We are growing older as a community.  With increased age comes increased prevalence of neurological conditions associated with aging, such as Alzheimer’s disease, Parkinson’s disease, migraine, epilepsy, and stroke.  Did you know that the number of people with Parkinson’s disease (PD) is expected to double from about 4.3 to 9 million people worldwide over the next 25 years?  It has been reported that 67 of every 1000 older Americans carry a diagnosis of Alzheimer disease (AD) and 9.5 a diagnosis of PD.  The annual incidence of stroke is 183, major traumatic brain injury 101, spinal cord injury 4.5 (per 100,000).  

How will we care for those with serious neurological needs?  The incidence of epilepsy (recurrent, non-provoked seizures) is 46 per 100,000.  The median estimate of annual incidence of Multiple Sclerosis (MS) is 4.2 per 100,000 in the US.   Is MS more prevalent in our part of the US?   Four studies covering populations in Alberta and Minnesota have demonstrated a median estimate of 2.0 per 1000.  The peak age of MS onset is 30 years, with twice as many women acquiring the disease.

It is projected that by 2050 there will be 10 million cases of Alzheimer’s Disease (AD) in the US, of which 6 million will have moderate to severe AD. If we were able to delay onset of AD by 6.7 years (similar to what occurred with CHF), we would see 6 million cases of AD of which 4 million would be moderate to severe.  Projections for increased treatment efficacy could significantly reduce the burden of illness for AD.

Another serious neurological concern, the risk of stroke, almost doubles with each decade of age during adulthood.  The highest risk is among people 85 years or older.  The risk of a first stroke for all ages together is 183 per 100,000 people.  The risk of stroke is twice as high for Hispanic and African Americans as for whites.

Estimating the increasing prevalence of a disease is the first step in determining the impact of treatment advances on disease burden.  Disease burden looks at the full economic impact to the individual and the community of the disease, including years of life lost, as well as the duration, character and degree of disability/suffering.    Did you know that migraines affect approximately 18% of adults in the US, three times as often in women than men?  And, one-third of headache attacks require bed rest during attacks. This increasing prevalence and disease burden of neurological disease requires a different approach to prevention and care in our community.  That’s why plans for the Neuroscience Center are underway.  Our community needs easy access to a multi-disciplinary and focused approach to diagnosis and treatment, as well as intensive prevention activities for the neuroscience needs in our community. 

The new Neuroscience Center is designed to provide the full spectrum of neurology, neurosurgery, physical therapy, physiatry and chiropractic care therapies to meet the neuroscience needs in our community. We know that neurological and neurosurgical patient care is improved when physicians (MDs) and Associate Practitioners (APs)  (nurse practitioners and physician assistants) work as a team in conjunction with therapy services and other specialist providers.  At the Neuroscience Group of NE Wisconsin, physician-associate practitioner (MD-AP) teams provide convenient care to patients by improving access to care, coordinating care and sharing in the responsibilities of patient care, such as follow-up calls, providing reports on diagnostic findings, ordering medications and other treatments.  By working together, these teams can provide care to more patients.  The combination of physician and associate practitioner skills enhances the clinical interaction. Patients receive more one-to-one training and coaching on how to better meet their neurological care needs.

Our MD-AP teams specialize in providing all encompassing individualized care.  There are some differences in the role of team members.  APs spend more time with patients focusing on prevention, wellness, and education.  The APs provide inpatient and outpatient medical and surgical support to neurological and neurosurgical patients and their families.  The MD-AP team works to identify, treat, and manage chronic diseases such as epilepsy and multiple sclerosis. Physicians and APs work together to diagnose, plan and implement interventions and treatments.  Both MDs and APs order and interpret diagnostic tests such as MRI studies, CT Scans, x-rays, blood work, and EKG's.  Both MDs and APs prescribe medications, physical therapy, massage therapy, and other rehabilitation therapy for patients with neurological diseases.  Some APs provide surgical support in the operating room and perform procedures in the clinic such as suturing, refilling pain pumps and lumbar punctures.  APs provide patient and family education to allow patients to make decisions about their own health.  APs provide emotional support, and are excellent patient advocates.