University of California, San Francisco CADC
Memory and Aging Center at UCSF
350 Parnassus Avenue, Suite 905
UCSF Box 1207
San Francisco, CA 94143-1207
PH: 415-476-6880 (main phone)
PH: 415-476-3898 (appointments)
Howard Rosen, M.D., Director/Principal Investigator
History and Background
The University of California, San Francisco (UCSF) California Alzheimer's Disease Center (CADC) was established in 1985 as one of six original Centers. The Center was initially developed in the Department of Psychiatry's Mental Health and Aging division at the Langley Porter Psychiatric Institute (LPPI). The LPPI program has a long history of social science and behavioral investigations that have led to improved understanding of caregiver stress and patient care management across cultures.
In 1999, Dr. Bruce Miller became the Principal Investigator and Medical Director of the UCSF CADC. Dr. Miller is a Professor of Neurology and Psychiatry at UCSF where he directs the aging and dementia program. Dr. Miller was recruited to UCSF in the fall of 1998 in order to establish a clinical dementia program, and holds the A.W. and Mary Margaret Clausen Distinguished Chair. Since his arrival, Dr. Miller has established strong linkages between existing clinical, research, and basic science programs and community agencies. The UCSF CADC has been organized to provide outstanding diagnostic and treatment services to individuals with dementia and to their families.
One of the primary focuses of research at UCSF is to learn more about the clinical, genetic, imaging, emotional and diagnostic features of mild cognitive Impairment (MCI); Alzheimer's disease (AD); and non-AD dementias including frontotemporal lobar degeneration (FTLD), Creutzfeldt-Jakob disease (CJD), corticobasal degeneration (CBD), dementia with Lewy bodies and vascular dementia. The purpose of these studies is to collect longitudinal clinical, imaging, behavioral, and autopsy data to be analyzed with the goal of improving clinical care for patients with these conditions.
Early identification of cognitive decline and AD is critical so that available treatments, which are most effective before extensive damage to the brain has occurred, can be started, and families can plan for the future, take advantage of available community services, and develop effective coping strategies. UCSF CADC clinicians bring state of the art methods to accurately differentiate between normal aging, MCI, and dementia. The UCSF CADC also brings state of the art culturally sensitive methods to assist English, Spanish, Chinese, and other non-English speaking individuals and their families through the diagnostic process.
Economic Development and Professional Training
The UCSF CADC provides the basic infrastructure to attract new resources into the local economy leveraging the investment of the state by approximately 6-fold or more. These include support from various federal and private foundation grants, industry and specialized research student training awards. The UCSF CADC translates basic findings from the laboratory into general practice within the broader health care community in a cost-effective fashion. Better behavioral and pharmaceutical interventions must be developed in tandem.
The CADCs have helped to build a vital workforce for the growing needs of the State addressing the current and changing demographic needs in California. This includes the training of physicians, nurses, physician’s assistants, health care professionals, and research investigators. The UCSF CADC has trained hundreds of professionals and students through fellowships, residencies, internships, rotations, clerkships, continuing medical education courses, academic classes, lectures, and presentations. Through their training programs the CADCs have shaped the practice of doctors, nurses, psychologists, social workers and other providers who now staff hospitals and clinics throughout the state making daily life more manageable for thousands of people who live with dementia.
The UCSF CADC has also educated the lay public, caregivers and families on cognitive decline, prevention strategies, and the management of those afflicted by MCI and AD. The UCSF CADC provides many forums on dementia education and also serves to integrate education opportunities in the community.
The limitations in the current health care delivery environment and constrained budgets in both the public and private sectors require solutions that are cost-effective for patients and their families, as well as for businesses. The Centers continue to provide education, provide new opportunities for improving the quality of life of the elderly, and reduce the burden for those with dementia in California.
Information about the Clinic
The UCSF CADC is located at two sites, the San Francisco Veteran’s Administration Hospital and the UCSF Memory and Aging Center located on Parnassus Campus in the Ambulatory Care Center.
San Francisco Veterans Administration (SFVA)
The San Francisco Veterans Administration site offers comprehensive evaluations to veterans with cognitive changes or memory loss. Family members, patients or health care providers can make a referral to the Memory Disorders Clinic for an evaluation. Referrals from physicians, other health care providers, and agencies are welcome. No referral is necessary for a memory assessment. We specialize in the evaluation of memory loss, AD and related illnesses such as FTLD, vascular dementia, and MCI. We have the expertise for complex or unusual cases, and are happy to provide second opinions.
Anyone who served in the military is potentially eligible to be seen in the VA system. Patients must submit discharge papers and enrollment forms to establish eligibility and then register with member services at the specific medical center where they wish to be seen. Forms and further details are available at Department of Veterans Affairs or by calling (877) 222-VETS. These steps are required prior to scheduling appointments or services. Once eligibility is determined, the individual will need to register at the San Francisco VA by calling (877) 487-2838. Once registration is complete, an appointment in the clinic can be scheduled.
UCSF Memory and Aging Center (UCSF MAC)
During evaluation at the UCSF Memory and Aging Center Clinic, the patient will undergo an extensive neurological, neuropsychological, and nursing assessment, usually lasting about three hours. The input of the caregiver is sought in every case. Because memory loss and other related symptoms are often multi-factorial and complex, we believe that a multidisciplinary and comprehensive evaluation is necessary for most patients. This extensive initial evaluation accomplishes an assessment that may take two or three visits in a traditional medical setting.
The purpose of this comprehensive evaluation is to determine the cause or causes of the patient's symptoms and to recommend treatment. After the initial evaluation, the clinicians involved with each case hold a conference during which they discuss the diagnosis and potential treatments. Following this conference, the clinicians discuss their findings with the patient and the family. In some cases, a diagnosis will be deferred until more information (such as blood tests or brain imaging) is collected. A written report is sent to the primary care physician and/or referring physician.
All visits must be authorized including follow-up visits. If they are not authorized, you will be charged the balance in full. Please have your primary care physician fax a copy of the authorization to the Memory and Aging Center at (415) 476-4800.
The UCSF Memory and Aging Center has specialists from a wide-variety of disciplines including neurology, neuropsychology, geriatrics, geropsychiatry, pharmacy, nursing, social work, genetic counseling and speech pathology who are available to participate in a patient's evaluation.
Costs for diagnostic evaluations and professional services may vary on an individual basis. Please contact us for more information. Often, tests performed outside of our CADC may be necessary to complete a diagnostic workup, such as laboratory tests and/or brain scans.
- Bruce L. Miller, MD, Neurologist
- Kristine Yaffe MD, Psychiatrist & Neurologist
- Howard Rosen MD, Neurologist
- Mary De May MD, Geriatric Psychiatrist
- Joel Kramer, Psy.D., Neuropsychologist
- Cindy Barton, RN, Geriatric Nurse Practitioner
- Natasha Boissier, MSW Social Worker
- Rosalie Gearhart, RN, Administrative Nurse
- Tricia See, Genetics Counselor
- Interns and Residents
Opportunities to Participate in Research
Our Center is part of the UCSF’s Alzheimer’s Disease Research Center. We refer patients to clinical trials evaluating new ways of treating and diagnosing FTLD, AD and related disorders. We also refer patients to studies of aging, and how different factors may protect against or accelerate mental decline in old age. Depending on your eligibility you may be invited to take part in one or more of these studies.