Montefiore Einstein Hudson Valley Center of Excellence for Alzheimer’s Disease

The Montefiore Einstein Hudson Valley Center of Excellence for Alzheimer’s Disease (CEAD) is at the forefront of research and treatment innovation for individuals with Alzheimer’s disease and other types of dementia. Committed to clinical care excellence for older adults, we are leaders in the management of memory disorders, recognized as an Age-Friendly Health System and one of only ten Alzheimer’s Disease Centers of Excellence in New York State, supported in part by a grant from the New York State Department of Health. We are among the highest-performing centers in the nation for neurology and neurosurgery, according to U.S. News & World Report, and we serve as a national and international referral site for complex and challenging cases of dementia.

Our Center of Excellence combines the expertise and best-in-class practices of Montefiore Einstein’s extensive network of hospitals and physician groups in the Hudson Valley, the acclaimed Montefiore Einstein Center for the Aging Brain (CAB), and the research and training capabilities of the Albert Einstein College of Medicine.

Offering access to state-of-the-art technologies, the CEAD emphasizes comprehensive care for older adults with cognitive complaints to optimize neurological function and brain health by providing highly coordinated multidisciplinary care, including diagnosis, treatment, counseling, education and assistance through community-based support systems for people with Alzheimer’s disease and related dementias, their caregivers and their families.

Our team of renowned specialists, including neurologists, geriatricians, neuropsychologists, geriatric psychiatrists and social workers, works collaboratively to treat the full range of memory disorders and to determine the etiology of an individual’s memory issues, whether caused by Alzheimer’s disease, another form of dementia, or are the result of an unrelated medical issue.

Our center provides access to state-of-the-art diagnostic technologies, promoting early and accurate diagnosis to help identify at-risk patients when the disease burden is lower. We offer access to advanced and newly emerging treatments, including disease-modifying therapies, as well as community-based support services to maximize brain health and resilience and improve quality of life.

Your evaluation will take place at our Center for the Aging Brain and typically involves several visits. Evaluations via telemedicine are also available. The assessment typically includes the following:

• A review of your health history and current medications
• A complete physical exam
• Tests of your memory and other cognitive functions
• Potential blood tests, MRI or CT scan of your brain
• Community referrals for support services

Following your evaluation, your team will prepare recommendations for you and your primary care doctor or referring specialist. They will carefully review your plan with you, share information on helpful community services and schedule regular follow-ups to determine if adjustments are required to your care plan.

Caregivers, friends and family members play vital roles in a patient’s journey. We encourage you to attend appointments in person or on video whenever possible. We have also compiled a shortlist of warning signs and suggestions as you navigate the patient’s individual path to health.

For more information on Alzheimer’s disease, we suggest the following websites:

Our elite team spans an extensive range of specialties and includes neurologists, neuromuscular specialists,  geriatricians, neuropsychologists, geriatric psychiatrists and social workers who collaborate on research, treatment and comprehensive care.

Alzheimer’s disease is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. In most people with the disease, symptoms first appear when they are in their mid-60s. Early-onset Alzheimer’s occurs between a person’s 30s and mid-60s and is very rare. Alzheimer’s disease is the most common cause of dementia among older adults.

The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.

This damage initially takes place in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex, such as those responsible for language, reasoning and social behavior. Eventually, many other areas of the brain are damaged.

In some dementias, changes in the tau protein, which plays an important role in the structure and formation of brain cells, cause it to form clumps inside nerve cells in the brain, which is believed to make the cells stop functioning properly and die. Disorders that are associated with the abnormal buildup of tau are called tauopathies.

In Alzheimer’s disease, the tau protein aggregates (accumulates into abnormal clumps) and becomes twisted and tangled, forming fibers—neurofibrillary or tau tangles—inside neurons. Abnormal clumps (plaques) of the beta-amyloid protein (a protein believed to play a role in the communication between brain cells) are prominent in the spaces between brain cells. Both plaques and tangles are thought to contribute to reduced function and nerve-cell death in AD and are hallmarks of the disease.

There are two types of Alzheimer’s—early-onset and late-onset. Both types have a genetic component. Most people with Alzheimer’s have late-onset disease, in which symptoms become apparent in their mid-60s.

Researchers have not found a specific gene that directly causes late-onset Alzheimer’s . However, a genetic risk factor (indicating an increased risk of developing the disease) has been identified—having one form, or allele, of the apolipoprotein E (APOE) gene on chromosome 19. However, inheriting an APOE ɛ4 allele does not mean that a person will definitely develop Alzheimer’s. Some people with an APOE ɛ4 allele never get the disease, and others who develop Alzheimer’s do not have any APOE ɛ4 alleles.

Signs of late-onset Alzheimer’s:

• Symptoms first appear in a person’s mid-60s
• Most common type of Alzheimer’s disease
• May involve a gene called APOE ɛ4

Early-onset Alzheimer’s disease occurs between a person’s 30s and their mid-60s and represents fewer than 10 percent of all Alzheimer’s cases. Some cases are caused by an inherited change in one of three genes. For other cases, research shows that other genetic components are involved. Researchers are working to identify additional genetic risk variants for early-onset Alzheimer’s disease.

Signs of early-onset Alzheimer’s:

• Symptoms first appear between a person’s 30s and their mid-60s
• Very rare
• Usually caused by genetic changes passed down from parent to child