Memory, Medicine & Equity: A Conversation on Aging, Dementia, & Health Disparities w/ Dr. Amy Kind
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LeAnn: Hello everyone! My name is LeAnn Aschkar, and you're listening to Isthmus, the auditory section of the Journal of Undergraduate Science and Technology at the University of Wisconsin-Madison. We focus on highlighting the incredible research being done here in the Madison community.
I'm here with a very special guest whose research focuses on social determinants of health and mechanistic health disparities. Her clinical interests include Alzheimer's disease and related dementias and geriatric transitional care. She's a professor at the Geriatrics and Gerontology Department here at UW-Madison and is a geriatrics fellow at the University of Wisconsin School of Medicine and Public Health. Currently, she's a director at the UW Center for Health Disparities Research and is a recipient of many awards, such as the American Geriatric Society Award for Outstanding Scientific Achievement for Clinical Investigation. She was also elected as a member of the American Society of Clinical Investigation, as well as the White House Task Force on Aging and Technology.
Sitting here with me today, as accomplished as she is, is Dr. Amy Kind. Hello, Dr. Kind. How are you today?
Dr. Kind: Hi, LeAnn. It's so great to see you today! I'm really thrilled to have you here.
LeAnn: I'm just going to start off with a very light question. So, can you just share a funny anecdote from the lab?
Dr. Kind: Absolutely. Well, it's interesting because my lab is a little different than those that work with pipettes or reagents in that we tend to work with quite a bit of data, but we do have individuals that come from across the United States to join our lab. We have lots of PhD students, medical students that work with us, postdoctoral students– and they come from all over the United States. So, I would say one of the most interesting things that we've experienced is just trying to help individuals who are coming from warmer climates to be ready for the Wisconsin winter. And we've had individuals who, despite our best efforts, are in their Patagonia all year long, which is, I think, really sweet. But ultimately, we have such a wonderfully supportive team that we've even talked about getting blankets– team blankets– for the team to be as welcoming as we possibly can to those who are not quite as used to the snow. And of course, we get some pretty big snow here in Wisconsin.
LeAnn: So, one thing we love to highlight at JUST is just the connection that researchers have with the Wisconsin community and just Madison in general. So just following along with the Wisconsin idea, can you tell me more about how your research on Alzheimer's disease and dementia-related diseases has impacted Madison or Wisconsin as a whole?
Dr. Kind: Absolutely. I think that's a great question, LeAnn. I'm a big fan of the Wisconsin idea. It's one of the reasons… I've left the University of Wisconsin many times, and I've come back many times. Ultimately, it is this idea that we should be thinking beyond our brick-and-mortar walls, and we should be aware of the world around us in a way that's very intentional.
The work that I've been doing and that my team has been doing for these last almost three decades has focused on thinking about the world around us, or the exposome, and the different factors in the world around us that might either promote or decrease health. And so, this world of the exposome can include things like neighborhood disadvantage, different types of experiences like poverty, education, but ultimately, we spend a lot of time quantifying these factors, turning them into mathematical constructs that then can be used to measure neighborhood disadvantage across the entire United States.
We started producing a metric two decades ago called the Area Deprivation Index, or ADI. It was a tool that was designed specifically for the public. So, we had public input as we were designing it to make sure non-researchers/non-scientists could understand and interact with the tool. And if you can use a smartphone mapping app, you can use this tool, because it takes 39 million data points and turns them into a heat map– a color map– in which you can understand where areas of greatest neighborhood disadvantage exist across the United States.
This tool has become so popular that right now we're getting about 10,000 hits a week and almost 1,000 downloads of the full data set every week. But most of our users are outside the academic world. They're non-profit community groups that are working to make their worlds a better place. It's local city governments, state governments, federal governments, different industry partners.
And so, we sent out a survey, a use case survey, of how different groups are using this particular tool. And what we found were countless stories of just wonderful, wonderful examples. The City of Milwaukee Water Works Department, for instance, is using the tool to inform their lead pipe mitigation strategies within inner city Milwaukee to try to make water safer within that city, which is very exciting. So being able to work with people from a water department, out of all things, and they've reached out to us, and other cities are using this strategy now. So yeah, it's very exciting. So, in my role, I have worked with rural farming groups, educational groups, all sorts of different groups. And I do think this is a great example of the Wisconsin idea, in which we get to work with these partners. They help inform our work to understand what's most important, how we can move things forward, how we can communicate more effectively, how we can produce research that is of greatest need, while also helping to share the knowledge that comes forward from the research that we do.
LeAnn: I'm glad you brought that up because I actually did some research on the Neighborhood Atlas for this interview and found out that it was used for COVID resource allocation.
Dr. Kind: It was, yes.
LeAnn: How did that make you feel seeing your work being used in this huge way that was benefiting all of these people in your community?
Dr. Kind: Well, it's a dream of anyone that goes into healthcare or healthcare research. Certainly, for me, I grew up in a very, very poor rural area, and I've always wanted to be able to give back in some way. It's the core of why I'm so interested in social determinants and the intersection with multiple diseases. To see them being applied just before COVID and then during COVID, the need, again, this need for targeting, for resource targeting. States as diverse as Pennsylvania and Alaska, and a number of others, use these metrics again to decide who gets the nurses flown out in the Alaskan wilderness first to administer vaccinations or things like that. So that's great to see in that we're helping to inform leaders at the front line– community members at the front line– that have to make these heart-rending decisions. How do you even begin to go about making those decisions? And the fact that we could give them a tool that allowed them– that informed them– in some way towards a solution, I thought was really wonderful.
LeAnn: That's a great application of just research in general because it's not just ending in the lab, you know, it has to go out in some way. There's a lot of mythology that depicts aging as some kind of punishment. Greek mythology with Tithonus: he was a Greek god who was granted immortality, but he didn't ask for indefinite youth. So, he aged and he withered into a frail state, and eventually he was transformed into a cicada, endlessly chirping until death. I know, very interesting. And this is just one of the many ways that the media and stories and things in popular culture are pushing the idea of aging as a punishment instead of a blessing. So, what role do you think the media in general plays in pushing the fountain of youth as opposed to the blessing of aging, and how can they change that?
Dr. Kind: Yeah, I think that's a great question. I don't do a lot of work with media, so I can only speak from my personal experience on this one. What I can say from my mantle of expertise would be that we talk in geriatrics about health span versus lifespan. Have you heard of this concept?
LeAnn: I have not.
Dr. Kind: So, this idea of lifespan, I'm sure you've heard of that, is how long– it's counted in years. You know, how old you are, how long you live until you die. But then there's this other concept of health span, in that the goal is for you to be as healthy as possible up until those last years. So, the story you told, I was thinking about that while you were telling it. I was like, oh, if only he had asked for health span. And the goal of a lot of the work that we do as well is to try to keep people as healthy and able to engage in the things that they love and enjoy doing for as long as possible.
I have seen a lot of bias towards aging. There's a lot of, for instance, it's not uncommon to watch a comedy show, and there'd be some joke made about an older adult and something that is stereotypical that might come with age. But many of the stereotypes of aging are actually false, from a medical perspective. Just to take a few, this idea, I think, one of the most common things that I encounter as a dementia doctor in geriatrics is sometimes this perception that dementia is inevitable. That as you get older, you automatically develop Alzheimer's disease, and this is something that happens to everyone. That's absolutely not true. So, lots and lots of older adults will never get Alzheimer's disease. They will never get dementia, and they'll be just as sharp as they were in their 20s.
Things change about the brain and the way the processing works, but ultimately, this idea of dementia being inevitable is not true. And yet, so often with older adults in the media, you see the forgetful stereotype, right, with the older person. Very, very much not a reflection of reality. It would be great if we could have more examples of older adults that are living very rich lives that show them interacting with society, contributing, moving forward. And I'm sure there are examples of TV shows like that out there, stories like that out there. But just as you noted that there are examples that are quite prevalent of the other, more negative stereotype of aging, too.
LeAnn: So, just staying with the idea of aging, as you age, in what ways do you wish to see the most change or improvement in either or both the geriatrics and gerontology department, as well as how health disparities are researched in general?
Dr. Kind: I think we, as a society, have a lot to learn by understanding why differences occur in health. It's just a fact that disease is not distributed equally. There are certain populations that have a greater risk of disease, certain types of diseases– now, it could be cancer, it could be asthma, it could be visual changes, a whole bunch of things. But ultimately, as scientists, it's important for us to understand exactly why those differences occur, because it gives us an opportunity to potentially lead towards a pathway towards solutions, cures, prevention, and therapy.
So, as I move forward, I remain hopeful that this type of important work continues. I remain hopeful that the value of science towards improving everyone's health– bringing new treatments forward, better ways to prevent illness, better opportunities to deliver clinical care– that that remains a priority of our society so that we can improve the health of our population. As I get older, I just hope that we don't lose momentum in this area, and that we can continue as a society to ensure that the next generation has more health, more opportunity, more ability to move forward than I ever did.
LeAnn: Thank you so much for sitting down to talk with me. I would like to show gratitude on behalf of JUST, the Journal of Undergraduate Science and Technology, and the UW-Madison community as a whole. Thank you so much, Dr. Kind, for graciously accepting my interview. And it's been such a pleasure learning more about you and your research. I think it's incredible just seeing how it was more of a building block that has led to the important discoveries you and your team have done. The ADI turning into the Neighborhood Atlas, and just how your dedication has progressed in such a way that's actually improving the research that you're doing. It's admirable to see in general.
Dr. Kind: Thank you very much for this, and good luck in your studies too.
LeAnn: Thank you so much.
Dr. Kind: Absolutely.
LeAnn: I'd like to sincerely thank the College of Agricultural and Life Sciences, the Wisconsin Institute for Discovery, the Associated Students of Madison, the Wisconsin Alumni Research Foundation, Dr. Todd Newman, and Dr. Joan Jorgensen for sponsoring and supporting the production of JUST’s Spring 2025 issue. Keep an eye out for our printed issues at the end of the semester at the unions. My name is LeAnn Ashker, and this has been Isthmus, with the Journal of Undergraduate Science and Technology.
