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Marcum takes a multi-prong approach toward developing a dementia prevention strategy

Zach Marcum, Plein Center Assistant Director of Research and Bailey Faculty Fellow and Assistant Professor of Pharmacy
Zach Marcum, Plein Center Assistant Director of Research and Bailey Faculty Fellow and Assistant Professor of Pharmacy Photo: Alex Levine

The prospect of developing dementia is terrifying for most people, particularly for those with family members who have had the disease. Many wonder what they can do to prevent the onset of dementia—which is where the research of the Plein Center for Geriatric Pharmacy has some answers.

Experts know there are healthy habits that will make a difference—exercising regularly, managing heart health, staying intellectually challenged and being connected socially, are among those habits.

Zach Marcum surveyed Kaiser Permanente Washington (KPW) members (1661 total) to learn more about their attitudes and beliefs toward health habits and what they could do to ward off the onset of dementia. Of the survey respondents, most believed that it is possible to improve brain health and reduce their risk of dementia, but one-third lacked confidence that they could take action to reduce their risk. Health habits like managing mid-life hypertension, socializing, and keeping the mind sharp with learning, new activities, and exercise make a difference.

“Dementia is not an inevitable part of the aging process. There are steps people can take right now to reduce the risk of the disease—and it’s never too late to start. We are investigating repurposing medications as a dementia prevention strategy.” —Zach Marcum, Plein Center Assistant Director of Research and Bailey Faculty Fellow and Assistant Professor of Pharmacy

Zach’s study is looking at what the experts say and what the public knows to understand what the gaps are between public and expert knowledge. By understanding the gaps, he anticipates being able to improve public health communications and care recommendations. Additionally, it’s been shown that the earlier Alzheimer’s Disease and related dementias (ADRD) are diagnosed, the better the outcomes are for the patient, making it important to find new ways to detect undiagnosed dementia.

Using the KPWHRI data, he looked at the historic patterns of chronic medication use in patients who are later diagnosed with dementia, prior to that diagnosis. He found that patients with sub-optimal adherence to taking anti-hypertensives were more likely to develop dementia.

Moreover, one of the most promising areas for dementia prevention is managing mid-life cardiovascular risk. One such risk factor is cholesterol. Zach is using the KPW data to examine how cholesterol levels from mid-life onward are associated with late-life dementia. He found both low and high levels of non-HDL (“bad cholesterol”) were associated with an increased risk of future dementia. “It makes sense that high levels of bad cholesterol would increase the risk of dementia,” notes Zach, “but it’s not as clear why the low levels of bad cholesterol do.”

In addition, Zach is looking at medications that might be repurposed to ward off or delay the onset of dementia. This approach aims to investigate the repurposing of blood pressure medications as a dementia prevention strategy.

“Like so many people, I’ve seen first-hand the effect Alzheimer’s disease has on patients and their family members—and that motivates me to find solutions,” said Zach.


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Click here for more information about the Plein Geriatric Pharmacy Certificate or click these links to learn about the UW PharmD program.