By Robin Erb  The fight to find a cure for Alzheimer’s disease faces yet another setback following allegations that a foundational study into the cause of the illness – the basis of years of research and billions of dollars in investment – may have been fraudulent. The revelations, published last week in Science magazine, are a gut punch to the scientific community, which fears that if the allegations are true they will erode trust in medical research while having the effect of discouraging robust funding for other avenues of research for more than a decade. The report will surely prove devastating as well to more than 190,000 Michigan residents now living with Alzheimer’s. “For the scientific community – and even for the non-science person – this is more than outrageous,” if fraud is proven, said Peter Lichtenberg, director of the Institute of Gerontology at Wayne State University. “It’s not that fraud or any scientific conduct wipes out the good work that’s been done,” he said. “But it’s heartbreaking.” Lichtenberg and others say that there’s more research now than ever that could lead to the eventual big win over this disease.  

Michigan's Financial Exploitation Prevention Act, which took effect last September, requires banks and credit unions to train employees and put procedures in place to spot signs of financial exploitation. The goal is to make Michigan's financial institutions better equipped to identify and report the financial exploitation of older consumers and vulnerable adults. The Michigan Legacy Credit Union now partnering with Wayne State University's Institute of Gerontology to offer a survey to customers that can help prevent financial abuse. The survey, which is voluntary, can help give a baseline of someone's vulnerability and then alert employees at the cred union to be on the lookout for potential issues. Peter A. Lichtenberg, director of the Institute of Gerontology, said adults don't have to be well into their retirement years to end up being financially vulnerable. "Older adults are not scammed more often than other people are," Lichtenberg said. "Unfortunately, they lose more money." Lichtenberg, who has spent nearly two decades researching financial vulnerability, said the main goal of the survey is to prevent financial exploitation. "We look at it as a risk scale," he said. Often, Lichtenberg said, people view financial decisions as purely an intellectual activity, but ignore the emotional and psychological triggers. One's financial health, he noted, is part of one's overall health. 

Michigan Legacy Credit Union (MLCU) has announced a pilot program with Wayne State University’s Institute of Gerontology to help protect its vulnerable members from financial exploitation. New members of the credit union age 50 and up are automatically offered the Financial Vulnerability Survey – and dozens have taken it thus far. Their scores are included in a database to help monitor these members’ accounts for abnormal financial activity. All MCLU credit union staff participated in multiple training sessions with Wayne State on the survey and learned how to identify and discuss cognitive risk factors before exploitation occurs. As a result of this training, staff members have already been able to address several cases of older financial exploitation. The Financial Vulnerability Survey (FVS) is one of several tools created by Peter Lichtenberg, director of the Institute of Gerontology, to combat fraud and financial exploitation in older adults. “The FVS is easy to understand and to complete,” Lichtenberg said. “It resonates with older people who are concerned about their financial decision making. Finances are often a taboo topic for discussion, yet people are hungry for information about their own financial vulnerability level.” 

“The number of Americans 65 and older is expected to nearly double in the next 40 years,” according to a recent Kaiser Health News report. Experts say the aggregate cost of care for our elderly population is ballooning, particularly in Southeast Michigan. The burden of long-term care has fallen on families and, for many, finding adequate care and resources has proven to be a grueling process. “We are dramatically underfunded, especially in Southeast Michigan. And the population just keeps getting older,” says Tom Jankowski, associate director for research and adjunct professor of gerontology and political science. Jankowski’s work revolves around the aging of the population, as well as the historical origins and implications of policy that pertain to older adults. ”Michigan faces some special challenges because it was historically a younger state in the ‘50s, ‘60s and ‘70s … But today … it’s one of the fastest aging states,” he says. He explains there are limited resources for elderly Michigan residents. ”Unfortunately, the services are a patchwork. We’ve got the Medicaid home and community-based waiver program … In Michigan, that program is underfunded, there are wait lists in most areas of the state. And in Michigan, only about a third of our Medicaid long-term care folks are at home,” he says. ”I have been an advocate for increasing that at-home spending for years … it’s what most people prefer and it’s less expensive than putting people in nursing homes.” 

COVID-19 has taken a toll on mental health in Michigan and across the world, but new Wayne State University research shows that burden has been heaviest for people of color. WSU researchers Peter Lichtenberg and Wassim Tarraf are examining how race, employment, and socioeconomic status intersect with pandemic-related stress, depression and anxiety. They've used U.S. census data to identify individuals to poll every two weeks about how their mental health has changed throughout the pandemic. "The findings that we have are pretty concerning," Tarraf says. "What we see through the data is a large percent of individuals who do report that they have mental health issues. What’s also concerning is these rates of mental health issues have remained stable over time. … People are not adapting and there are not enough tools for helping them reduce that level of stress. It is worth mentioning that rates are higher for people of color than those reported among whites." Lichtenberg and Tarraf also took stock of the social determinants of health that are affecting their subjects' mental health. "Food insecurity and job loss really stood out to us," Lichtenberg says. "65% of people with food insecurity had mental health issues. The numbers were similar for job loss in the household during the time of COVID-19."

The Michigan Health Endowment Fund awarded more than $370,000 to a pair of Wayne State University programs aimed at improving the well-being of older adults in the area. Rosanne DiZazzo-Miller, associate professor of occupational therapy in the Eugene Applebaum College of Pharmacy and Health Sciences, received a two-year, $221,992 grant for her project, “Supporting African American Older Adults Who Care for Family Members with Dementia.” Peter Lichtenberg, Distinguished University Service Professor of Psychology and director of the Institute of Gerontology, received an 18-month, $152,231 grant for his project, “Integrating Financial Vulnerability Tools into Geriatric Medical Settings.” DiZazzo-Miller’s project will design and implement web-based, real-time support and training to African American caregivers, addressing this population’s historical lack of access to culturally relevant information. The goal is that this training will increase caregivers’ knowledge and confidence about providing safe and compassionate care. Lichtenberg’s project aims to integrate financial vulnerability and capacity tools into geriatric medical care. The program will help protect older adults from financial exploitation through early detection in medical settings. Both program grants were part of the Health Fund’s Healthy Aging initiative, which supports projects that improve access to care, allow Michigan residents to age in place, and help communities build a culture of emotional support for older adults.

Nursing homes closed their doors to most visitors in March in an attempt to shield vulnerable residents from the virus, which has killed more than 75,000 residents and staff in long-term care this year, according to early-September Kaiser Family Foundation data. But cautionary confinement has meant a second affliction for residents, and not just for those who missed final goodbyes. Some experts on aging say isolation can lead to depression, anxiety, and overall health decline. Desperate for connection, relatives of the country’s more than 1 million nursing home residents have scrambled for creative workarounds – from strained video calls to bucket truck-assisted window visits. And now, care facilities face high-stakes decisions about how to reopen safely. That means most reunions will come for the foreseeable future at a wrenching 6-foot distance. “The benefits [of visits] are really enormous,” says Peter Lichtenberg, director of Wayne State University’s Institute of Gerontology, who also speaks from personal experience. After weeks of isolation, he visited his own father for an end-of-life exception visit at a Pennsylvania facility this spring. My dad died without anxiety,” says Dr. Lichtenberg. “I thought in large part that was because I was there.”  

These days, the sick go to the hospital alone — family isn't allowed inside because of the contagious nature of the coronavirus — and many end up dying alone without so much as a comforting word or caress from those who love them most. Family members and friends, devastated at the suddenness of it all feel guilty for not being there, for not helping with their loved one's transition. Funerals are spare, socially distanced occasions. Visitations are minimal; no more than 10 masked people in a room at a time, though many funeral homes offer live-streaming. There's no hugging or holding hands, no reassuring touch to soothe the grieving and remind them that even though they may feel alone, they are not. Large religious services are forbidden. There are no graveside vigils. No repast luncheons. Those familiar rites and traditions, those services "help us all kind of acknowledge the loss and kind of come to understand this loss is profound and permanent," said Peter Lichtenberg, a Wayne State University psychology professor who serves as director of the school's Institute of Gerontology. "When people aren't able to adjust to the environment in which the deceased is missing after a period of time, and the grief is as fresh as it was, it can be very difficult," Lichtenberg said. "People really start to have, not just the grief, but they have deeper depression and deeper traumatic reactions, almost like post-traumatic stress."

As the coronavirus advances, it is taking a particularly harsh toll on the many who are caring for a loved one with dementia or Alzheimer’s, the most common form of dementia. While the disease itself does not necessarily place patients at high risk for contracting the virus, they and their caregivers face a range of special challenges. Dementia patients are typically very sensitive to changes in routine and often require a great deal of hands-on care, both factors that are hard to manage now. Family members who usually rely on day care programs or visiting caregivers may be finding themselves with full-time responsibilities, while others whose loved ones are in facilities are unable to visit them now. Among the greatest challenges is how to minimize disruption in care that is intensely personal. “Care for dementia patients is ‘high touch,’” said Peter Lichtenberg, a professor of psychology and director of the Institute of Gerontology at Wayne State University. He recommends that caregivers take measures to avoid their own exposures by having provisions delivered, disinfecting surfaces and employing proper hand-washing techniques

A proposed change in state law would take the first steps in formalizing support for a growing number of Michiganders raising their grandchildren. State representatives Kathy Crawford and Frank Liberti have sponsored legislation that would take first steps to better recognize and support older Michiganders raising grandchildren. Both bills are before the House’s Families, Children, and Seniors Committee, which Crawford chairs. The state, Crawford said, is already behind in recognizing the critical and exhausting work of grandparents thrust back into full-time parenting. And their numbers are growing. Twice as many grandparents today in Michigan report raising or helping to raise grandchildren than a generation ago — an estimated 120,206 Michiganders in 2019 compared to 58,220 in 1987, according to the survey, called the Older Michigander Needs & Solutions Assessment. Tom Jankowski, associate director for research at Wayne State University’s Institute of Gerontology, developed questions for the report. The language about caregiving for grandchildren shifted slightly between the first and second surveys, he cautioned. Still, he said, the questions were close enough to roughly capture how the caregiving landscape has grown over time. Child care is expensive, meaning that Michigan’s poorest families often turn to grandparents for help, said Jankowski. Those growing numbers, along with Michigan’s demographic shift toward an older population — 2.4 million Michiganders age 60 or older last year compared to 1.5 million in 1987 — show the stark challenge facing so many families across the state. 

Addressing what some call “The Crime of the 21st Century” Peter Lichtenberg of Wayne State University delivered an eye-opening presentation on the prevalence of financial exploitation in older adults. And the statistics reveal that it is growing at a rapid rate. In 2013, there were on average 1,300 suspicious activity reports a month, a figure that jumped to 5,700 a month in 2017 with an estimated loss of $1.7 billion in that year alone. “I just saw that millennials are getting scammed at a higher rate than older adults,” said Lichtenberg noting we are all vulnerable, “but the big losses, where you are scammed repeatedly are older adults.” Lichtenberg explained that cognitive impairment and probable Alzheimer’s Disease will affect nearly one out of every five individuals by the time they reach their 80th birthday. That figure jumps to nearly 40 percent by the age of 90. Referring to the insidious onset of the decline Lichtenberg said it often can be hidden. With cognitive aging folks can continue to retain facts, vocabulary and procedural knowledge without showing any signs in those areas, while at the same time losing reaction speed, memory and the ability to problem solve and plan. “They almost self-correct,” he observed changing social routines and curtailing their former hobbies. “It’s easy not to notice.” In the category of theft and scams, seniors can fall victim to various ploys losing their money to con artists, but often times the money is taken by family members, friends and trusted caregivers utilizing abuse of power, financial entitlement and coercion to access funds and even homes. “Just because someone has a cognitive impairment that doesn’t mean they can’t make any decisions,” said Lichtenberg offering a free service to assist with evaluations.

African Americans have the lowest survival rate of any racial or ethnic group in the United States for most cancers – a problem that is magnified in southeast Michigan. These differences are often due to socioeconomic disparities that result in unequal access to medical care, health insurance, healthy food and more. African Americans who survive cancer also have the shortest survival of any racial/ethnic group in the United States for most cancers, according to the American Cancer Society. A team of researchers from Wayne State University and the Barbara Ann Karmanos Cancer Institute are investigating the combined role that community, interpersonal and individual influences have on the health-related quality of life for African American cancer survivors, and how those influences create racial health disparities between African Americans and white survivors. The team includes Felicity W.K. Harper, Ph.D., associate professor of oncology in the Wayne State School of Medicine and the Karmanos Cancer Institute; Malcolm P. Cutchin, Ph.D., professor in the Institute of Gerontology and the Department of Health Care Sciences in Wayne State’s Eugene Applebaum College of Pharmacy and Health Sciences; and Hayley Thompson, Ph.D., professor of oncology in the School of Medicine and associate center director for community outreach and engagement at Karmanos. The study, “ARISE: African American Resilience in Surviving Cancer,” is a five-year, $3.1 million project funded by the National Cancer Institute of the National Institutes of Health that aims to identify targets of change and inform the development of interventions to address causes of poorer health-related quality of life experienced by African American cancer survivors.

Steven Ondersma discovered that "only a very small proportion, maybe 10 percent" of the people who need professional care realize that need and have the means to address it. "I've just become really interested in having whole-population effects, rather than helping a few people who might be ready to make use of the treatment and have access to that treatment," says Ondersma, deputy director of the Merrill Palmer Skillman Institute at Wayne State University. Ondersma and others in Michigan who are interested in addressing the social determinants of health have increasingly turned to technology as an answer to that question. Weisong Shi, professor of computer science at Wayne State envisions the potential for technology to bring a doctor's office to those more remote patients. He proposes a vehicle, "just like an ice cream truck," that would allow people to get basic physical tests in their communities, with the results being transmitted back to a provider's office. Asthma disproportionately affects African-Americans nationwide, but in Detroit the problem is particularly pronounced – and often an emergency situation. Karen MacDonell, associate professor in Wayne State’s School of Medicine, has been using technology to improve those outcomes with the Detroit Young Adult Asthma Project. Funded by a series of National Institutes of Health grants, MacDonell began the project over 10 years ago by interviewing young African-American Detroiters about their asthma. She asked participants what strategies would help them adhere to their medication before an emergency arose. "Long story short, they wanted something using technology – something they could have with them, something easy to manage, something brief," she says. MacDonell developed a text messaging program that collects information about a patient's asthma and then sends the patient conversational messages encouraging medication use.

Scientists looking into age-related financial vulnerability are very interested in physical changes to the aging brain, the way eyesight and hearing can get less keen. In some cases, a new pattern of making mistakes with money may be a harbinger of cognitive bad things to come, the “first thing to go,” as it were. McGill University neuroscientist Nathan Spreng was able to track down 13 elderly scam victims and 13 others equivalent in age, gender and education who had successfully fended off a scam. Spreng’s research found the brains of the two groups were physically different. He noticed this thinning of the part of the brain called the “insula,” which, along with a lot of other things, may help us trigger our “spidey sense,” the hunch that can warn us away from dicey financial situations. Some experts are skeptical about practical applications of research like Spreng’s. Peter Lichtenberg, director of the Institute of Gerontology at Wayne State University, is not a neuroscientist but a psychologist who studies financial decision-making capacity. While he sees the brain scanning as promising, his experience tells him financial acumen and scam-spotting are really complex matters. “There is no one aging pattern,” Lichtenberg said. “You know, some older adults are as good as they were in their fifties and sixties. Others are showing a more significant decline.” Lichtenberg says he has data showing 20 percent of older people admit when they do talk about money with others, it’s out of loneliness. That is, people might engage with a scammer because they want to talk to someone, anyone.

Around 7,500 people die each day in the United States—one person every 11.5 seconds. By your 50s and 60s, you’ve almost certainly had personal experience with death—a parent’s death, other close family members, and/or personal friends. And yet, when you hear that someone has died, it’s still hard to know what to say to their loved ones. Part of the reason is that seeing the grief and pain of others surrounding death is uncomfortable. You also may be grappling with your own feelings about your experiences. They may also be busy making arrangements, causing it to appear like they’re handling the death particularly well. “Then you might find a few months later that it’s all starting to hit,” says Peter A. Lichtenberg, a clinical psychologist and director of the Institute of Gerontology at Wayne State University. “Grief is very variable. It brings out a sense of finality and a sense of helplessness in all of us,” says Lichtenberg. 

Three Michigan universities are using a $3.5 million federal grant renewal for efforts to improve the health of older blacks and other minorities. The National Institutes of Health grant allows the Michigan Center for Urban African American Aging Research (MCUAAAR) to expand its work through 2023. The center's research and education is led by faculty and staff from Wayne State University, the University of Michigan and Michigan State University. Black residents have higher rates of diabetes, stroke and other diseases than their white counterparts, officials said. Researchers seek to prevent health disparities. The center has focused on Detroit since its 1997 launch, but the latest grant brings aboard Michigan State and expands work into Flint. Goals include establishing a Healthier Black Elders Center in Flint, based on the one in Detroit. According to Peter Lichtenberg, director of the Institute of Gerontology at Wayne State, MCUAAAR is a catalyst for widespread change. “It has two major aims,” he said. “Increase the number of diverse junior faculty working in aging and health research, and partner with older African Americans in meaningful ways to improve health and well-being.”

There have been at least three cases in the past two days in Michigan where people with dementia or early onset dementia walked out in the cold and died. Psychologist Dr. Peter Lichtenberg, the director of the Institute of Gerentology at Wayne State University, tells Michigan News Network many people with dementia do some kind of wandering. “Some of it the need for stimulation, and some of it is sort of an idea that comes to them to go somewhere, and then losing that train of thought,” Lichtenberg said. “It’s incredibly dangerous with the way the weather is now.”