Section 4 Intro to the Memory and Aging Center

One challenge for new research coordinators is that the Memory and Aging Center is a huge institution with its own specific culture and organization, partly just reflecting the broader norms of academic medicine. There is a lot of helpful information on [MACipedia][MACipedia], the MAC wiki. Still, it can be tricky to figure out how all these pieces fit together, particularly given all the three-letter acronyms in use, so here is a brief orientation:

4.1 The MAC in the context of UCSF & the Weill Institute

In 2016, a large donation prompted a reorganization of the clinical and bench neurosciences at UCSF, under the broad umbrella of the Weill Institute for Neurosciences. This new institute, directed by Dr. Stephen Hauser, now includes:

  • The Department of Neurology
  • The Department of Neurological Surgery
  • The Department of Psychiatry
  • The Institute for Neurodegenerative Diseases
  • The Neuroscience Graduate Program

The MAC is part of the Department of Neurology, chaired by Dr. Andy Josephson. It’s one of several different divisions; other divisions that we work with a lot (particularly in the Neurotech project) are Movement Disorder/Neuromodulation and Epilepsy.

4.2 MAC clinic & MAC research

Our lab is part of the research program at the MAC, but when most people in the community think of the MAC, they’re usually thinking of the MAC Clinic. The clinic is located on the 2nd floor of 1651 4th Street, and provides neurological care for patients with cognitive disorders. I usually see my clinic patients on the 2nd Wednesday afternoon and the 3rd Tuesday morning of each month (also: some Monday mornings supervising a neurology resident, not open for observation). For a while we didn’t have any visitors “shadowing” in clinic, but we’ve now opened this up for people working in MAC research–let me know if you’d like to observe.

MAC research appointments principally take place in the Neurosciences Clinical Research Unit in the Sandler Neurosciences Center at 675 Nelson Rising Lane. Patients as well as healthy control participants volunteer for studies to help understand the neurobiology of dementia and aging–this can include clinical trials, observational studies, neuroimaging (fMRI, structural MRI, PET, MEG), and sampling of blood and cerebrospinal fluid. Generally we anticipate that people who volunteer for studies will be comfortable with having observers, and family conferences (see below) can be valuable learning opportunities for staff; note that research participants can always decline observation by staff who aren’t directly involved in their research visit.

Some patients are seen in MAC clinic and are participants in MAC research (often being referred from clinic to the research program, if they’re interested); some patients are only seen in MAC clinic and not in research (e.g., if they don’t meet inclusion criteria for our studies or aren’t interested in participating); some patients (particularly with rare conditions who are recruited from other states or regions) are only seen in research; and generally our healthy control participants are seen in research only.

4.3 MAC research “parent projects”

Many of our research participants are recruited through the MAC’s longitudinal “parent projects.” These are multi-year, longitudinal research projects that follow different clinical cohorts of research participants over time. Our lab, like many others at the MAC, runs “subprojects” for which participants in the parent projects are screened and referred.

Principally, we work with three of these parent projects:

4.3.1 Our lab projects in context

As of 2025, we have transitioned from one set of main projects to another. Here are the new main projects in lab, and how they are related to one another:

  • Making Decisions for Other People
    In lab often referred to as “DfO,” or “Decisions for Others”; or with our grant administrators as the “K24.”

    This project addresses challenges in surrogate decision-making, in which a family member or other close associate must make financial or medical or personal care decisions on behalf of an incapacitated (often older) adult. People are often unprepared for this burdensome role, and prior work in cognitive science indicates systematic biases in making decisions for others. We use a REDCap database to e-mail questionnaires roughly three times per year to three groups (1) dementia caregivers, (2) healthy older adults, and (3) a matched cohort of non-caregiving healthy adults who are relatives/friends of healthy older adults in group (2).

    • Practically all the data for this grant are in REDCap. Some materials such as the original grant proposal and our IRB and RPPR documentation are in the R: drive: R:\groups\chiong\decisions-for-others\.
    • This project is funded by NIH grant K24AG083117 from the National Institute on Aging.
    • In this project we recruit from the PPG, the ADRC, BRANCH, and other resources such as the Care Ecosystem project and the MAC Clinic.
    • The SpeedType code for this grant iS MNECHW0004.
    • Project notes for this project should be documented in the lab GitHub repo at decisions-for-others/decisions-for-others_notebook.md.

  • Dementia Experience and Caregiving
    In lab generally referred to as “Personal Values”; or with our grant administrators as the “RF1.”

    This project draws on conceptual work by our collaborator Agnieszka Jaworska at UC Riverside to examine changes in motivation and decision-making (which we generally frame in terms of participants’ personal values) in dementia and the effects of such changes on caregivers and care relationships.

    • Recruitment and tracking for our participants are in REDCap. Much of the data as well as materials such as the original grant proposal and our IRB and RPPR documentation are in Box.
    • This project is funded by NIH grant RF1AG083830 from the National Institute on Aging.
    • In this project we recruit from the PPG and the ADRC.
    • The SpeedType code for this grant is MNECHW0005.
    • Project notes for this project should be documented in the lab GitHub repo at personal-values/personal-values_notebook.md.

  • Desiging Devices for Human Needs
    In lab often referred to as “HCD Neurotech,” as distinguished from older neurotech projects (below).

    This project represents an extension of our prior work documenting participant and researcher experiences in neurotechnology research, now addressing how the lived experiences of neurotechnology users can be effectively incorporated into the design of new interventions. (Drawing on disability theory and on human-centered design.)

    • Recruitment and tracking for our participants are in REDCap. Much of the data as well as materials such as the original grant proposal and our IRB and RPPR documentation are in Box.
    • This project is funded by NIH grant R01MH137095.
    • The SpeedType code for this project is MNECHW0003.
    • Project notes for this project should be documented in the lab GitHub repo at neurotech/hcd-neurotech_notebook.md.

Our older projects in lab are:

  • Decision-Making in Alzheimer’s and Related Dementias (DMA)
    This project studied decisional impairments in different subtypes of dementia.
    • Guidelines for managing this project can be found in the Standard Operating Procedures on the R: drive: R:\groups\chiong\DMA\.
    • This project was funded by NIH grant R01AG058817.
  • Genes, Brains and Decisions (GBD)
    This study investigated the hypothesis that decision-making problems are a very early sign of FTD, potentially preceding a formal disease diagnosis. We compared presymptomatic mutation carriers of genes for familial FTD with their noncarrier family members, recruited through ALLFTD both at UCSF and at other sites in the ALLFTD network.
    • Standard Operating Procedures on the R: drive: R:\groups\chiong\GBD\.
    • This project was funded by NIH grant R01AG022983.
  • Neuroethics in Novel Neurotechnologies (Neurotech)
    This study addressed ethical implications of implanted neurotechnology in patients with epilepsy, mood and movement disorders.
    • Standard Operating Procedures on the R: drive: R:\groups\chiong\Neurotech\.
    • This project is funded by NIH grant R01MH126997.
  • Online Studies of Decision-Making in Healthy Aging
    These studies addressed decision-making an online panel of healthy older adults recruited through the BRANCH Network.
    • Standard Operating Procedures on the R: drive: R:\groups\chiong\aging-and-cognition\.

4.4 Learning opportunities in the MAC

One of the great advantages of working at an academic institution like UCSF is our access to a multitude of learning opportunities such as lectures, didactics, conferences given by world-renowned experts. A calendar including some of these events is maintained at calendar.ucsf.edu/group/memory_and_aging_center; opportunities include:

  • MAC Grand Rounds
    Mondays from 10-11am (mostly in person, some hybrid)
    Weekly lectures, often featuring esteemed visiting scholars or other special guests.
  • MAC didactics
    A two-week didactic series at the beginning of each month covering foundational topics in dementia and aging, taught by MAC faculty. These are intended for visiting students, rotating medical students/interns, fellows and new MAC staff members.
  • Clinical-Pathological Case Conferences (CPCs)
    Typically about three times a year on Mondays from 10am-noon
    This is a dynamic and interactive experience where MAC fellows first present an interesting/unique patient case, complete with family history, social context, and clinical examination/neuropsychological findings. MAC faculty and staff are encouraged to ask questions and discuss potential diagnoses for the patient. Cases conclude with an overview of the presentation, neuroimaging, and key findings from autopsy.
  • PPG family conferences
    (check MAC Family Conference Calendar)
    Case conferences where clinicians discuss a patient’s diagnosis based on neurological, behavioral, and cognitive data. In the first hour, the neurology fellow and neuropsycholgist (see Who’s who at the MAC, below) will present to the attending details of the patient’s background, symptoms, family/social history, physical examination, and neuropsychological testing. In the second hour, the patients and family/caregiver are invited to speak with the team, ask questions, and formulate a plan going forward. Usually held at the end of each patient’s research visit.

4.4.1 Learning opportunities within our lab

In addition to these MAC-wide opportunities, our lab hosts other learning experiences:

  • Lab didactics and journal club
    Second hour (if there is one) of lab meeting
    Usually in the fall we have a series of 7-8 didactics tailored to our lab’s specific research interests, methods and practices, with the aim of establishing common understanding across different new lab members with various backgrounds and interests. After completing this series, we’ll have a journal club: lab members will prepare a brief presentation on a journal article of interest to them, connected to our lab’s current research projects. Another great use for this time is to present work in progress, such as a manuscript or poster that someone is working on. Some weeks we’ll skip if I have a conflicting clinic or committee meeting.
  • Mentoring meetings
    Wednedsays from 10-10:30am (flexible)
    Rotates across lab members from week to week; designated time to discuss job performance, team issues/concerns, career opportunities, applications to grad/professional schools, or other topics important to you.
  • (Code meeting). Currently on pause, previously a meeting on Thursday mornings to discuss issues in computational code.

Finally, technically not within our lab or MAC, but several people in our lab are helping to organize events through UCSF Bioethics:

  • Clinical ethics journal club (details at tiny.ucsf.edu/ClinEthicsJC)
    4th Thursdays of each month from 4-5pm
    A meeting aimed at clinicians in the 5 UCSF-affiliated Bay Area hospitals, to discuss a recent paper relevant to the ethics of clinical practice and research. Currently run over Zoom, let Chanel Matney know if you’d like to be added to the mailing list.
  • Grand Rounds (scheduling variable)
    These will be meetings coordinated with other clinical departments or research institutes at UCSF, to address ethical and societal questions arising in these specific domains.

4.5 Who’s who at the MAC

You’ll be interacting with a lot of different people in different roles. Not comprehensive, but here are some of the titles people will have and how they’re related:

  • The boss
    Dr. Bruce Miller, MD, behavioral neurologist and Director of the MAC
  • “Attendings”
    This is a medical education term for the supervising physician on a clinical team. These are MDs who’ve completed training in a clinical specialty (mostly behavioral neurology, though Victor Valcour is a geriatrician and Mary De May is a psychiatrist); they’re responsible for the fellows’ and/or any students’ work in research and clinical visits. All are faculty; some are also researchers who run their own labs/research programs, while some are purely clinical faculty.
  • Neuropsychology faculty
    Psychologists (PhDs or PsyDs, distinct from MD-psychiatrists) with expertise in neuropsychological testing, who’ve completed training. Some are researchers who run their own labs/research programs, while some are purely clinical faculty.
  • Nurses, social workers, genetic counselors
    I’d encourage getting to know these other clinicians–some are based in the research program, and others are based in the clinic. They’re great resources for understanding clinical issues, practical tools, community resources, and patient/family concerns.
  • BNTP fellows
    Mostly US-trained MDs who’ve completed medical school and residency training (usually in neurology, sometimes in geriatrics, psychiatry or other fields) and are pursuing further training in behavioral neurology. You’ll see them presenting at PPG/ADRC case conferences and at CPCs.
  • GBHI Atlantic Fellows for Equity in Brain Health
    An international cohort of scholars from various disciplines and many different countries, hosted at UCSF and Trinity College Dublin. Some who have clinical (MD or neuropsychology) backgrounds will occupy clinical research roles analogous to BNTP fellows or neuropsychology trainees.
  • Neuropsychology trainees
    People who either have finished their clinical doctorate (PhD or PsyD), or are in the clinical training portion of their doctorate, involved in neuropsychological testing of clinic patients and research participants.
  • Postdocs
    Researchers who have completed graduate-level doctoral (usually PhD) training, engaged in research here usually for between 2-4 years before seeking a permanent academic or industry research position.
  • Research coordinators
    Most of you–research staff engaged in documentation, participant recruitment/tracking, administering tasks/measures, and many other things necessary to keep the place running. One of the great strengths of the MAC is its robust RC community, with many people who are preparing to go to graduate or professional schools, or are deliberating about next steps in their careers.