Early Diagnosis of Mild Cognitive Impairment and Alzheimer’s Disease

Faculty

Sharon Cohen, MD, FRCPC
Medical Director, Toronto Memory Program
Assistant Professor, University of Toronto
Consultant Neurologist, North York General
Toronto, Ontario, Canada

Marwan N. Sabbagh, MD, FAAN
Director, Cleveland Clinic Lou Ruvo Center for Brain Health
Camille and Larry Ruvo Endowed Chair for Brain Health
Professor of Neurology, Cleveland Clinic Lerner College of Medicine
Clinical Professor, Department of Neurology
University of Nevada, Las Vegas
Las Vegas, Nevada

Target Audience

The educational design of this activity addresses the needs of physicians, nurse practitioners, and other allied health care professionals who treat patients with Alzheimer's disease (AD).

Educational Objective

After completing this activity, the participant should be better able to:

• Assess patients with mild cognitive impairment and Alzheimer’s disease using cognitive scales, biomarker imaging, clinical examination, and patient/caregiver interviews

Statement of Need

AD is a common neurodegenerative condition that results in a range of profoundly disabling cognitive, affective, and behavioral symptoms.¹ Mild cognitive impairment (MCI) affects a large percentage of preclinical AD patients, and studies have found that 32% to 38% of patients with MCI will develop AD within 5 years.^2,3 Early diagnosis, while challenging, is critical to initiate nonpharmacologic and pharmacologic therapy targeting symptoms of MCI or AD, as well as to allow for long-term planning.⁴ Guidelines recommend that standardized cognitive tests be applied in addition to patient and caregiver interviews to determine risk for and symptoms of MCI or AD.⁵ Standard imaging, including magnetic resonance imaging (MRI) and possibly fluorodeoxyglucose (FDG)-positron emission tomography (PET), is useful to rule out causes other than AD, although it is insufficient for diagnosis on its own.⁶ The diagnosis of AD is rapidly evolving from one of exclusion to one of inclusion by employing established biomarkers – both in cerebrospinal fluid and amyloid or tau PET tracers – to confirm diagnosis. As research continues to evolve and diagnostic capabilities expand, clinicians must remain up to date on new guidelines, technologies, and strategies to identify appropriate patients for further testing. Dr. Cohen and Dr. Sabbagh provide expert insight into risk factors for MCI and AD, symptoms indicative of MCI or AD, neuropsychologic testing, standard imaging, and the evolving future of MCI and AD diagnosis.

References

1. Alzheimer’s Association. 2021 Alzheimer’s Disease Facts and Figures.
   https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf. Accessed April 6, 2021.
2. Mitchell AJ, Shiri-Feshki M. Acta Psychiatr Scand. 2009;119(4):252-265.
3. Ward A, et al. Dement Geriatr Cogn Dis Extra. 2013;3(1):320-332.
4. Dubois B, et al. J Alzheimers Dis. 2016;49(3):617-631.
5. Petersen RC, et al. Neurology. 2018;90(3):126-135.
6. Femminella GD, et al. Int J Mol Sci. 2018;19(12):3702.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global Education Group and Integritas Communications. Global Education Group is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 0.5 contact hour (which includes 0.1 hour of pharmacology).

Term of Offering

This activity was released on April 21, 2021 and is valid for 1 year. Requests for credit must be made no later than April 21, 2022.

Global Contact Information

For information about the accreditation of this activity, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Integritas Communications Contact Information

For all other questions about this activity, please contact Integritas Communications at info@exchangecme.com.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the preactivity questionnaire, view the educational content, score 70% or better on the posttest, and complete the program evaluation.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited Continuing Education (CE), set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies:

Sharon Cohen, MD, FRCPC: Nothing to disclose

Marwan N. Sabbagh, MD, FAAN Consultant/Independent Contractor: Acadia Pharmaceuticals, Inc., Alzheon Inc., Biogen Inc., Cortexyme, Inc., Danone S.A., Neurotrope Biosciences, Regeneron Pharmaceuticals, Inc., Roche-Genentech, Inc., State 2 Innovations; Speakers Bureau: Health and Wellness Partners, LLC, Knapp Healthcare Communications, LLC; Stock Shareholder: Athira Pharma, Brain Health Inc, NeuroReserve Inc., NeuroTau, Inc., Optimal Cognitive Health Company, LLC, uMETHOD Health, Inc., Versanum Inc.

The planners and managers have the following relevant financial relationships with ineligible companies:

Kristin Delisi, NP, Lindsay Borvansky, Andrea Funk, Liddy Knight, Ashley Cann, Gena Dolson, MS, Stacey JP Ullman, MHS

System Requirements

PC
Microsoft Windows 2000 SE or above.
Internet Explorer (v5.5 or greater), Chrome, or Firefox

MAC
MAC OS 10.2.8
Safari
Internet Explorer is not supported on the Macintosh.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global and Integritas Communications do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.