BRANDEIS UNIVERSITY
Health: Science, Society and Policy
HSSP 110A: Integrative Seminar on Health
Spring 2016
Monday and Wednesday, 5:00 to 6:20 p.m.
Section 4: Alzheimer’s Disease
Walter Leutz, PhD
Heller School
215 Schneider
x6-3934
leutz@brandeis.edu
Office Hours: Wednesdays, 2-5 PM
Classroom: _______________
COURSE DESCRIPTION
“S/he has Alzheimer’s.” These seem like the most devastating words you can hear about your
father or mother or grandparent – or yourself. Prevailing wisdom says that it’s downhill from
now on. There’s no cure and here come loss of self, loss of control, becoming a burden to your
family, and in the U.S. – the possibility of spending all your assets on expensive care. Is
Alzheimer’s Disease (AD) really a slow-drip sentence of decline and tragic loss, or are there
more hopeful paths? How fast is neuroscience moving to improve understanding of AD? Will
science soon find ways to cure or even prevent AD? Will drug regimens follow and will the
drugs be affordable? What are the known risk factors for AD, and are there things that
individuals and public health efforts can do to lower risks? What are the impacts of AD on
family members, and are there effective ways to reduce caregiver burden and help families to
care for their loved ones with AD? Is the care covered by public and private health insurance?
What are the most effective new approaches to long-term services and supports, and what are
the policy supports and barriers to seeing them implemented? These are the kinds of questions
we will explore in this capstone class. The instructor’s ties with local scientists, professionals,
and provider organizations will be used to facilitate face-to-face interviews and field
experiences for students. At the end of the semester, students will make recommendations for
AD research, practice, and policy.
The format of this course is based on a “problem based learning” (PBL) format. This will require
students to be active learners for the course. An initial list of background reading will be
supplied, after which the work will be student-directed. Students will decide (with guidance)
how to tackle the problem of Alzheimer’s Disease in America and learn about it in all its
“science” “society” and “policy” aspects. Students will be responsible (again with guidance) to
generate readings and discussion materials for most classes. The instructor will suggest and
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recruit a preliminary list of outside speakers, which will be open to discussion and possible
supplementation by students. With the PBL approach, students will use all resources available
to obtain information about the problem at hand depending on their section. This means
exploring the scientific literature, contacting experts, evaluating claims-makers and
stakeholders, locating and evaluating advocacy or self-help groups, etc. Students will be asked
to develop a group presentation on a significant approach to solving specific aspects to the
problem. Based on these presentations, each student will develop an Op-Ed making a concise
argument for a specific solution. In-class time will be made available for some of the group
work. Grading will be based on participation (class attendance, active classroom participation,
and online discussion participation) and evaluation of written and presentation material.
COURSE OBJECTIVES
1. To examine Alzheimer’s Disease, an important health problem in terms of “Science,
Society and Policy.”
2. To bring together information and perspectives students learned in other HSSP courses.
3. To learn to work together as teams to research and present information.
4. To identify key issues, major debates and leading organizations focused on Alzheimer’s
Disease.
5. To learn to independently use a range of resources to interrogate the issues around the
problem.
6. To present verbal and written findings to instructor and class in a coherent and
professional style.
ASSIGNMENTS, COURSE GRADING
The final grade will be determined as follows:
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25% Class participation/preparation
10% Two reflective essays
25% Group presentation and annotated PowerPoint
15% Field Interview and reflection
25% Op-Ed on a solution to a major Alzheimer’s Disease issue
25% Class participation/preparation: The success of this class depends on full preparation
by all students for each class, demonstrated by participation and contribution to class
discussions, and participation in discussions in the LATTE Forum throughout the
semester. There are different styles for demonstrating class participation and
preparation and no one style is preferred over others. The goal is to demonstrate
engagement and investment in the class and evidence of interest in the material under
study.
Attendance is required and recorded at every class. Absences will be excused only for
exceptional circumstances. If an absence is anticipated, please request it in writing by
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submitting an e-memo to the professor no later than the day before the scheduled
class. If an unanticipated need to be absent arises, please submit a written memo or
email explaining the circumstances as soon as possible before the next class.
10% Two reflective essays: At the beginning of the semester, each student will write a short
essay (no longer than two double-spaced pages) to address the following:
1) What do you know about Alzheimer’s Disease?
2) What do you think are the consequences of AD for individual adults, individual
children, and society overall?
3) Do you know of any effective approaches to prevent or treat the disease?
4) What do you predict will be recommendations to address this issue?
This essay is due January 20 by 5:00 pm. There are no wrong answers here, but rather
the goal is to consider your baseline knowledge and thoughts as the class starts.
Near the end of the semester, each student will write a second essay on:
1) What have you learned about AD that was new or unexpected?
2) What was consistent with your expectations?
3) How do you think that the issue of AD will be a factor in your professional
career?
This essay is due April 13 by 5:00 pm. Each of these essays will be graded as pass if turned
in on time and show a thoughtful effort.
25% Group presentation and annotated PowerPoint: Much of the class will be designed and
led by the students themselves. In small groups (about 5 students), students will
organize and lead a class session. The groups will be responsible for researching the
topic, assigning background reading to their peers, presenting their findings, and leading
class discussion on how this topic fits with the overall course theme. Background
reading should be forwarded to the professor at least two class sessions prior to
presentation in order for it to be posted on LATTE and available to other students in
time for them to prepare. Each student will receive an individual grade based on a
combination of the following:
o Group presentation
o Quality of Power Point including notes (revised final version based on feedback
due two days after in-class presentation). This PowerPoint with notes will be a
resource for everyone in the class for the OpEd assignment.
o Peer assessment of self and of team members on: reliability/responsibility,
participation in group work, intellectual contribution, contribution to annotated
PowerPoint (Team Peer Assessment Form and Instructions on Latte)
o Whole class assessment of presentation and Power Points through an online
survey -- due two days after the presentation (See specific link for feedback
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survey under the date of each presentation. Students are required to post
feedback for each of the four teams they are not members of).
In preparing for the group presentation, each team should schedule a meeting with the
instructor. In addition, after you have developed a draft of the PowerPoints and plan for
presentation, each team is required to meet with the Brandeis Experiential Learning
staff to consult on your presentation
(http://www.brandeis.edu/experientiallearning/contact.html)
15% Field Interview and Reflection: The context and nuance of the problem of and solutions
to Alzheimer’s Disease cannot be found exclusively in the published, peer-reviewed
literature. It is important to extend beyond the classroom and absorb the experiences
those with first-hand experience and expertise. Either individually or in pairs, students
will be required to select and interview a person who can offer unique insights. These
interviewees can range from a scientist studying Alzheimer’s, any of several types of
clinicians (physician, nurse, social worker) who treat AD clients, makers of drugs for AD,
advocates (e.g., from the Alzheimer’s Association), or managers of services for
individuals with AD. Before interviewing, each student (or two person team) is expected
to hand in a profile of interviewee, including their bio, their organization, how the
individual connects to the topic at hand, and an interview guide/questionnaire. Once
approved by the professor, the student(s) will conduct an interview by phone or in
person (in person is preferable) and then present their findings to the class. The class
presentation should take 6-7 minutes, allowing ~3 minutes for questions at the end. The
in-class presentation should include a very brief bio, brief explanation of interview
subject’s relevance to Alzheimer’s, as well as highlights of what you found most
interesting in the interview, what you learned, and your feelings about how the
interview went. Each student separately will write a 2-3 page “reflection” of their
interview, outlining important findings, key quotes (paraphrased is acceptable), and a
discussion of how the interview fits within the larger themes of the course; the
interview guide should be included as an addendum. Please obtain all appropriate
permissions before conducting the interview. The “reflection” is due at 5 PM on the day
you present.
25%: Op-Ed or Issue Brief on Solution to addressing AD: This assignment is to draft an
opinion editorial piece or an Issue Brief of between 750 and 800 words focused on a
path for addressing AD at the local, state, and/or national level. The goal will be to
develop a concise and cogent argument using factual information and/or data. The
piece should catch the reader’s attention and be persuasive. You can identify a “dream
target” newspaper based on the content of your Op-Ed. For example, a locally focused
solution might appropriately target at a local or regional newspaper. A Policy Brief
might focus on a policy-making audience. Use the PowerPoint (annotated pages
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particularly) as a source of information. You are not limited to your own team’s
solution.
Your Op-Ed or Policy Brief should be uploaded on Latte by 5 pm on April 13. Also please
bring a hard copy to class that day. When you save the document, include your name,
Op-Ed/Policy Brief, brief title, and version/date/#of words in the header. The word limit
is real, and papers must be on time. In class on April 13, we will randomly assign you a
colleague’s paper to critique and to discuss in class on April 20. Bring in a hard copy of
your critique to share with the author. Authors will also have independent feedback
from the instructor and Teaching Assistant. Please revise your Op-Ed/Policy Brief and
upload a final version by 5:00 pm on May 2.
LIBRARY RESEARCH and CITATION PROTCOL
All students must know how to research library and web resources and proper citation
protocol. When in doubt, please consult a reference librarian or the Instructor and Teaching
Assistant.
DISABILITY STATUS
If you are a student with a documented disability on record at Brandeis University and wish to
have a reasonable accommodation made for you in this class, please see me immediately.
ACADEMIC INTEGRITY
Academic integrity is central to the mission of educational excellence at Brandeis University.
Each student is expected to turn in work completed independently, except when assignments
specifically authorize collaborative effort. It is acceptable to use the words or ideas of another
person provided the source is properly acknowledged. This means that you must use footnotes
and quotation marks to indicate the source of any phrases, sentences, paragraphs or ideas
found in published volumes, on the internet, or created by another student. Violations of the
Brandeis University policy on academic integrity may result in failure in the assignment or
course, and could end in suspension from the University. f you are in doubt about the
instructions for any assignment, ask for clarification. (See Rights & Responsibilities Handbook
(http://www.brandeis.edu/studentlife/srcs/rr/index.htmlI)
CLASSROOM ETIQUETTE
Classes will start promptly. Please refrain from parallel conversations, using any kind of noiseemitting devices, using your laptop for anything other than class-related activity, or using or
taking out your cell phone at all without prior permission from the instructor.
COMMUNICATIONS/ SNOW POLICY
A class mailing list is included on LATTE for students to communicate with each for the team
project. Generally, in the event of a snow day, please assume that we will hold an online
session during the regularly scheduled class time, utilizing Blue Jeans. For student
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presentations, your PowerPoint can be posted and presented using Blue Jeans. For all guest
speakers, there will be a back-up day scheduled in case the campus is closed.
https://bluejeans.com/1571119490/
To use a regular phone for audio (rather than a microphone in your computer), mute your
speakers in the meeting and use this call in:
Call in number -- to be supplied
Meeting ID: to be supplied
Participant Passcode: to be supplied
CLASS BY CLASS COURSE OUTLINE
The syllabus is subject to changes during the semester. Updates will be announced to class
and listed on LATTE; the schedule as listed on LATTE supersedes the one listed here.
Session # & Date
1. Wednesday January 13
(Monday January 18 – no class
Martin Luther King Day)
2. Wednesday January 20 –
“Brandeis Monday”
3. Monday January 25
4. Wednesday January 27
5. Monday February 1
6. Wednesday February 3
7. Monday February 8
8. Wednesday February 10
Topic/Activity
Introduction (Joint) and introduction
(section)
--Lecture & discussion of readings on science
of AD, risk factors, and drug treatments
(First reflective essay due)
Lecture & discussion of readings on prevention,
treatment, caregiving, and policy for AD
Brainstorm class mission and topics
Team Assignments (5 groups), discuss
format/grading, get started in class
In-class work in assigned groups (instructor
rotates)
Presentation Skills – Dan Langenthal and
Alyssa Canelli (entire cohort)
Interview Skills – Sara Shostak
(entire cohort)
Monday February 15 –
vacation
Wednesday February 17 vacation
9. Monday February 22
----In-class work in assigned groups
(instructor rotates)
Outside speaker
10. Wednesday February 24
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11. Monday February 29
12. Wednesday March 2
13. Monday March 7
14. Wednesday March 9
15. Monday March 14
16. Wednesday March 16
17. Monday March 21
18. Wednesday March 23
Monday March 28 – vacation
19. Wednesday March 30
20. Monday April 4
21. Wednesday April 6
22. Monday April 11
23. Wednesday April 13
24. Monday April 18
25. Wednesday April 20
Monday April 25 - vacation
Wednesday April 27 – vacation
26. Monday May 2 – last day of
class
Speakers – Mike Doonan and Max
Pearlstein(entire cohort)
In-class work in assigned groups (instructor
rotates)
Speaker – To be decided
Student presentation – Group 1
Student presentation – Group 2
Student presentation – Group 3
Student presentation – Group 4
Student presentation – Group 5
--Field Interview Presentations
Field Interview Presentations
Field Interview Presentations
Field Interview Presentations
Working Session, Regroup to Discuss All Policy
Options
(Assignment 4 due: Op-Ed)
Outside speaker
Discussion of students’ Op-Eds
(Second reflective essay due)
----Capstone Celebration
(Final revision of Op-Ed/Policy Paper due at
5pm)
Team Topics and Presentations
Date
Topic
Team members
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Interview Presentation Schedule
Date
Student(s)
Interviewee
READINGS AND OTHER RESOURCES
BACKGROUND MATERIALS – You don’t need to read/view all these background materials
before the first lecture on January 20, but they will also be useful to come back to as you go
through the semester.
These three links are a good place for a brief introduction to AD– two on the
neuroscience and one on the costs and family impacts.
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NIH science/chemical intro video:
https://www.nia.nih.gov/newsroom/resources/images-and-video
AA slides of map of brain and transmission and decline:
https://www.alz.org/braintour/plaques_tangles.asp
Caregiving/families and cost of AD- PBS Newshour video
http://video.pbs.org/video/2365593450/
This 67-page report from the Alzheimer’s Association is a good overall introduction to
AD, including prevalence, prevention, costs, caregiving and more.
Alzheimer’s Association. (2015). "2014 Alzheimer’s Disease Facts and
Figures." Alzheimer’s & Dementia 10(2). (PDF in LATTE)
In 2009, the National Institute on Aging and HBO produced the Alzheimer’s Project,
which consists of 5 films (for hour-long TV slots) and other shorter videos. They portray
the science (in two segments), the progression of the disease, caregiving, and the
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perspective of a child or grandchild of a person with AD. Link:
https://www.nia.nih.gov/alzheimers/alzheimers-project-hbo
This 55-page report from NIA and NIH provides the latest update from the government
on the status of research findings and initiatives on AD.
NIA/NIH: 2014–2015 Alzheimer’s Disease Progress Report: Advancing
Research Toward a Cure. https://www.nia.nih.gov/alzheimers. (also PDF in
LATTE)
January 20, 2016 – Introduction to Class and to the Science of AD
Here’s an article about the neuroscience of AD.
Raskin, J., J. Cummings, J. Hardy, K. Schuh and R. A. Dean (2015).
"Neurobiology of Alzheimer's Disease: Integrated Molecular, Physiological,
Anatomical, Biomarker, and Cognitive Dimensions." Curr Alzheimer Res
12(8): 712-722. (PDF in LATTE)
Here’s a more in-depth article about risk factors for AD.
Lista, S., B. Dubois and H. Hampel (2015). "Paths to Alzheimer's disease
prevention: from modifiable risk factors to biomarker enrichment
strategies." J Nutr Health Aging 19(2): 154-163. (PDF in LATTE)
Here’s an article about drugs for AD.
Rafii, M. S. and P. S. Aisen (2015). "Advances in Alzheimer's disease drug
development." BMC Med 13: 62. (PDF in LATTE)
January 25, 2016 – Prevention and Treatment, Care Giving, and Policy
Here are two articles about services.
Lin, S. Y. and F. M. Lewis (2015). "Dementia friendly, dementia capable, and
dementia positive: concepts to prepare for the future." Gerontologist 55(2):
237-244. (PDF in LATTE)
Gaugler, J. E., F. Yu, H. W. Davila and T. Shippee (2014). "Alzheimer's disease
and nursing homes." Health Aff (Millwood) 33(4): 650-657. (PDF in LATTE)
Here are two articles about caregiving.
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Epstein-Lubow, G. (2014). "A family disease: witnessing firsthand the toll
that dementia takes on caregivers." Health Aff (Millwood) 33(4): 708-711.
(PDF in LATTE)
Cheng, S. T., E. P. Mak, R. W. Lau, N. S. Ng and L. C. Lam (2015). "Voices of
Alzheimer Caregivers on Positive Aspects of Caregiving." Gerontologist. (PDF
in LATTE)
Here are two articles about cultural differences and AD.
Barnes, L. L. and D. A. Bennett (2014). "Alzheimer's disease in African
Americans: risk factors and challenges for the future." Health Aff (Millwood)
33(4): 580-586. (PDF in LATTE)
Dong, X. and E. S. Chang (2014). "Lost in translation: to our Chinese patient,
Alzheimer's meant 'crazy and catatonic'." Health Aff (Millwood) 33(4): 712715. (PDF in LATTE)
Here are two articles about policy and AD.
Hoffman, D. (2014). "Alzheimer's disease legislation and policy--now and in
the future." Health Aff (Millwood) 33(4): 561-565. (PDF in LATTE)
Lin, S. Y. and F. M. Lewis (2015). "Dementia friendly, dementia capable, and
dementia positive: concepts to prepare for the future." Gerontologist 55(2):
237-244. (PDF in LATTE)
February 10 – Op-Ed Examples
Jennifer Braisted, Miami Herald, 8/2/15: Alzheimer’s disease is a woman’s
issue.
Don Gale, Salt Lake Tribune, 9/29/15: If we can go to Pluto, we can solve
Alzheimer’s — if we want to.
Sandra Day O’Connor, Stanley Prusiner, and Ken Dychwald, 10/27/10, NY
Times. The Age of Alzheimer’s.
February 24 & April 18 – Speaker-related readings (to be assigned)
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