Mark Sager, MD, Director

Phone: 608-829-3300
Email: masager@wisc.edu
Mailing address: Wisconsin Alzheimer's Institute, 7818 Big Sky Drive, Suite 215, Madison, WI 53719

Positions

Director, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health
Professor of Medicine, Departments of Medicine and Population Health Sciences, University of Wisconsin, Madison

Education

B.S., 1968 Chemistry and Biology, University of Illinois (Champaign); M.D., 1972 University of Michigan; Residency, 1972-1975, Internal Medicine, University of Minnesota; 1985-1987, Geriatrics Fellowship, University of Wisconsin-Madison

Honors

Phi Beta Kappa, Phi Kappa Phi, Alpha Omega Alpha (medicine)

Research Interests

Alzheimer's disease prevention; Improving quality of care in long term care

Background

Dr. Sager is Director of the Wisconsin Alzheimer's Institute and a Professor of Medicine at the University of Wisconsin-Madison School of Medicine and Public Health. He is the founder of the Wisconsin Registry for Alzheimer's Prevention (WRAP) which is a longitudinal study of adult children of persons with Alzheimer's disease. The primary goal of WRAP is to conduct genetic, epidemiological and clinical research that could lead to the prevention of Alzheimer's disease. Dr. Sager also developed the WAI affiliated network of dementia diagnostic clinics consisting of Wisconsin physicians and health care providers dedicated to improving the care provided to persons with Alzheimer's disease and their families. He is a fellowship trained geriatrician and received his MD from the University of Michigan. Dr. Sager joined the UW faculty in 1992.

Research Description

The proportion of the population aged 65 and older is projected to increase from 13% in 2000 to 20% by 2030, primarily because of the aging of the baby boom generation and increased longevity. Persons aged 85 and older (the oldest old) will represent an increasing proportion of this aging population and an estimated 40% of persons turning 65 in 2000 will survive to the age of 85 years. The implications of this aging phenomenon for the delivery and financing of long-term care will be especially profound because the oldest old are the largest consumers of long-term care services and one-half of them will develop Alzheimer’s disease (AD).

Alzheimer’s disease currently affects between 5-10% of the population aged 65 and older and is the most frequent cause of institutionalization for long-term care in the United States. An estimated $2 billion of public and private dollars is spent each year in Wisconsin for nursing home care alone, and almost half of that is to provide care for persons suffering from AD and related dementias. In Wisconsin, the number of affected persons is expected to increase by 58% from 103,000 to 163,000 persons over the next 25 years. The expected rapid increase in the number of persons with AD will translate into higher public and private long-term care costs that will be paid by private payers, state Medicaid programs and long-term care insurers. One way to reduce the cost of long-term care is to lower the need for long-term care by delaying the onset or slowing the progression of AD. Estimates are that a delay in the onset of AD by five years would result in a 50% reduction in prevalence in one generation. A 10-year delay in the onset of AD would result in only 3.5 million affected persons by 2040 instead of the anticipated 14 million persons.

Current data indicate that AD is a lifelong disease with a prolonged pre-clinical phase during which prevention strategies would be most effective in delaying or preventing the onset of AD. Neuritic plaques and neurofibrillary tangles, the pathological hallmarks of AD, have been found in adults without dementia, suggesting that the neuronal deficits leading to AD begin years before any symptoms develop. Other studies have found metabolic and structural changes, typical for AD, in the brains of asymptomatic middle aged persons. As in other chronic degenerative diseases of aging, a person’s risk of developing symptoms of AD is most likely the result of genetic, environmental, socioeconomic and lifestyle factors which interact to determine age of onset. Because of this, a person’s risk of developing symptoms of AD is potentially modifiable either by changes in the environment or lifestyle or through external interventions.

Dr. Sager’s research interests are in identifying ways to delay the onset or slow the progression of AD using the latest knowledge and technologies available. He is also committed to developing programs that promote: early diagnosis and treatment of persons with AD; improved quality of care for persons with AD; and recognition of the unique needs of families and caregivers of persons with AD.

Representative Publications

Sager MA, Hermann BP, La Rue A. Middle-aged children of persons with Alzheimer’s disease: APOE genotypes and cognitive function in the Wisconsin Registry for Alzheimer’s Prevention. J Geriatr Psychiatry Neurol 2006; 18:1-5.

Ward MA, Carlsson CM, Trivedi MA, Sager MA, Johnson SC. The effect of body mass index on global brain volume in middle-aged adults: a cross-sectional study. BioMed Central Neurology 2005; 5:23.

Woodard JL, Dorsett E, Cooper JG, Hermann BP, Sager, MA. Development of a brief cognitive screen for mild cognitive impairment and neuro-cognitive disorder. Aging Neuropsychol Cogn 2005; 12:1-18.

Schraeder, C., Shelton, P., Sager, M. (2001). The effects of a collaborative model of primary care on the mortality and hospital use of community-dwelling older adults. Journal of Gerontology, 56A(2):M106-M112.

Mahoney, J.E., Sager, M.A., Jalaluddin, M. (1999). Use of an ambulation assistive devise predicts functional decline associated with hospitalization. Journal of Gerontology, 54A(2):M83-M88.

Mahoney, J.E., Sager, M.A., Jalaluddin, M. (1998). New walking dependence associated with hospitalization for acute medical illness: Incidence and significance. Journal of Gerontology, 53A(4):M307-M312.

Sager M.A., Franke, T., Inouye, S., et al. (1996). Functional outcomes of acute medical illness and hospitalization in older persons. Archives of Internal Medicine, 156:645-652.

Sager, M.A., Rudberg, M., Jalaluddin, M., et al. (1996). Hospital admission risk profile (HARP): Identifying older patients at risk for functional decline following acute medical illness and hospitalization. Journal of the American Geriatrics Society, 44:251-257.

Sager, M., Dunham, N., Schwantes, A., et al. (1992). Measurement of Activities of Daily Living in hospitalized elderly: A comparison of self-report and performance-based measures. Journal of the American Geriatrics Society, 40:457-462.

Sager, M.A., Easterling, D.V., Kindig, D.A., Anderson, O.W. (1989). Changes in the location of death after passage of Medicare's Prospective Payment System. New England Journal of Medicine, 320:433-439.