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CME: Contemporary challenges and updates and in the diagnosis and management of Alzheimer’s disease – from early disease onward

Activity Description / Statement of Need:

In this online, self-learning activity:

Alzheimer disease (AD) is a degenerative disease that most commonly affects the elderly, although it is occasionally detected as early as middle age. AD’s prevalence has more than doubled since the year 2000, with recent data suggesting that it will double again by the year 2050. In 2020, AD was the seventh-leading cause of death in the US, and the COVID-19 pandemic has further increased AD-related mortality by 16%. Furthermore, AD impacts the family members and loved ones of people with AD. More than 11 million Americans are estimated to provide 15.3 billion hours of unpaid care, with costs expected to exceed $1 trillion by the year 2050.

AD has traditionally been difficult to diagnose because its onset is oftentimes insidious, with a definitive diagnosis made only on neural tissue examination. The disease is often undetected in its early stages because the symptoms can be similar to cognitive decline that is generally assumed to occur naturally with the aging process, such as forgetfulness and difficulty learning new information. When a patient presents with possible AD, the gathering of information from the family members and specific cognitive tests are used to rule out other possible diseases and to rule in the probable diagnosis of AD. While a number of different practice guidelines are available, but none are recent enough to cover the incorporation of monoclonal antibodies into care and developments in the treatment of early Alzheimer’s disease, including eligible candidates for therapy. Helping the clinician discern the role of these agents merits CME as research suggests that HCPs are unable to keep up with the  publishing of literature and evolution of clinical practice.

Target Audience:

The following HCPs: Neurologists and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in neurology; and any other HCPs with an interest in or who clinically encounter patients with AD or who frequently encounter them or their caregivers in practice.


Commercial Support Disclosure: This program is supported by an educational grant from GE Healthcare.

This activity is free of charge.


Release Date: July 08, 2022 -- Expiration Date: July 08, 2024

Faculty: Zaldy Tan, MD, MPH

Agenda

Introduction, Disclosures

Epidemiology of and risk factors for AD

  • Statistics
  • Gender and racial disparities
  • Age
  • Genetics
  • Comorbid diseases (diabetes, vascular disease)
  • Modifiable risk factors (smoking)

Symptomology and diagnosis of AD

  • Cognitive decline (language, motor function, poor insight, neuropsychiatric manifestations)
  • Neuropsychiatric assessments (Mini Mental State Examination)
  • Pathology and changes in brain
  • Imaging and CSF evaluations for amyloid and tau

Treatment in patients with AD

  • Therapies
    • Pharmacologic vs nonpharmacologic (behavioral, rehabilitation)
    • First-line and beyond
    • Updates: First approval of a monoclonal antibody for early AD - Clinical questions and practical considerations
  • Emerging strategies, trends, and therapies in recent years
    • Investigational monoclonal antibodies and early AD
    • Plasma exchange with albumin replacement
  • Complications and barriers to optimal care in patients with AD

·       The range of cognitive and behavioral complications

·       Safety first: pitfalls in antipsychotic use

·       Adherence to therapy and modifiable risk factors

  • Best practice: Putting it all together
  • Patient cases

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Describe the challenges associated with diagnosis and treatment of AD, including those related to behavioral and cognitive complications.
  • Identify the present treatment options currently available for management of AD and apply them to patient cases using evidence-based medicine.
  • Describe emerging drug therapies in the treatment of AD.
  • Suggest therapies for treating cognitive and behavioral complications secondary to AD.
  • Evaluate a treatment plan for a specific patient based on degree of AD and cognitive or behavioral complications to optimize safety and efficacy, suggesting modifications for improvement.

Accreditation

ACCME Activity #202301832

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

ABIM MOC Credit Type: Medical Knowledge

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABIM.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-22-036-H01-P. This is an application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure: Zaldy S. Tan, MD, MPH, FACP, Director, Cedars-Sinai Health System/Memory & Aging Program, has no relevant financial disclosures.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty will discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from GE Healthcare.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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