in downtown Las Vegas. On July 13, 2009,
Cleveland Clinic Lou Ruvo Center for Brain multiple sclerosis, and it is clear Nevada is for the Lou Ruvo Center for Brain Health
Health welcomed its first patient. facing an unprecedented need. and our commitment to caregivers through
no-cost educational, therapeutic and support
Since that time, the center has hosted more
Turning Pain into Purpose: services (clevelandclinic.org/NevadaEvents).
than 246,000 patient visits, and expanded to
Our first Power of Love without Angie
treat and research additional neurodegenera- On May 12, 2022, Angie Ruvo died These programs are part of Angie’s
tive diseases. In the process, it has become peacefully in her sleep at age 98. The remarkable legacy, as is our Angie Ruvo
the Nevada’s first and only to earn these wife of Lou Ruvo, namesake of our center, Endowed Caregiving Chair, funded by Larry
designations for its research and care: and mother of Larry Ruvo, Angie was the and Camille. A caregiver in every sense of
matriarch of our Cleveland Clinic Lou Ruvo the word — wife, mother, grandmother and
• CurePSP Centers of Care
Center for Brain Health family, and looked great-grandmother — Angie undeniably
• Parkinson’s Foundation Center forward each year to attending the Power impacted our center and our community.
of Excellence of Love.
• Exploratory Alzheimer’s Disease We will Keep her Memory Alive forever.
Research Center from the NIH The burden of Angie's caregiving journey
We hope you can celebrate her legacy with
— one that more than 11 million Americans
• “Partners in Care” from the us at this year’s Power of Love.
experience today — served as the catalyst
National Multiple Sclerosis Society
(only program in Southern Nevada)
A NEUROLOGY DESERT JOIN US TO KICK OFF THE NEXT 25 YEARS OF FUNDRAISING
Not just Alzheimer’s: Cleveland Clinic is committed to growing Nevada's neuroscience
The need is far-reaching landscape, and you can help.
Yet, despite these accomplishments, there’s Displaying a spirit of warmth and giving, Angie never said no to a charity and
still not enough access to accommodate the as Co-Owner of the Venetian, routinely donated dinners at the restaurant for
fundraising events.
oncoming neurological tsunami. Declaring
Nevada a “neurology desert,” the It’s this spirit of philanthropy and hospitality that she instilled in her son. Larry and his
Alzheimer’s Association’s 2022 Alzheimer’s wife, Camille, serve as Co-Founders and Vice Chairs of Keep Memory Alive, and have
Disease Facts & Figures report projects raised millions for healthcare in Nevada.
that by 2025, the state will have fewer Fittingly, on February 18, 2023, the anniversary
than 10 neurologists per 10,000 residents of the very day Lou Ruvo died, we’re celebrating
with dementia — despite ranking third our 26th annual Power of Love® gala (see page 5).
nationwide for anticipated growth of
Join us to celebrate the impact of the entire Ruvo
Alzheimer’s disease.
family on their adopted hometown, Las Vegas.
Factor in the impact of Huntington’s, Tickets at keepmemoryalive.org/POLnt
Parkinson’s and the other movement or 702.263.9797.
disorders we treat, as well as that of
clevelandclinic.org/Nevada 4
25 YEARS OF
IMPACTFUL GIVING:
Celebrating the Power of Love®
On Saturday, February 18, 2023,
the anniversary of the very day Ask Larry Ruvo for a memorable moment from
our namesake, Lou Ruvo, died, the first 25 years of the Power of Love and he’ll
cite the 1996 gala when he ran out of auction
we’ll kick off the next 25 years
items, and John Paul grabbed the mic to say, “I
of fundraising to benefit have an additional auction item. It’s from your
Cleveland Clinic Lou Ruvo heart. I want to auction off absolutely nothing.”
Center for Brain Health. After an enthusiastic bidder snatched up
“nothing” for $25,000, the duo — encouraged
The highly anticipated evening of by the audience — repeated the feat twice
friendship and philanthropy will more, and the concept of giving from the heart
showcase performances from a list became forever synonymous with the Power
of notable artists, as well as live of Love.
and silent auctions featuring an And so, Keep Memory Alive will present its
array of truly priceless products and 2023 Community Leadership Award to John
Paul DeJoria, Co-Founder of John Paul Mitchell
experiences that you've come to
Systems and Patron Tequila. See page 3 for
expect at the Power of Love gala. more about our friend, John Paul, who wrote
Celebrity Chefs Wolfgang Puck the first check to keep Lou Ruvo’s memory alive.
and Tal Ronnen will take your palate
on a culinary journey with
distinctive dishes made especially
for the Power of Love gala. Community Leadership Award Recipient John Paul DeJoria
And you could be there.
5 New Thinking About Thinking Spring 2023
Remembering David Humm You are the power behind
our promise to families
Pay tribute to a Las Vegas
and to our community.
native and the original Las Vegas
Raider, the late David Humm,
JOIN US ON
to shine a light on multiple SATURDAY,
sclerosis and the innovative FEBRUARY 18, 2023
clinical care and research at the MGM Grand in Las Vegas
being done at Cleveland Clinic
Lou Ruvo Center for
TO SUPPORT
Brain Health. (See page 7.)
Chef Wolfgang Puck We encourage you to buy a seat,
table or ad. Bid on auction items. Every
Combining classic French investment makes a big impact on our
techniques with California and Asian
ability to sustain the Lou Ruvo Center
influences, Wolfgang Puck has
for Brain Health’s important work.
changed the face of dining in cities
throughout the nation and across This not-to-be-missed event will
the world. Starting in Los Angeles, sell out. Get your tickets today:
then in Las Vegas, where he was keepmemoryalive.org/POLnt or
the first celebrity chef to create a 702.263.9797
contemporary fine dining restaurant,
he paved the way for the city’s If you’re not receiving our event
metamorphosis into an acclaimed updates in your inbox, go to
dining destination. clevelandclinic.org/NVnews
to get on the list.
Chef Tal Ronnen SPONSORED BY:
The founder and chef of Crossroads
Kitchen in Los Angeles’ West
Hollywood neighborhood, with
recent openings in Calabasas +
Resorts World in Las Vegas,
Tal Ronnen first became known
nationwide as the chef who prepared
the meals for Oprah Winfrey’s
21-day vegan cleanse. He's a New
York Times best-selling cookbook
author and conducts master
vegetarian workshops for students
and staff at Le Cordon Bleu College.
clevelandclinic.org/Nevada 6
FE ATURES
Remembering David Humm, the Original Las Vegas Raider
At the peak of his professional football career,
with a physique likened to Adonis, David DAVID HUMM
Humm was a product of six to seven hours An All-American quarterback at Bishop Gorman High School, David Humm was
of daily workouts and nutritious eating, among the most heavily recruited prospects to ever come out of Nevada. He won two
Super Bowl rings with the Raiders, and was so beloved by former owner Al Davis
punctuated by the beer and fellowship he
that he remained on the team’s payroll — appearing on Raider radio broadcasts and
enjoyed with friends, family and teammates. helping sell suites — decades after his playing career ended.
Retired Dallas Cowboy and fellow Nevada The Las Vegas native and lifelong Southern Nevada resident is recognized as "The
native Glenn Carano recalls speaking on Original Las Vegas Raider," even though the team was not based in Las Vegas during his
the phone from Reno with his friend after playing days. In 2022, the David Humm Broadcast Booth was unveiled at Allegiant
David's retirement. When David "didn’t sound Stadium, the team’s new home in Las Vegas.
like himself," Glenn knew just what to do: “I Humm was the first inductee into the Southern Nevada Sports Hall of Fame in 1997.
rallied our friends Conrad Dobler of the Buffalo He was inducted into the Nebraska Sports Hall of Fame in 1985 and, in 1999, the Las
Bills and Phil Villapiano of the Raiders and Vegas Review-Journal sports staff voted him the No. 9 local athlete of the 20th century.
we flew to David’s home with pizza and beer.
We hung out and reminisced, because that’s Tom once asked Raiders owner Al Davis Even from his wheelchair, David would say,
the kind of thing we’d do for each other.” why their family loved David so much. The “MS is not going to beat me.”
reply? David's relentless commitment to
Respected for his successes on the field excellence and his pride and poise on the Yet, he opted never to have treatments for his
and for his vivacious spirit that inspired field, in the broadcast booth and in life. MS. Ultimately, David realized you can’t eat
those around him, David was fun and family or exercise your way out of this disease, says
focused, remembers his brother, Tom Humm, The Raiders’ support — and David’s Tom: “That was a big departure because in
one year his junior: “David never took his fame tenacity — lasted to the end. When David high school football in our era, you didn’t get
seriously. He just wanted to play golf with me was very ill, Al’s son and Raiders owner hurt. You played through.”
and looked forward to our family Thanksgiving today, Mark Davis, spent time in David’s
celebrations. I wear David’s Super Bowl ring hospital room. The pair had great respect It was his sister, Lori's, MS diagnosis in 2005
that he gave me on our dad’s birthday. for each other, says Lori. that opened David’s eyes to the benefits of
disease-modifying therapies (DMTs).
“Growing up, for David and me, everything A family affair
revolved around the sports he and I played “He saw me doing so well and couldn’t deny
Courtney, the primary caregiver for her
together,” says Tom. “Our sisters, Cathy and the difference,” says Lori, who walks without
father, says he almost died when she
Lori, were in the background. Yet, they have assistance and frequently hears, “What?
was 12 and again when she was 21:
been the guiding light, the stability, the You have MS? But you look so good!”
“He was crazy tough. Mentally, he never
kindness that Mom and Dad loved about faltered. Physically, he was really good David died in 2018 at age 65; Courtney
our family. People stand in galas and talk until he just wasn’t.” was 28.
about David, but his essence came from
our parents and our sisters.”
Raider for life “Our father, Clair, always said
the only thing you’re born and
In 1986, after retiring from the NFL, David
die with is your name. The
received a diagnosis of multiple sclerosis 2023 Power of Love® gala is
(MS). He was in a wheelchair by the time honoring David’s name. Even
his daughter, Courtney, was 8. Yet, she says, though he was exceedingly
her father was a willing accomplice in her humble and deflected attention,
school show and tells, sharing football stories David would be proud to
and memorabilia, and giving her classmates know he’s lending his name to
rides in his wheelchair. help shine a light on multiple
sclerosis in collaboration with
“I played every sport and by my graduation, Cleveland Clinic, a world-
renowned treatment and
he had only missed two of my games,
research center right here
and we all gave him good-natured crap for in his beloved Las Vegas.”
those two,” recalls Courtney. David playing college ball for David Humm with daughter, — Tom Humm
the Nebraska Cornhuskers Courtney, circa 2002
7 New Thinking About Thinking Spring 2023
FE ATURES
L-R: Tom, Cathy, Lori and David Humm
Dr. Hua. “DMTs reduce the frequency and
MOST FREQUENT SYMPTOMS
severity of MS attacks. All current research
35%
indicates that individuals will be less 49% VISION
disabled if on a treatment. Even a five-year COGNITIVE PROBLEMS
SYMPTOMS
delay from diagnosis to treatment has a 43%
DEPRESSION
significant negative impact in wellbeing.” 32%
VERTIGO 84%
Team MS FATIGUE
In addition to DMTs, today’s standard of 23%
BOWEL 51%
MS care dictates a multidisciplinary team
DYSFUNCTION PAIN
approach to address symptom and lifestyle
42%
management, including a specialized MS BLADDER
neurology provider and experts in neuroreha- 70% DYSFUNCTION
bilitation, behavioral health and more, with NUMBNESS
71%
a shared goal to improve quality of life. WALKING
A disease that doesn’t kill, 51% PROBLEMS
but shortens lifespan What’s next in MS? Dr. Hua predicts: SPASMS 6%
Affecting nearly 1 million Americans, • Improved biomarkers – treatment OTHER
MS is one of the leading causes of response, early predictors of progression
non-traumatic disability in young adults. “As a neurologist, I’d like to increase
• Better interventions for disabling, invisible
symptoms, such as numbness and eyesight general awareness of the varied
“MS is an autoimmune demyelinating
symptoms of MS, in
disease of the central nervous system, • Evidence to guide treatment approaches
hopes the public will
meaning immune cells target your own body, • New treatment targets (reparative/
destroying the myelin, a protective cover on seek medical care
restorative; neuroprotective) so an early diagnosis
the nerves,” explains Le Hua, MD, Director,
Neuroimmunology and Multiple Sclerosis can be made and
To make an appointment at Southern
Program at Cleveland Clinic Lou Ruvo treatment started
Nevada’s only National Multiple Sclerosis
Center for Brain Health. as soon as possible,
Society Partner in Care, please call
which presents
The first therapy for MS was approved in 702.483.6000 or learn more at
the opportunity to
1993, and there has been an explosion of clevelandclinic.org/NevadaMS.
reduce disability and
therapies in the last 10 years. disease progression,”
To support our MS program,
says Dr. Le Hua.
“Even today, a lot of people still aren’t contact us at DonateNevada@ccf.org
getting the treatment they need,” says or 702.263.9797.
MS DISEASE MODIFYING THERAPY APPROVAL TIMELINE 2014
Pegylated IFNβ-1a
Alemtuzumab
1993 2017
IFNβ-1b (Betaseron®) 2009 Ocrelizumab
IFNβ-1b (Extavia®) 2019
1996 Siponimod
2010
IFNβ-1a (Avonex®) Cladribine
Fingolimod
Glatiramer Acetate 2002 2005 Diroximel Fumarate
IIFNβ-1b (Rebif®) Lori Humm 2012
2021
1986 diagnosed with MS Teriflunomide 2020
Ozanimod Ponesimod
David Humm
diagnosed with MS 2000 2006a 2013 Ofatumumab
Mitoxantrone Natalizumab Dimethyl Fumarate Monomethyl Fumarate
1995 2000 2005 2010 2015 2020
Ù Studies conducted at Cleveland Clinic Lou Ruvo Center for Brain Health
Infusions Oral Injections a
Re-approved under Risk Evaluation and Mitigation Strategies program
clevelandclinic.org/Nevada 8
CLINICAL RESE ARCH UPDATE
Research Studies Drive Advances in Quest
to Unlock the Mystery of AD
It’s been more than 100 years since Alois Health has contributed to numerous research proteins in the brain associated with
Alzheimer identified “an unusual disease studies in Alzheimer’s disease (AD), driving Alzheimer’s disease (tau and amyloid)
of the cerebral cortex” that now bears his significant progress in clinician-scientists’ • Gaining understanding of how biological
name. We now know that this “unusual” understanding of the disease. markers such as inflammation and brain
disease is in the brains of more than shrinkage contribute to cognitive decline
6 million Americans, and it is a condition Highlights include:
• Studying the potential for
whose effects extend far beyond an • Conducting trials of the first FDA-approved
monoclonal antibodies to delay or
individual’s cortex. Yet there is still no medication in the past 20 years
prevent cognitive decline
cure for this devastating malady. (aducanumab), along with other promising
treatments (e.g., lecanemab) Here’s a small portion of the research
However, since opening our doors in 2009,
• Imaging and laboratory tests for major we’ve conducted that makes it all possible.
Cleveland Clinic Lou Ruvo Center for Brain
The Painstaking Path to Understanding Alzheimer’s Disease
CATEGORY OF STUDY THE STUDIES WHAT WE LEARNED WHY IT MATTERS
Biomarker Studies ADNI Biological changes in AD occur Understanding the biological
ADRC decades before symptoms changes is invaluable.
What can we learn about the
emerge. We can identify these Biomarker studies have led to
natural course and biological
changes in the brain. more sophisticated drug trials
changes that occur in AD?
that take our understanding of
AD to the next level.
Repurposed Agents BEAT AD (bexarotene) Although some of these studies Repurposing agents is faster
TOMMOROW (pioglitazone) showed benefits, none of these because these medications
Can medications currently
medications seemed powerful are already available. The future
used for some other RASAGILINE RESCUE
enough to have a meaningful of AD therapies will likely
condition be helpful in AD? (rasagiline)
effect on AD. combine treatments of various
MCLENA (lenalidomide) medications, including
repurposed agents.
Monoclonal Antibodies EMBARK, EMERGE Although these monoclonal Amyloid is a major contributor
(aducanumab) antibodies all target amyloid, to the risk for cognitive decline,
Can designer antibodies
AHEAD they operate at different steps especially from Alzheimer's
activate the body’s immune
in plaque formation. disease. They clearly are
system to remove toxic CLARITY (lecanemab)
effective at removing amyloid
molecules from the brain? A4 EXPEDITION (solanuzemab) but their clinical benefit is
These antibodies are
GRADUATE (gantenerumab) still uncertain.
designed to “flag”
amyloid for removal. CREAD (Crenezumab)
TANGO (Gosuranemab)
Small molecule studies GENERATION (umibecestat) So far, small molecules have The biochemical reactions
MISSION AD (elenbecestat) not stopped the progression that lead to AD are numerous
Can new medications
of disease. In some instances and probably not the same
targeting biological NOBLE (edonerpic)
studies were stopped before in everyone. Molecules that
processes other than
completion. Nevertheless, worked in animal studies did
plaque formation disrupt
even a “failed” study teaches not succeed in people. But, like
the biology of AD?
us about targets that are not other drugs, small molecules
worth further investigation. may turn out to be important
in combination therapies.
9 New Thinking About Thinking Spring 2023CLINICAL RESE ARCH UPDATE
What’s on the horizon?
Locally, our research represents and
supports the rich diversity of our Nevada
communities. Our research follows strict
scientific standards that protect patients
and produce reliable, repeatable results.
Each and every study visit is a chance for
us to learn, then apply that new knowledge.
Each participant’s role in our research is a
gift to future generations.
“We’ve established a critical mass of
outstanding investigators in Las Vegas to
pursue funding and conduct the research,”
says Dylan Wint, MD, Director, the Lou Ruvo
Center for Brain Health. “We can’t operate
research without funding, and we can’t make
new discoveries without study participants.”
(See page 23.)
Our goal? We will help to discover more
effective and accessible treatments,
diagnostic methods, and processes that
can be developed and moved to the
market quickly.
We’re striving to:
• Better understand and treat Alzheimer’s
disease and related dementias
• Develop therapies and combinations
that target specific disease processes
• Include individuals across
socioeconomic, geographic,
racial and ethnic backgrounds to
capture all aspects of disease and
individualize interventions
YOU A ND YOUR BR AIN C A N HELP
Together as collaborators, we can advance scientific knowledge, investigate new treatments
and potential cures, and discover new ways to maximize brain health to prevent disease right
here in our community.
Learn more at clevelandclinic.org/NevadaResearchNT or contact us at healthybrains@ccf.org
or 702.701.7944.
clevelandclinic.org/Nevada 10CLINICAL RESE ARCH UPDATE
In Rural Nevada, an Urgent Need to Reduce Dementia Disparities
Health disparities in Alzheimer’s disease
(AD) and related dementias are particularly The Nevada Numbers: • By 2025, Nevada will have
striking in rural communities, where • 10% of Nevada’s population is fewer than 10 neurologists per
residents often go undiagnosed or are Alzheimer’s spread across roughly 90% of 10,000 people with dementia
(the bottom 40% nationwide)
misdiagnosed due to lack of access to
dementia specialists. More specifically:
Disease in its land mass, making access
to healthcare geographically • In 2022, the Alzheimer’s
• The relative risk for dementia is 80% The Silver challenging Association labeled Nevada
higher for those living in rural State • 49,000 Nevadans are currently
living with Alzheimer’s disease
a ‘neurology desert’
The impact in Nevada:
communities
• Survival following diagnosis is often • Age is the greatest risk factor • 48,000 family caregivers
shorter compared with those in urban for Alzheimer’s disease bear the burden
communities • Nevada is ranked 3rd nationwide • 79 million hours of unpaid
for growth of Alzheimer’s and care by families
Ten percent of Nevada’s population is spread related dementias (© 2022 Cleveland Clinic)
across roughly 90% of its land mass,
making access to healthcare challenging for This gap in care and lack of reliable data Lower education, access to quality health
individuals living outside the urban cores of for rural patients is the driving motivator for care, and social connectedness can also
Reno and Las Vegas. An unfavorably low the NVeADRC, awarded to Cleveland Clinic influence the risk of developing Alzheimer’s
ratio of providers to population throughout Nevada in 2020 and supported by $3.3 and other dementias and have also been
the state further compounds access issues. million in funding from the National Institute found to differ between urban and rural
on Aging at the National Institutes of Health communities. Collectively, these and other
Enlisting patients to fill research gaps (see page 24). social determinants of health account for
What’s more, those living and aging in rural upwards of 40% of health outcomes, and
communities are severely underrepresented The NVeADRC is developing novel addressing them is a key step toward
in research. methodologies and technology to establish eliminating health disparities.
a cohort of rural-dwelling older adults and
“The literature on people with dementia in collect high-quality data to share with the Out and about: a mission for the mind
rural areas is scarce and usually includes only broader scientific community. The goal is To date, the NVeADRC has enrolled more
a small number of non-diverse individuals to better understand aging in rural America, than 70 individuals from the communities of
with limited sets of biomedical data, largely including geographic disparities and the Mesquite, Pahrump and Laughlin, Nevada
derived from retrospective healthcare claims determinants of health that may increase and neighboring communities in northwestern
data,” says Justin B. Miller, PhD, Director, risk for developing Alzheimer’s and other Arizona and southwestern Utah.
Nevada exploratory Alzheimer’s Disease dementias in our rural communities.
Research Center (NVeADRC). The goal is to identify individual risk factors for
Where you live matters atypical brain aging and to intervene when
Rural living presents a complex set of environ- and where possible to maximize everyone’s
SOCIAL DETERMINANTS OF HEALTH mental exposures, some of which promote chances for successful, healthy aging.
Non-biological factors that influence healthy aging and longevity, such as reduced
health outcomes air and noise pollution, stronger sense of We are seeking research volunteers at least
40% from community, greater access to outdoor recre- 55 years old who live elsewhere in Nevada
socioeconomic ation and green space, and reduced stress. than Las Vegas or Reno and are interested
factors (education, in participating in an observational study.
employment, income) On the other hand, neighborhood We need individuals without memory issues
40% disadvantage (ND) — as measured by a as well as people with mild memory
30% from health 17-factor Area Deprivation Index spanning problems. A stipend will be provided as a
behaviors population age, income, housing costs, courtesy for participation. Together, we can
30%
residents per bedroom and more — is higher learn more about Alzheimer’s disease and
20% from access in most rural communities throughout the how we can improve brain health for you
and quality of care
United States. However, Dr. Miller notes, and your neighbors.
20% “Most of the literature on ND has focused on
10% from the Learn more at
physical environment small pockets of disadvantage within urban
10% communities. These findings may not apply nvadrc.org/NewThinking or contact our
(housing, etc.)
to rural communities.” recruitment specialist at 702.701.7944.
11 New Thinking About Thinking Spring 2023CLINICAL RESE ARCH UPDATE
Retired Fighters Gain Improvement
in Cognitive Function, Study Shows
Repetitive hits to the head increase the then went two years without fights while governing bodies are educating individuals
risk of long-term neurologic conditions like active fighters continued to fight. Over around the number of rounds they should
chronic traumatic encephalopathy (CTE), three years, all fighters had brain scans. fight,” he says.
cognitive and behavior problems, and They completed tests of how well their
parkinsonism. However, clinician-scientists brains were working at the beginning and Adds Dr. Bernick, “Future research is
haven’t known what happens to people the end of the study. needed to determine if there is a time in
who have been exposed to head blows a fighter’s career where recovery is less
that then stop. Until now. In the areas of verbal memory, motor likely to happen, or to identify factors that
speed and processing speed, the retired might indicate greater risk for developing
Boxers and mixed martial arts (MMA) fighters saw improvements in their scores a neurodegenerative condition.”
fighters may see some recovery in their over time, while the active fighters’ scores
thinking and memory skills as well as brain were stable or showed subtle declines.
structure after they stop fighting, according PHIL A NTHROPY
to a Cleveland Clinic Lou Ruvo Center for For verbal memory, Dr. Ritter and PACK S A PUNCH
Brain Health study published online in co-author Charles Bernick, MD, used
scores from an FDA-approved thinking and The Professional Athletes Brain
Neurology in September. Health study has received funding
behavior test, with higher scores indicating
from the Department of Defense,
“The results of this study suggest a recovery better memory. They found that over time,
Lincy Foundation, Ultimate Fighting
of cognitive functioning in fighters who are retired fighters on average had an increase
Championship Company (UFC),
no longer exposed to repetitive hits to the of three points whereas active fighters had
Top Rank Promotions, Haymon
head,” says Aaron Ritter, MD, who has an average decrease of two points.
Boxing and the August Rapone
served since 2018 as principal investigator Family Foundation.
of the Professional Athletes Brain Health Increasing awareness
Study (PABHS). Dr. Ritter notes that since his own youth Interested in funding novel research
football days, most play has turned to flag at the Lou Ruvo Center for Brain
Encouraging Results football until high school. In mixed martial Health? Contact our philanthropy
All fighters had fought professionally within arts, too, “there is broader awareness of how team at 702.263.9797 or
a year of the study’s start. Retired fighters much sparring fighters should do, and sports DonateNevada@ccf.org.
BERNICK IS BACK !
Charles Bernick, MD, MPH, has been involved in Alzheimer’s disease research
and treatment for more than 30 years. He moved to Las Vegas in 1994 to join
the University of Nevada School of Medicine and directed the development of a
statewide network of Alzheimer’s disease care.
Dr. Bernick joined the Lou Ruvo Center for Brain Health upon its opening in 2009
and, in 2011, launched the PABHS. With more than 900 participants, it is the
largest longitudinal study of repeated head injury in professional athletes.
While relocating his clinical practice to the University of Washington in 2018
to be closer to family, Dr. Bernick remained involved in the PABHS. In October
2022, he returned full time to the Lou Ruvo Center for Brain Health. Although
Dr. Ritter's clinical practice has now moved out of state, the pair continue to
collaborate in their study of professional athletes at Cleveland Clinic.
clevelandclinic.org/Nevada 12WORLD CLASS CARE
Specialty Certifications Affirm
Center’s Exceptionalism
Patients often say, “I knew something was conferring their designations only on those Neurorehabilitation (physical,
changing in my health, but I wasn’t sure who meet the criteria that will produce the occupational and speech therapy)
what to do.” Navigating care can be best possible results for patients.
As of October 2022, 100% of our
challenging. That’s why consumers and
Since opening in 2009, Cleveland Clinic physical and occupational therapists
referring providers — such as internists,
Lou Ruvo Center for Brain Health has had become PWR!Moves® certified
geriatricians and general neurologists —
received an array of such designations. therapists. The Parkinson Wellness
look to centers of excellence and other
Recovery program addresses specific
designations for consistent, evidence-based
INDIVIDUAL PROVIDER CERTIFICATIONS exercise types to trigger brain health and
specialty care.
Our care teams have achieved additional, repair mechanisms in individuals with
The most informative designations are optional specialty certifications unique to Parkinson’s disease (pwr4life.org/moves).
conferred by third parties, such as disease their respective professions.
The American Physical Therapy
associations or the National Institutes of
“We believe this targeted training positively Association (APTA) offers optional
Health — entities that understand nuanced
impacts patients and their families through opportunities for therapists to prove
health conditions, have established
more nuanced diagnoses and treatment knowledge in focused areas of practice.
standards for research and treatment, and
plans,” says Dylan Wint, MD, Director, Our PTs have earned the Board-Certified
have surveyed the national landscape,
Lou Ruvo Center for Brain Health. “This is Clinical Specialist designation in
reinforced each time a family tells me how Neurologic Physical Therapy and
a member of our care team was able to Geriatric Physical Therapy and the
‘get through to their loved one when no Certificate in Vestibular Rehabilitation.
Only top-10
neurology one else could’ or a patient thanks us for
To find specialized PT near your home,
program in the ‘reassurance of a firm diagnosis after
visit apta.org.
Nevada a long quest for an explanation.’”
CERTIFICATIONS ACROSS DISCIPLINES
Neurology
Multiple sclerosis
Exploratory Not to be confused with trainees (see
Alzheimer’s Disease sidebar on fellowships), “Fellow” status The Consortium of Multiple Sclerosis
Research Center Centers supports a voluntary certification
with the American Academy of Neurology
from the NIH process, the Multiple Sclerosis Certified
(Nevada’s first (AAN) recognizes exemplary work and
and only) achievements in the neurosciences and Specialist (MSCS) examination, which
the clinical practice of neurology. In formally recognizes a specialized body of
Parkinson’s addition to meeting the requisite criteria, knowledge believed necessary to provide
Foundation applicants must be endorsed by more optimal care to individuals and families
Center of Excellence living with MS. At the Lou Ruvo Center
seasoned neurologists. Three of our
(Nevada’s first for Brain Health, a team of PTs,
and only) neurologists have achieved this honor.
occupational therapists and social work
Neuropsychology professionals has earned this certification.
CurePSP
Centers of Care According to the American Board of
Certified Dementia Practitioner (CDP)
(among the first five in Clinical Neuropsychology (ABCN), its
the United States) certification process is designed to CDP certification complements the
assess scientific knowledge and clinical professional credentials and training
“Partners in Care” skill, and to provide external evidence already obtained in one’s chosen
from the National healthcare profession. A CDP
Multiple Sclerosis of competence in the practice of
Society neuropsychology. In 2022, 40% of certification reflects a deep personal
(only program in those who had obtained this optional commitment, inspiring confidence in
Southern Nevada) certification and practiced in Nevada a professional’s knowledge of quality
were employed at our center. care for individuals with dementia.
13 New Thinking About Thinking Spring 2023WORLD CLASS CARE
New in 2022: “While a Center of Excellence is a source of Training, which is designed to increase
pride to all recipients, more importantly, it’s an knowledge and build capacity for comprehensive,
Parkinson’s Foundation indication to prospective collaborators — be they inter-professional care in the treatment of
Center of Excellence patients, researchers or healthcare professionals Parkinson’s disease, focusing on:
— of an organization’s aptitude and approach to
We were honored to • Challenges in managing medication
patient care,” says Zoltan Mari, MD, director of
have been part of the and its side effects
our Parkinson’s Foundation COE, with support
Parkinson’s Foundation from Jenny Nguyen, APRN, and Stephanie • Non-pharmacologic management
Center of Excellence Giuffre, RN. “We are proud to expand upon our strategies for non-motor symptoms
(PF COE) awarded to work as Nevada’s first and only Parkinson’s
• Support for people with PD and their
Cleveland Clinic in 2018. Foundation COE.”
families in self-management
In 2022, the Lou Ruvo This sought-after COE identifies hospitals and • The unique and complementary role of
Center for Brain Health in academic medical centers with specialized each discipline on the COE care team
Las Vegas was named a teams — neurologists; movement disorders
standalone COE — one specialists; physical, occupational and music Next up for our PF COE? Expand research,
of only 51 sites globally. therapists; and behavioral health professionals infrastructure, patient support, community
— at the leading edge of the latest medications, outreach and educational programming here
therapies and innovations in Parkinson’s in Nevada.
disease. As a team and individually, they meet
the PF’s rigorous qualification requirements. To make an appointment with the neurology
team at our Parkinson’s Foundation Center
In October, our transdisciplinary team traveled of Excellence, call 702.483.6000.
to Kansas for the Parkinson’s Foundation’s Team
L to R: Janet Nacua-Peck;
Jenny Nguyen, DNP; Lucille
Carriere, PhD; Justina Selim;
Angela Cesena; Becky Wellman,
PhD; Jessica Grocott;
Shehroo Pudumjee, PhD and
Zoltan Mari, MD
FELLOWSHIP FOR SPECIALIZED CARE As an academic health center, we contribute • Clinical Neuropsychology Postdoctoral
to training the next generation of neurologists. The neuropsychology fellowship
Medical school followed by four years of
Ours are the only fellowship programs for boasts six graduates and two trainees.
residency in neurology prepares a general
these specialties in Nevada: (See page 21.)
neurologist to care for patients across
an array of conditions, from epilepsy • Behavioral Neurology and
• Clinical Neuroimmunology and
to spine to stroke to sleep to dementia to Neuropsychiatry (BNNP)
Multiple Sclerosis
neuroimmunology and more. Accredited in 2012, we have trained
Our first fellow completed his training
three fellows for careers in cognitive
in June 2022; our second is actively
At the Lou Ruvo Center for Brain Health, disorders to date, with another currently
training with us.
all of our neurologists have achieved on campus.
additional specialization through a year
or two of fellowship.
clevelandclinic.org/Nevada 14WORLD CLASS CARE
In Families With Huntington’s Disease,
an Agonizing Decision for Every Member
Huntington’s disease (HD) is a devastating
genetic disease passed down from one
generation to the next, with notable
symptoms including uncontrollable
twitching of arms, legs or face. If one
parent has the disease, you have a 50%
chance of inheriting the gene; if you have
the gene, you have a 100% chance of
developing HD.
Genetic testing for HD has a 99.9%
accuracy rate, so a simple blood test will
reveal your status. Yet, the decision to
test is not a simple one.
“We hope no one will take the test without
the proper support network,” says Cleveland
Clinic Lou Ruvo Center for Brain Health
movement disorders neurologist Odinachi
Oguh, MD. “Anyone can get testing at a lab
with an order from a primary care provider
but, in the aftermath, if it turns out the
individual is positive, psychological grief with the coordinated expertise of three
typically arises from the diagnosis.” clinicians, can help. spanning genetic discrimination,
workplace issues, insurance and more
And among those who are negative, she has Cleveland Clinic team members work in
seen the downstream effects first hand: relief, concert to address key components with “Our clinic will walk you through the pros
certainly, but often survivor’s guilt. Dr. Oguh those considering testing: and cons of seeking testing, from the
explains: “You have relatives testing positive, • Movement disorders neurologist: practical financial considerations, such as
but you didn’t. You’ve been spared because Discusses family history and evaluates purchasing enhanced insurance policies,
you were randomly selected at birth to have for any subtle symptoms of HD to the psychosocial, notably the impact
a negative gene. Your good news may leave • Health psychologist: Reviews patient’s in learning test results – whether negative
you or others in your family feeling badly.” emotional health, family situation and or positive,” says Lucille Carriere, PhD,
readiness for testing, and addresses Behavioral Health Director and Angie Ruvo
Support for HD families the psychosocial aspects of receiving Endowed Caregiving Chair at the Lou Ruvo
The estimated 300 individuals living with test results Center for Brain Health in Las Vegas. She
HD in Nevada have family members who collaborates with genetics counselor Amy
• Genetics counselor: Provides HD
need to decide whether to test. That’s Shealy, MS, CGC, located at Cleveland
genetics information and covers the
where the multidisciplinary Huntington’s Clinic’s main campus in Ohio, and the pair
benefits, limitations and risks of testing,
Disease Predictive Genetic Testing Clinic, together present the results to the patient.
If the test is positive…
M A K E A N A PPOINTMENT Your movement disorders team will discuss
best approaches for disease management.
To make an appointment with our movement disorders team for the
Huntington’s Disease Predictive Genetic Testing Clinic or the affiliated “Our goal is to arm individuals with the
Huntington’s Disease Comprehensive Clinic, call 702.483.6000. information they need in time to make
Learn more at clevelandclinic.org/NevadaMovement. important life decisions based on knowledge
of their health status,” says Dr. Carriere.
15 New Thinking About Thinking Spring 2023WORLD CLASS CARE
Wondering About Wandering?
A new environment can be disorienting to An underreported concern
anyone. For people with dementia, even
While around 20% of community-dwelling
a place where they’ve lived for years can
individuals with dementia and 60% of
seem unfamiliar, frightening or disturbing. In
those living in institutionalized settings
such an uncomfortable situation, it’s human
are reported to wander, “Wandering
nature to want to return to familiar places
is underreported and not addressed
and people.
as frequently as it should be,” says
With dementia, that quest for comfort may Ms. Flores, who adds that the risk of
manifest in a behavior known as wandering. wandering increases with severity of
cognitive impairment, and that individuals
A fairly broad concept, wandering doesn’t who wander multiple times a week almost
refer just to individuals straying from home or always have at least moderate dementia.
walking off on their own in public. Wandering
can also happen within the home, in the form Wondering if OT can help with wandering
of repetitive actions, pacing or expressing the that you’ve observed? Contact our
need to "go home” when already there. neurorehabilitation team at 702.483.6032.
Individuals may also have difficulty TIP
locating familiar and essential places such See something, say something
as the bathroom. They may inquire about
Anyone would try to assist a lone
the whereabouts of long-deceased loved Priscilla Flores, OTD, MSOTR/L
wandering 3-year-old child; but what
ones and past friends, or get nervous in
about a senior sitting on a bus bench
crowds, new settings, or even familiar but
for hours? Or walking slowly, seemingly
forgotten locations.
without purpose? Consider notifying HOW TO REDUCE
Partnering With OT your local police department. Your tip WA NDERING RISK S
may help reunite a missing person with Family and caregivers can consider:
Occupational therapy can help. Priscilla
loved ones.
Flores, OTD, MSOTR/L, an occupational • Redirecting or reducing access
therapist (OT) at Cleveland Clinic Lou Ruvo — Detective Richard Tennant, Missing
Persons Detail, Las Vegas through camouflage; for
Center for Brain Health, explains: “OTs
Metropolitan Police Department example, by placing a mirror
can provide recommendations to decrease
in front of exit doors, covering
unsafe behaviors, support safety, and teach
doorknobs or installing latches
family, friends or caregivers to stop unsafe TIP out of the individual’s reach
wandering in its tracks. OT's also assist
with de-escalating unwanted behaviors Invest in a Medic Alert Foundation or line of sight.
when needed.” ID bracelet (medicalert.org/alz ) • Installing interior alarms that alert
The Alzheimer’s Association, in to departure from a safe zone.
Caregivers can learn “to understand the collaboration with MedicAlert®
signs of discomfort and make sure that the Foundation, provides nationwide • Disabling or
patient’s basic needs — such as being fed, membership plans with 24/7 wandering locking up keys
using the bathroom and pain relief — are support. The Association also has to vehicles.
being met,” says Ms. Flores. “Caregivers can a 24/7 Helpline (800.272.3900) • Using GPS
also explore meaningful activities to reduce available in more than 200 languages. trackers on
the risk of boredom for the patient, such as It is staffed with clinicians who provide
smart devices,
encouraging walking or exercise programs, additional assistance for families living
music, meaningful occupations or hobbies, or alert systems
with Alzheimer’s and other dementias.
social experience and purposeful tasks outside
— Caroline Baumis, MSW, the home.
around the home.”
Alzheimer's Association
clevelandclinic.org/Nevada 16WORLD CLASS CARE
Can You “Dual Task”?
Physical and Cognitive Tasks Work Body and Brain
Alone at the gym or in a physical therapy challenging and cause the task to be For example, explains Dr. Gevertzman, he
(PT) appointment, we all want to use our less efficient; they can also lead to falls. might guide a patient to practice standing
workout time as efficiently as possible, Skill building across the four physical from a chair, then repeat the exercise using
working different areas of the body in and six cognitive domains can help. a chair that is higher or lower, then adding
different sessions and multitasking, where (See callout box.) a dual-task component. Then, the PT might
possible, to get an exercise “two-fer.” change the environment or add other goals
Mix it up vs. pick it and stick with it to the task so that each set is unique.
“In PT, we refer to With patients experiencing cognitive
working the body decline, PTs sometimes use an exercise Yet, variable practice isn’t for everyone,
and the brain approach known as variable practice, which is why specialized physical therapy
simultaneously which loops back to previous tasks after comes in handy.
as ‘dual-tasking,’” introducing new ones.
says Christy Ross, “For those with a significant degree of
PT, DPT, a Research supports cognitive dysfunction, ‘blocked practice’
board-certified the impact that — where tasks are performed multiple
Geriatric Clinical variable practice times in a row in the same way — can
Specialist. “We can make on be more effective than variable practice,
may ask our patients to walk on the retention of a creating more carryover benefit when
treadmill while naming places they’ve new skill, “either performing the same task again in the
traveled or as many animals as possible. because it trains future,” says Dr. Gevertzman.
In individuals with some level of cognitive the body for
Our specialized physical therapists
impairment, this approach not only different strategies
are proficient in every approach (see
maximizes our hour together, but simulates to improve a given
page 13).
what happens out in the ‘real world,’ such task, or because the task needs to be
as the distraction of being interrupted reconstructed in the brain each time it is Wondering if targeted neurological
with a question while walking through the performed in a new context,” says Michael physical therapy can help you?
grocery store and searching for an item.” Gevertzman, PT, DPT, a board-certified Call our neurorehabilitation team
Neurologic Clinical Specialist. “Alternating at 702.483.6032.
Distractions in the real world may not tasks increases engagement and challenges
only make everyday activities more the brain anew with each performance.”
PH YSIC A L DOMA INS NEURO C O GNITIVE DOM A INS
Balance Perceptual motor function Social cognition
Strengthening (visual perception, (insight, contextually appropriate
perceptual motor coordination) emotional reaction)
Stretching
Aerobic Language Complex attention
(word finding, fluency, grammar (processing speed, divided attention)
and syntax)
Executive function
Learning and memory (planning, decision making,
(recall, recognition memory) flexibility, inhibition)
17 New Thinking About Thinking Spring 2023WORLD CLASS CARE
“Microhabits” Yield Macro Results in Personal Health
We all have great ambitions to live healthier. However, if we don’t set our goals realistically, we may set ourselves up for failure, which leads to
self-blame and decreased self-confidence. That’s where micro-habits, a term that has worked its way into the vernacular, can help.
“Implementing small, everyday actions to improve your health is a great way to start,” says Dylan Wint, MD, Director, Cleveland Clinic Lou Ruvo
Center for Brain Health. “Our advance practice providers, with their rich background in primary care and ongoing commitment to furthering their
own health education, are astute advisers on practical habits.”
Let’s see how they practice what they preach.
Jenny Nguyen, DNP, APRN, FNP-C Simrit Kaur Saraon, DNP, APRN
Nurse Practitioner, Movement Disorders Team Nurse Practitioner, Cognitive Disorders Team
Without an adequate amount of sleep, mental and Learn something new. It could be as simple as brushing
physical health can suffer. Not getting enough sleep your teeth with your non-dominant hand. There is a
can also impact memory, work performance and growing body of evidence that learning new information
interpersonal relationships. Good sleep tonight is the helps with neurogenesis.
foundation for a good tomorrow.
I’m currently challenging myself to learn to use a sewing
I strive to do what I advise my patients: Get as close to machine, which is indeed a challenge!
eight hours of sleep as possible.
Maileen Ulep-Reed, PhD, APRN, FNP-BC Erin Wilkinson, MSN, APRN, FNP-C
Nurse Practitioner, Cognitive Disorders Team Nurse Practitioner, Multiple Sclerosis Team
It’s okay to take that time for self-care. Scheduled Exercise and physical activity can improve brain health,
breaks are much needed to prevent burnout. None assist in managing depression and anxiety, improve mood,
of us finds it easy. boost energy, promote better sleep, prevent falls, strengthen
bones and muscles, and reduce certain health risks.
I try to dedicate at least 30 minutes each day to
sitting and enjoying my backyard. On the weekends, I enjoy riding my bike outdoors when the weather permits,
I garden. as well as walking around outdoor craft fairs or farmers’
markets for a few hours on weekends.
WHAT IS A NURSE PR AC TITIONER?
At the Lou Ruvo Center for Brain and physician assistants — are trained prescribe drugs and order and interpret
Health, we address brain disease to detect subtle changes in condition diagnostic tests, and are astute overseers
through two important steps: accurate and adjust treatment plans accordingly. and strong communicators on the
diagnosis provided by our physicians, relationship between overall health
and expert disease management. Nurse practitioners (NPs) have advanced and neurological conditions.
Each component requires unique degrees and are board certified; NPs at
neurological specialization. our center have published research in To make an appointment
peer-reviewed journals, have earned or with our neurology
As our experts in ongoing disease are completing doctorate degrees and are team, contact us at
management, the team’s advanced licensed as family nurse practitioners 702.483.6000 or
practice providers — nurse practitioners who specialize in neurology. They can clevelandclinic.org/Nevada.
clevelandclinic.org/Nevada 18You can also read
