Cognitive Assessment of Alzheimer’s Disease and Dementias in Clinical Practice: Pragmatics of Brief Instruments and Neuropsychological Evaluation

Evaluating cognition in older adults when possible cognitive impairment and dementia are present can be quite beneficial. Learn more in this CME activity.

Abstract

Detection of cognitive impairment and dementia (CID) through the use of brief cognitive assessment tools (BCATs) is the first step to establishing an accurate diagnosis and care plan for individuals seen in primary practices. While the cognitive-behavioral syndrome and underlying etiology may not be readily apparent through brief assessment, clinicians can refer patients for a more comprehensive neuropsychological evaluation. A timely diagnosis maximizes the potential for patients to be involved in decision-making and planning for their future, and allows for expedited intervention and harm reduction. This activity provides a practical review of validated and standardized BCATs that can aid in the detection of CID; reviews cognitive and neuropsychological domains and their clinical relevance; and delineates circumstances for referral to neuropsychology and the utility of neuropsychological evaluation to practicing clinicians.

From the Series: A Multidisciplinary Approach for Addressing Challenges in Alzheimer’s Disease

To cite: Shaughnessy et al. Cognitive assessment of Alzheimer's disease and dementias in clinical practice: pragmatics of brief instruments and neuropsychological evaluation. J Clin Psychiatry. 2019;80(4):MS18002BR2C. 

To share: https://doi.org/10.4088/jcp.ms18002br2c 

© Copyright 2019 Physicians Postgraduate Press, Inc.

Target Audience

  • Neurologists
  • Psychiatrists
  • Primary care clinicians
  • Nurse practitioners
  • Physician assistants

Learning Objectives

After completing this educational activity, you should be able to:

  • Incorporate a process using observation, queries, and assessment tools for recognizing and diagnosing patients at risk for AD
Activity summary
Available credit: 
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Participation
Activity opens: 
06/05/2019
Activity expires: 
06/30/2022
Cost:
$0.00
Rating: 
0

Support Statement

Supported by educational grants from ACADIA Pharmaceuticals Inc.; Allergan; Avanir Pharmaceuticals, Inc.; and Biogen MA, Inc.

Learning Objective

After completing this educational activity, you should be able to:

  • Incorporate a process using observation, queries, and assessment tools for recognizing and diagnosing patients at risk for AD

Release, Review, and Expiration Dates

This brief report activity was published in June 2019 and is eligible for AMA PRA Category 1 Credit™ through June 30, 2022. The latest review of this material was April 2019.

Statement of Need and Purpose

Globally, more than half of patients with dementia due to Alzheimer’s disease (AD) and Related Dementias (ADRD) do not receive a timely and appropriate diagnosis. Several barriers including gaps in clinician knowledge, skills, communication strategies, perceptions, and attitudes towards the benefits of evaluation and the process of diagnostic disclosure contribute to a low rate of timely and appropriate diagnosis in ADRD. This activity was designed to meet the needs of participants in CME activities provided by the CME Institute of Physicians Postgraduate Press, Inc., who have requested information on Alzheimer’s disease.

Disclosure of Off-Label Usage

The chair has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents that is outside US Food and Drug Administration–approved labeling has been presented in this article.

Review Process

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.

Acknowledgment

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.

Faculty Affiliation


Lynn Shaughnessy, PsyD
Ray Dolby Brain Health Center, California Pacific Medical Center, Sutter Health, San Francisco
 


Simon Sheard, DO
Banner Health Center, Maricopa, Arizona
 


Danielle Goldfarb, MD
Banner Alzheimer’s Institute, Phoenix, Arizona
 


Alireza Atri, MD, PhD
Banner Sun Health Research Institute, Sun City, Arizona
 

Financial Disclosure

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 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:

Drs Goldfarb, Sheard, and Shaughnessy have no personal affiliations or financial relationships with any commercial interest to disclose relative to the activity. 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. Dr Atri has received honoraria for consulting, educational lectures/programs/materials, or medical/scientific advisory/data safety monitoring boards from AbbVie, Allergan, Alzheimer’s Association, Eisai, Grifols, Harvard Medical School Graduate Continuing Education, Lundbeck, Merck, Roche/Genentech, Suven, and Synexus. Dr Atri’s institution (Banner Health) has received investigational observational study/clinical trial-related funding from Novartis. Dr Atri’s previous institution had contracts for or had received investigational clinical trial–related funding from The American College of Radiology, AbbVie, Avid, Biogen, Lilly, Lundbeck, Merck, and vTV. Dr Atri has received book royalties from Oxford University Press.

Accreditation Statement

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.

 

 

 

CREDIT DESIGNATION

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit(s)™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1.5 hours of Category I credit for completing this program.
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, Cognitive Assessment of Alzheimer’s Disease and Dementias in Clinical Practice: Pragmatics of Brief Instruments and Neuropsychological Evaluation 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

Available Credit

  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Participation

Price

Cost:
$0.00
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