Medical director discusses Matters of the Brain

Medical director discusses Matters of the Brain
Dr. Nicole Absar of the Senator William and Ellen Proxmire Memory Clinic at Integrace Copper Ridge in Sykesville. (Courtesy photo)

It is the loss of memory that has become the hallmark symptom of Alzheimer's disease, a progressive, degenerative brain disease that affects around 5.4 million Americans, according to the Centers for Disease Control and Prevention. But Alzheimer's, and other, related forms of dementia, are not all about the loss of memories, and they do not always strike those of advanced age.

Learning about these other symptoms, and varieties of dementia and how they are diagnosed will be the focus of the second in a series of free presentations on aging being hosted by the McDaniel College Center for the Study of Aging. The center developed as a resource for professionals who work with older adults; caregivers, such as family and spouses; and older adults themselves, according to Director Diane Martin. The Focus on Aging series features one presentation a month, September through December, to help answer people's questions and prepare them for working with, caring for or just plain being older, she said.


"Every month we are going to focus on aging, get people thinking about this growing older population that we have, and then a different topic related to that month," Martin said.

October's theme will be Matters of the Brain, and will feature Dr. Nicole Absar, medical director of the Senator William and Ellen Proxmire Memory Clinic at Integrace Copper Ridge in Sykesville.

"I've asked Dr. Absar to speak on some of the new advancements in treating Alzheimer's disease; just to kind of update us on what we know," Martin said. "This is what we know about AD today compared to five years ago. How we are treating it today compared to five years ago?"

The Times recently caught up with Absar to learn more about her work at the Memory Clinic and her upcoming talk.

Q: Not everyone may be aware of the Senator William and Ellen Proxmire Neurocognitive Clinic at Copper Ridge. What is the clinic's role and how long have you been there as the medical director?

A: I have been the medical director of the neurocognitive outpatient clinic for the past four years. The clinic has been an integral part of Copper Ridge and the Carroll County community since it opened in 1994. We serve individuals not only in Carroll County but also in the greater Baltimore/Washington region.

What used to be known as just memory care has evolved quite a bit since Copper Ridge opened. As we have grown over the years we are diagnosing and treating patients not only with traditional forms of dementia including Alzheimer's disease, we are now diagnosing and treating a much broader array of neurocognitive disorders including Lewy body dementia, frontotemporal dementia and Parkinson's with dementia, to name a few. Our clinic provides an integrated medical model that combines traditional neurology with cutting edge technology. We take the time to get to know and provide ongoing support for the whole family in their journey and have a wide array of programs for our patients and their care partners.

Q: Can you describe Alzheimer's disease? Many people have some understanding of this terrible disease, but can you help us understand more concretely how it manifests and affects older adults in our community?

A: Alzheimer's disease is the most common form of neurodegenerative dementia. In patients over 65 years old, it is the fifth-leading cause of death. Right now someone in the U.S. develops Alzheimer's disease every 66 seconds. Epidemiology studies predict that from 2010 to 2050, the prevalence of the disease in US is projected to increase by 110 percent.

Although Alzheimer's disease is the most common form of dementia, it is often misdiagnosed. Approximately 20 percent of cases of clinically diagnosed patients with possible Alzheimer's disease during life showed absence of Alzheimer's pathology upon autopsy. We know we have at least four to five different atypical variants of Alzheimer's disease and they all manifest very differently at the onset of clinical presentation and hence can be misdiagnosed or under diagnosed.

Q: How has our understanding of Alzheimer's disease and related dementia changed in the past decade or so? Are we any closer to having effective therapies to mitigate the course of the illness?

A: Although the majority of dementia secondary to Alzheimer's disease presents first with memory loss and forgetfulness, there are variants of atypical Alzheimer's disease that actually do not initially present with memory loss. They tend to occur at a younger age and often have a different mode of clinical course than the traditionally known forms of Alzheimer's disease. First symptoms might include personality changes, mood disturbances, word finding difficulties and visual impairment.

To date, there are still no effective therapies to slow down the progression. That is why a thorough diagnosis is so important so that the right treatment plan and support systems can be established.

Q: Is there anything concerning Alzheimer's that people either often misunderstand, or don't know about, that you wish they did? Any myths you'd like to dispel?


A: The take-home message is memory loss is not always the first presentation in every type of dementia diagnosis. Memory is only one of the cognitive domains and there are at least four to five other domains including language, visuospatial function and executive function, mood/motivation etc., also need to be involved.

In our society it is a myth that dementia means memory loss. Hence nonmemory-based dementias including various atypical Alzheimer's disease, Frontotemporal dementia, vascular dementia, Parkinson's dementia etc., often do not get diagnosed properly on time. Each of these dementias is different in symptoms, signs, treatment options and prognosis and hence every neurocognitive syndrome deserves a careful comprehensive evaluation and work up.

Q: What would you like people who come to your presentation on Oct. 10 to come away with?

A: Hopefully they will walk away with a better understanding of various neurocognitive disorders and an update on therapies. I will also emphasize how important it is to empower our loved ones and caregivers by focusing on their remaining abilities rather than what they can't do.

I always bring spiritual power in neurology. As Buddha said, in the end, only three things matter. How much you loved, how gently you lived your life and how gracefully you let go of things that do not serve you anymore. We have to empower our loved ones and caregivers to let go of the fear of uncertainties, embrace strength, love, and passion, and practice cognitive, mental and physical stimulation to maintain overall quality of life and happiness and slow down the progression of cognitive decline.

If You Go

What: Focus on Aging Monthly Event: Matters of the Brain

When: 4:30 p.m. Tuesday, Oct. 10


Where: Decker Center Forum at McDaniel College, 2 College Hill, Westminster.

Cost: Free, but with advanced registration required. Call 410-857-2506 or send email to to register.

For more information, visit the McDaniel College Center for the Study of Aging at