1. The Indianapolis Discovery Network in Dementia The IDND Project Malaz Boustani, MD, MPH Stephanie Munger, BS IUCAR, Regenstrief Institute, Inc IDND

2. Sponsorship Pfizer: –Facilitates creating environment for brainstorming by the IDND members. –No honorarium for any IDND members including Dr. Boustani –No restriction on the content of IDND IDND

3. Members disciplines MD PhD MHA RN MSN PharmD Others? IDND

4. Complex Adaptive System (CAS) A diverse system composed of multiple interconnected elements (COMPLEX) An adaptive system capable of changing and learning from experience (ADAPTIVE). The CAS term was coined at the interdisciplinary Santa Fe Institute (SFI), by John H. Holland, Murray Gell-Mann and others. John H. Holland is one of the inventors of evolutionary computation and genetic algorithms. Murray Gell-Mann is a Nobel Prize laureate. The science of CAS is seeking the answers to some fundamental questions about living, adaptable, changeable systems. IDND

5. CAS: John H. Holland “A dynamic network of many agents (which may represent cells, species, individuals, firms, nations) acting in parallel, constantly acting and reacting to what the other agents are doing. The control of a CAS tends to be highly dispersed and decentralized. If there is to be any coherent behavior in the system, it has to arise from competition and cooperation among the agents themselves. The overall behavior of the system is the result of a huge number of decisions made every moment by many individual agents.” Complexity: The Emerging Science at the Edge of Order and Chaos by M. Mitchell Waldrop) IDND

6. CAS: Kevin Dooley A CAS behaves/evolves according to three key principles: –Order is emergent as opposed to predetermined –The system's history is irreversible –The system's future is often unpredictable. The basic building blocks of the CAS are agents. Agents scan their environment and develop schema representing interpretive and action rules. These schema are subject to change and evolution. K. Dooley, AZ State University IDND

7. CAS The CAS main features –emergence behavior –self-organization Examples of complex adaptive systems: –stock market, –Weather forecasting –social insect and ant colonies, –the biosphere and the ecosystem, –the brain and the immune system, –the cell and the developing embryo, –Businesses –Any human social group-based endeavour in a cultural and social system such as political parties or communities. IDND

8. Common goal Of IDND Independent Scholar E Other Local CASs Stress Feedback Independent Scholar D Independent Schoalr C Independent Scholar B Independent Scholar A Changing Clinical & Research Environment Connection The IDND System The IDND Frame-Work

9. The Complex Adaptive System of IDND A number of independent diversified Scholars Common and prioritized goal/goals (the IDND identity) Local nonlinear dynamic interaction among these scholars The supportive Matrix for the IDND members’ interactions Aligns IDND members’ interactions with the IDND goal via –Rich matrix –multiple dynamic positive feedback loops No centralized control Self-organization (distributed control). IDND

10. Evaluating the Impact of IDND Attendance rates of the IDND meeting # of projects generated by the IDND members: –Clinical –Research –Advocacy activities # of publication generated by the IDND members # of educational activities generated by the IDND members Involvement of IDND members with state health policy and community outreach activities related to AD and dementia? IDND

11. The IDND Rules No rules Pro-Active listening Pro-Active involvement Regular meeting bimonthly or monthly Sharing the minutes with all IDND members. Group feedback for any new idea Self-organization IDND