Current and Emerging Solutions to Challenges in the Management of Alzheimer’s Disease
Learn from experts in neurology, psychiatry, neuropsychology, and primary care about working with patients and care partners to create management plans for Alzheimer’s disease that ensure safety, optimize patient autonomy, and minimize agitation and conflict.
Effective multifactorial management of Alzheimer’s disease (AD) requires a triadic alliance of the clinician, the patient, and the patient’s family and/or care partner(s). During the evaluation process and when the diagnosis of AD is delivered, these parties must work together to set goals and develop care plans. Care plans should be designed to help the patient maintain safety and autonomy as long as he or she can and, once autonomy is no longer possible, to allow the patient and care partner(s) to experience as much comfort and the best possible quality of life for as long as possible. In this Academic Highlights, faculty members from neurology, psychiatry, neuropsychology, and primary care share their recommendations, supported by current evidence and guidelines, for handling the complexities of providing care for patients with AD.
From the Series: Challenges in the Management of Alzheimer's Disease
To cite: Atri A, Goldfarb D, Sheard S, et al. Current and emerging solutions to challenges in the management of Alzheimer’s disease. J Clin Psychiatry. 2019;80(6):MS18002AH3C
To share: https://doi.org/10.4088/JCP.MS18002AH3C
© Copyright 2019 Physicians Postgraduate Press, Inc.
- Primary care clinicians
- Nurse practitioners
- Physician assistants
Provide pharmacologic and nonpharmacologic treatment options to diminish cognitive, behavioral, and psychological symptoms of AD in conjunction with other health care providers
Supported by a educational grants from ACADIA Pharmaceuticals Inc.; Allergan; Avanir Pharmaceuticals, Inc.; and Biogen MA, Inc..
After completing this educational activity, you should be able to:
- Provide pharmacologic and nonpharmacologic treatment options to diminish cognitive, behavioral, and psychological symptoms of Alzheimer's disease in conjunction with other health care providers
Release, Review, and Expiration Dates
This brief report activity was published in December 2019 and is eligible for AMA PRA Category 1 Credit™ through December 31, 2022. The latest review of this material was November 2019.
Statement of Need and Purpose
Clinicians are missing the diagnosis of about half of cases of Alzheimer’s disease (AD) and related dementias. When the illness is being recognized, providers often are not effectively communicating with patients and their care partners regarding the diagnosis and next steps. Clinicians also may not individualize treatment options to manage cognitive and behavioral symptoms in patients with AD. Task-sharing and collaboration must occur between specialists and primary care physicians to address the growing number of individuals with AD. Clinicians need education on early recognition of AD using a stepwise process that includes patient observation, informant report, use of assessment tools, and additional testing or referral, when appropriate. Practitioners also need guidance for sharing the diagnosis of AD along with education and next steps to take, including support services. Finally, providers need current information on pharmacologic and nonpharmacologic treatments for patients with AD.
Disclosure of Off-Label Usage
The authors have determined that, to the best of their knowledge, sertraline, citalopram, escitalopram, quetiapine, and risperidone are not approved by the US Food and Drug Administration for the treatment of Alzheimer’s disease, but their potential use in selective clinical situations for mood, anxiety, irritability, agitation, aggression, and psychosis symptoms in patients with Alzheimer’s disease was discussed.
The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
This activity is derived from the teleconference series “A Multidisciplinary Approach for Addressing Challenges in Alzheimer’s Disease,” which was held between September 2018 and February 2019 and is supported by educational grants from ACADIA Pharmaceuticals Inc.; Allergan; Avanir Pharmaceuticals, Inc.; and Biogen MA, Inc. The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporters.
Alireza Atri, MD, PhD
Banner Sun Health Alzheimer's Institute, Phoenix, Arizona
Danielle Goldfarb, MD
Banner Alzheimer's Institute, Phoenix, Arizona
Simon Sheard, DO
Banner Health Center, Maricopa, Arizona
Lynn Shaughnessy, PsyD
Beth Isreal-Deaconess Hospital and Harvard Medical School, Boston, Massachusetts
The faculty for this CME activity and the CME Institute staff were asked to complete a statement regarding all relevant personal and financial relationships between themselves or their spouse/partner and any commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) defines a commercial interest as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines relevant financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. The CME Institute has resolved any conflicts of interest that were identified. No member of the CME Institute staff reported any relevant personal financial relationships. Faculty financial disclosures are as follows:
Dr Atri has no equity, shares, or salary from any pharmaceutical or biotechnology company and is not a member of any pharmaceutical company’s speakers’ bureau. In the last 12 months, Dr Atri has received, or may receive, honoraria for consulting, educational lectures/programs/materials, or medical/scientific advisory/data safety monitoring boards from AbbVie, Alzheimer’s Association, Biogen, Eisai, Grifols, Harvard Medical School Graduate Continuing Education, Novo Nordisk, Roche/Genentech, Suven, and Synexus. Dr Atri’s institution (Banner Health) has received, related to Dr Atri’s activities, observational study/clinical trial study-, infrastructure development- and/or outreach and awareness-related funding from The Arizona Alzheimer’s Research Consortium, The National Institutes of Health/NIA, Novartis, The Alzheimer’s Clinical Trial Consortium (ACTC), The Alzheimer’s Therapeutic Research Institute (ATRI), University of Indiana School of Medicine, and the Global Alzheimer’s Platform (GAP). Dr Atri has received book royalties from Oxford University Press. Drs Sheard, Goldfarb, and Shaughnessy have no personal affiliations or financial relationships with any commercial interest to disclose relative to the activity.
The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporters.
The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.
MOC APPROVAL STATEMENT
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Current and Emerging Solutions to Challenges in the Management of Alzheimer's Disease has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC PART II CME ACTIVITY
Psychiatry and Neurology
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation