CENTER FOR ALZHEIMER'S AND NEURODEGENERATIVE DISORDERS
(CANDO)

The Alzheimer's and Neurodegenerative Disorders Center located at the Oklahoma City Veterans Affairs Medical Center is designed to serve as a regional and national model for treatment and maintenance of quality-of-life for individuals suffering from various forms of dementia. The clinic began  diagnosis, treatment, and documentation of clinical course and pathogenesis of dementia in patients in June 1995.

This facility functions primarily as an out-patient longitudinal care unit for patients who are diagnosed with dementia and provides patients and families with progressive feed-back and local support systems.  In-patient care is selective and driven by patient need.  One goal is to integrate federal, state and community resources for the care of Oklahoma veterans and their caregivers.

The clinical program is a Center of Excellence at the Department of Veterans Affairs Medical Center (VAMC) in Oklahoma City and provides:

• definitive multi-disciplinary clinical assessment for patients with Alzheimer's disease and related neurodegenerative disorders
• counseling and family support
• individualized treatment programs (to be performed at home, at other VAMCs, in veterans, or nursing homes)
• continuing information and education in procedures for caring of patients with neurodegenerative disorders aimed at physicians and other allied health care workers 
• final pathological confirmation of the diagnosis for family counseling and epidemiological purposes

A patient-focused and case management model of evaluation, treatment, and care is being utilized in order to implement this innovative longitudinal model of care. The patient and care-givers are monitored by a case manager at regular intervals, including telephone follow-up, home visits, and scheduled return visits to the out-patient clinic (approximately every six months), and during in-patient admissions for acute medical or surgical needs, or placement into nursing home care facilities.  The case manager identifies and arranges for community-based visits needed by the patient and care-giver (support groups, in-home assistance, home nurse services, adult day care, transportation, or respite care).  Included in all evaluations is administration of medically-indicated treatment, involving pharmacotherapy, behavior therapy, and rehabilitation therapy on an individual patient basis. counseling of the patient and care-givers regarding clinical diagnosis, care, and prognosis is also provided on a regular basis. 

A complete clinical evaluation of the patient includes: individual and family history, neurologic examination, medical examination, Folstein Mini-Mental Status Examination, abbreviated neuropsychologic examination, Yesavage Depression Scale for care-giver, Blessed Dementia Scale (ADL), complete blood count, blood chemistry profile, serum vitamin B12 and folate levels, thryoid function tests, magnetic resonance imaging (MRI), syphilis serology, chest radiographs, electrocardiography (EKG), and electroencephalography (EEG). 

A multi-disciplinary team of clinicians and scientists at the Oklahoma City VAMC and the University of Oklahoma Health Sciences Center provide comprehensive patient and family evaluation, including: 

For further information on the services offered by the Center: