Geriatric Research, Education and Clinical Center

GRECC research is supported by funding from the Department of Veterans Affairs, National Institutes of Health, Alzheimer's Association, Agency for Healthcare Research & Quality, foundations and corporations. In fiscal year 2019, the Minneapolis VA GRECC published 26 peer-reviewed papers, provided 4,602 person hours of geriatric education, and expended $3.3 million in research awards.

Clinical research is integrated into clinical care. Patients seen in the GRECC memory clinic are reviewed in a consensus diagnosis meeting, where appropriate subjects for research projects are identified. 

GRECC Clinical research focuses primarily on patients with Alzheimer's disease (AD), and includes:

• Clinical trials in Alzheimer's disease
• Animal models of Alzheimer's disease, Parkinson's disease, and metabolic changes of the aging brain
• Brain magnetic resonance imaging, spectroscopy and biochemical studies of brain and cerebral spinal fluid in dementia patients
• Systematic reviews on the accuracy of cognitive and biomarker tests for diagnosis of Alzheimer's disease and on the benefits and harms of drug and non-drug treatment of Alzheimer's disease
• New models of delivering geriatrics care and trainee education

According to the VA, 9.6 million Veterans are currently 65 and older, representing 38% of the total Veteran population. By 2030, the proportion of older Veterans will increase to 45% of the total. Mirroring the general population, the oldest demographic segment - those 85 and older - are the fastest growing segment of the Veteran population, currently representing 4.5% of Veterans.

Older Veterans, in contrast to younger Veterans:

• Use hospital resources 3-4 times more frequently.
• Have a greater number of and more complex set of health conditions.
• Suffer from more chronic, progressive, degenerative and permanent dysfunction
• Have fewer economic and social resources to assist in caregiving.

Cognitive impairment in older adults is usually due to chronic, progressive disease, such as Alzheimer's disease. Early diagnosis of cognitive impairment has the potential to reduce health care costs through more efficient use of resources and the avoidance of crises that are commonly associated with unrecognized dementia. While over 5 million Americans have Alzheimer's disease, most are not diagnosed until they are in the later stages of the disease, when impairments in their day-to-day function have the potential to adversely affect their ability to manage other disease, like diabetes, heart disease and emphysema. They are also more at risk for accidents, social isolation, poor nutrition and inadequate exercise.

Simple techniques are available to screen for cognitive impairment, and the GRECC-directed Dementia Demonstration Project determined that screening is well-accepted by older Veterans and leads to the identification of many previously unrecognized cases of cognitive impairment. While screening is not widely used in the medical community, the VA is making efforts to improve the recognition, diagnosis and management of cognitive impairment and, consequently, the care of any associated medical problems.

Patients with Alzheimer's disease are becoming more numerous and have average care costs that are three times as much as elderly patients without the disease. While screening can be done quickly (2-3 minutes) and inexpensively, the subsequent diagnostic evaluation costs about $800. Still, the investment is likely to pay off, as a single visit to the Emergency Room or an unscheduled admission to the hospital - a common occurrence for persons with undiagnosed dementia - more than offsets this cost.  More importantly, the quality of life of Veterans affected by cognitive impairment and their families is improved when the condition is recognized and addressed.

The GRECCs, as "Centers of Excellence", are designed to improve health care and quality of life for older Veterans through the advancement and integration of research, education and clinical care in geriatrics and gerontology. The Minneapolis VA GRECC assists the community through referrals to the Driving Assessment Program in Occupational Therapy and by the information it provides to the clinical staff across the VISN via its Seminar Series speakers.