Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging and Alzheimer's Association workgroup. Alzheimers Dement. 2011;7:270-279.
Alzheimer's Association. 2020 Alzheimer's disease facts and figures. Alzheimers Dement. 2020;16:391-460.
Brunet HE, Miller JB, Shi J, et al. Dose informant-based reporting of cognitive symptoms predict amyloid positivity on positron emission tomography? Alzheimers Dement (Amst). 2019;11:424-429.
Cohen RA, Alexander GE. Using TICS and T-MoCA for telephone assessments of vascular cognitive impairment: promising call or put on hold? Stroke. 2017;48:2919-2921.
Dhana K, Evans DA, Rajan KB, et al. Healthy lifestyle and the risk of Alzheimer dementia: findings from 2 longitudinal studies. Neurology. 2020;95:e374-e383.
Dunne RA, Aarsland D, O'Brien JT, et al. Mild cognitive impairment: the Manchester consensus. Age Ageing. 2021;50:72-80.
Falk N, Cole A. Evaluation of suspected dementia. Am Fam Physician. 2018;97:398-405.
Fillit H, Green A. Aducanumab and the FDA -- where are we now? Nat Rev Neurol. 2021. doi: 10.1038/s41582-020-00454-9 [Epub ahead of print]
Gale SA, Acar D, Daffner KR. Dementia. Am J Med. 2018;131:1161-1169.
Galvin JE, Aisen P, Langbaum JB, et al. Early stages of Alzheimer's disease: evolving the care team for optimal patient management. Front Neurol. 2021;11:592302.
Galvin JE. Using informant and performance screening methods to detect mild cognitive impairment and dementia. Curr Geriatr Rep. 2018;7:19-25.
Hwang PH, Longstreth WT Jr, Brenowitz WD, et al. Dual sensory impairment in older adults and risk of dementia from the GEM study. Alzheimers Dement. 2020;12:e12054.
ICD10 Data. 2021 ICD-10-CM diagnosis code R41.89: other symptoms and signs involving cognitive functions and awareness. Published 2021. Accessed February 15, 2021. https://www.icd10data.com/ICD10CM/Codes/R00-R99/R40-R46/R41-/R41.89
Jack CR Jr, Bennett DA, Blennow K, et al. NIA-AA research framework: toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14:535-562.
Jack CR, Petersen RC, Xu Y, et al. Rates of hippocampal atrophy correlate with change in clinical status in aging and AD. Neurology. 2000;55:484-489.
Jaeger J. Digit symbol substitution test: the case for sensitivity over specificity in neuropsychological testing. J Clin Psychopharmacol. 2018;38:513-519.
Khoury R, Ghoussoub E. Diagnostic biomarkers of Alzheimer's disease: a state-of-the-art review. Biomark Neuropsychiatry. 2019;1:10005.
Li JQ, Tan L, Wang HF, et al. Risk factors for predicting progression from mild cognitive impairment to Alzheimer's disease: a systematic review and meta-analysis of cohort studies. J Neurol Neurosurg Psychiatry. 2016;87:476-484.
Liew TM. Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia. Alzheimers Res Ther. 2020;12:107.
Liss JL, Seleri Marques Assunção S, Cummings J, et al. Practical recommendations for timely, accurate diagnosis of symptomatic Alzheimer's disease (MCI and dementia) in primary care: a review and synthesis. J Intern Med. 2021. doi: 10.1111/joim.13244 [Epub ahead of print]
Malek-Ahmadi M, Sabbagh MN. Development and validation of the Alzheimer’s Questionnaire (AQ). J Nat Sci. 2015;1:e104.
McCollum L, Karlawish J. Cognitive impairment evaluation and management. Med Clin N Am. 2020;104:807-825.
McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7;263-269.
Medicare.gov. Yearly "wellness" visits. Accessed February 12, 2021. https://www.medicare.gov/coverage/yearly-wellness-visits
Michalowski B, Hoffmann W, Kostev K. Association between hearing and vision impairment and risk of dementia: results of a case-control study based on secondary data. Front Aging Neurosci. 2019;11;363.
Montreal Cognitive Assessment (MoCA). Training & certification. Accessed February 17, 2021. https://www.mocatest.org/training-certification/
National Institute of Neurological Disorders and Stroke (NINDS); National Institute on Aging (NIA). The Dementias: Hope Through Research. National Institutes of Health; 2017. NIH publication No. 17-NS-2252. Accessed February 11, 2021. https://catalog.ninds.nih.gov/pubstatic//17-NS-2252/17-NS-2252.pdf
Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment. Neurology. 2018;90:126-135.
Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn). 2016;22:404-418.
Rabinovici GD, Gatsonis C, Apgar C, et al. Association of amyloid positron emission tomography with subsequent change in clinical management among Medicare beneficiaries with mild cognitive impairment or dementia. JAMA. 2019;321:1286-1294.
Sabbagh MN, Boada M, Borson S, et al. Early detection of mild cognitive impairment (MCI) in primary care.
Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:280-292.
Tsoi KKF, Chan JYC, Hirai HW, et al. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA Intern Med. 2015;175;1450-1458.
US Preventive Services Task Force (USPSTF). Screening for cognitive impairment in older adults. US Preventive Services Task Force recommendation statement. JAMA. 2020;323:757-763.
Zetterberg H, Bendlin BB. Biomarkers for Alzheimer's disease -- preparing for a new era of disease-modifying therapies. Mol Psychiatry. 2021;26:296-308.

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Faculty

Larry Culpepper, MD, MPH

Professor of Family Medicine
Boston University School of Medicine
Boston, Massachusetts

Disclosures

Disclosure: Larry Culpepper, MD, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Pharmaceuticals; Acadia; Allergan Pharmaceuticals; Eisai Pharmaceuticals; Takeda Pharmaceuticals
Owns stock, stock options, or bonds from: M-3 Information, LLC

Marwan Sabbagh, MD

Camille and Larry Ruvo Chair for Brain Health
Director
Cleveland Clinic Lou Ruvo Center for Brain Health
Las Vegas, Nevada

Disclosures

Disclosure: Marwan Sabbagh, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Acadia; Biogen; NeuroReserve; Neurotrope; Stage 2 Innovations
Served as a speaker or a member of a speakers bureau for: Acadia; HWP; Knapp
Owns stock, stock options, or bonds from: Alzheon; Athira; uMethod

Editors

Lisette Arnaud-Hevi, PhD

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Lisette Arnaud-Hevi, has disclosed no relevant financial relationships.

Christin Melton, ELS

Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Christin Melton, ELS, has disclosed no relevant financial relationships.

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

CME / ABIM MOC

How Early Is Too Early for the Diagnosis of Alzheimer Disease?

Authors: Larry Culpepper, MD, MPH; Marwan Sabbagh, MD
CME / ABIM MOC Released: 2/26/2021
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 2/26/2022

Start Activity

Target Audience and Goal Statement

This activity is intended for primary care physicians (PCPs) and neurologists.

The goal of this activity is to increase knowledge and confidence among PCPs in the ability to identify and screen patients who are at risk for AD.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Evidence supporting the involvement of amyloid β in the pathophysiology of AD
- Clinically relevant tools for the PCP to screen patients for evidence of early stages of cognitive impairment
- Clinical data on the use of therapeutic interventions for the management of early stages of AD

Disclosures

Faculty

Larry Culpepper, MD, MPH

Professor of Family Medicine
Boston University School of Medicine
Boston, Massachusetts

Disclosures

Disclosure: Larry Culpepper, MD, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AbbVie Pharmaceuticals; Acadia; Allergan Pharmaceuticals; Eisai Pharmaceuticals; Takeda Pharmaceuticals
Owns stock, stock options, or bonds from: M-3 Information, LLC

Marwan Sabbagh, MD

Camille and Larry Ruvo Chair for Brain Health
Director
Cleveland Clinic Lou Ruvo Center for Brain Health
Las Vegas, Nevada

Disclosures

Disclosure: Marwan Sabbagh, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Acadia; Biogen; NeuroReserve; Neurotrope; Stage 2 Innovations
Served as a speaker or a member of a speakers bureau for: Acadia; HWP; Knapp
Owns stock, stock options, or bonds from: Alzheon; Athira; uMethod

Editors

Lisette Arnaud-Hevi, PhD

Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Lisette Arnaud-Hevi, has disclosed no relevant financial relationships.

Christin Melton, ELS

Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Christin Melton, ELS, has disclosed no relevant financial relationships.

CME Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance, Medscape, LLC

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

Accreditation Statements

In support of improving patient care, Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

For Physicians

Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Aggregate participant data will be shared with commercial supporters of this activity.

Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit*:

Read about the target audience, learning objectives, and author disclosures.
Study the educational content online or print it out.
Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate, but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period, you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.

From Medscape Education Family Medicine

CME / ABIM MOC

How Early Is Too Early for the Diagnosis of Alzheimer Disease?

Authors: Larry Culpepper, MD, MPH; Marwan Sabbagh, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / ABIM MOC Released: 2/26/2021

Valid for credit through: 2/26/2022

processing....

Educational Impact Challenge

The goal of this activity is to increase knowledge and confidence among PCPs in the ability to identify and screen patients who are at risk for AD.

Before you begin this activity, please assess your clinical knowledge by completing this brief survey. Answering these questions again after the activity will allow you to see what you learned and to compare your answers with those of your peers.

Page 1 of 4

CME / ABIM MOC Information Download Slides

Activity Transcript

Print
Like Tweet

Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Larry Culpepper, MD, MPH

Marwan Sabbagh, MD

Editors

Lisette Arnaud-Hevi, PhD

Christin Melton, ELS

CME Reviewer

Robert Morris, PharmD

Peer Reviewer

CME / ABIM MOC

How Early Is Too Early for the Diagnosis of Alzheimer Disease?

Target Audience and Goal Statement

Disclosures

Faculty

Larry Culpepper, MD, MPH

Marwan Sabbagh, MD

Editors

Lisette Arnaud-Hevi, PhD

Christin Melton, ELS

CME Reviewer

Robert Morris, PharmD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

How Early Is Too Early for the Diagnosis of Alzheimer Disease?

Educational Impact Challenge