Alzheimer's Disease Brain Failure, Stopping the Momentum. Katherine E. Galluzzi, DO, CMD, FACOFP dist.

Size: px
Start display at page:

Download "Alzheimer's Disease Brain Failure, Stopping the Momentum. Katherine E. Galluzzi, DO, CMD, FACOFP dist."

Transcription

1 AOA/ACOFP 113th Annual Convention and Scientific Seminar Las Vegas, Nevada Alzheimer's Disease Brain Failure, Stopping the Momentum Katherine E. Galluzzi, DO, CMD, FACOFP dist. Monday, October 27, :00-11:00am CME/CEU Information The American College of Osteopathic Family Physicians is accredited by the American Osteopathic Association Council to sponsor continuing medical education for osteopathic physicians. The American College of Osteopathic Family Physicians designates the lectures and workshops for Category 1A credit on an hour-for hour basis, pending approval by the AOA CCME. ACOFP is not responsible for the content.

2 DISCLOSURE OF FINANCIAL RELATIONSHIPS WITHIN 12 MONTHS OF DATE OF THIS FORM Speaker Name: Katherine E. Galluzzi, DO, CMD, FACOFP dist Have you, or any of your immediate family, had a financial relationship or interest with any proprietary entity producing health care goods or services within the past 12 months? Yes If you answered Yes to the question above, please indicate the relationship(s): Relationships: Speakers' Bureau* If other: Organization/Clinical Area Involved: Pfizer/Eisai - Alzheimer's Disease *If you checked Speakers Bureaus: Did you participate in company-provided speaker training related to your proposed topic? No Did you travel to participate in this training? No Did the company provide you with slides of the presentation in which you were trained as a speaker? No Did the company pay the travel/lodging/other expenses? No Did you receive an honorarium or consulting fee for participating in this training? No Have you received any other type of compensation from the company? Please specify: No When serving as faculty for ACOFP, will you use slides provided by a proprietary entity for your presentation/handout materials? Will your topic involve information or data obtained from commercial speaker training? DISCLOSURE OF UNLABELED/INVESTIGATIONAL USES OF PRODUCTS Will the content of your material(s)/presentation(s) in this CME activity include discussion of unapproved or investigational uses of products or devices? Will touch on emergent therapeutic area of vaccination against B-amyloid. I have read the ACOFP policy on full disclosure. If I have indicated a financial relationship or interest, I understand that this information will be reviewed to determine whether a conflict of interest may exist, and I may be asked to provide additional information. I understand that failure or refusal to disclose, false disclosure, or inability to resolve conflicts will require the ACOFP to identify a replacement.

3 What is your age? Mild Cognitive Impairment: What s in Your Cranium? Katherine E. Galluzzi, D.O., CMD, FACOFP dist. Professor and Chair Department of Geriatrics Philadelphia College of Osteopathic Medicine I d rather not say What is your gender? 1. male 2. female Are you being treated for hypertension? 1. yes 2. no 1

4 Are you being treated for hyperlipidemia? 1. yes 2. no How do you rate your memory? 1. excellent 2. very good 3. fair 4. poor 5. I d rather not say Dementia COGNITIVE CONTINUUM Normal Mild Cognitive Impairment Dementia A clinical syndrome having major impact on an aging individual Alzheimer s Disease Parkinson s Disease Dementia with Lewy Bodies Vascular Dementia 2

5 Dementia of Alzheimer Type Neurodegenerative process that results in cognitive deficits which cause significant decline in social or occupational functioning and represent a substantial decline in previous level of functioning Other causes are not responsible for the deficits The deficits do not occur exclusively during delirium Mild Cognitive Impairment Transitional state between the cognitive changes of normal aging and the fully developed features of dementia Peterson, RC. Seminars in Neurology 2001;27(1):22-31 Original Criteria Memory complaint, preferably qualified by an informant Memory impairment for age and education Preserved general cognitive function Intact activities of daily living Not demented Adapted from Reisberg B et al. Am J Psychiatry 1982;139: Cognitive complaint Not normal for age, not demented Cognitive decline, essentially normal ADL s YES MCI NO Amnestic MCI Memory impaired? Non-amnestic MCI Memory Single non-memory YES Impairment NO YES cognitive domain NO only? Impairment? Amnestic MCI Single domain Amnestic MCI Multiple domains Non-amnestic MCI Single domain Petersen RC. J Intern Med 2004;256: Non-amnestic MCI Multiple domains M C I D E M E N T I A DEGENERATIVE VASCULAR OTHER Alzheimer s disease Frontotemporal dementia Dementia w/ Lewy Bodies Vascular dementia; vascular cognitive impairment Neoplasm Metabolic Psychiatric Normal pressure hydrocephalus NOS Peterson RC, O Brien J. J Geriatric Psychiatry Neurol 2006;19:

6 Modified from: Brumback RA, Leech RW: Alzheimer's Disease: Pathophysiology and the hope for therapy. Journal of the Oklahoma State Medical Association. 1994; 87: Dementia Evaluation Routine Mental Status Examination evaluates: level of consciousness orientation attention visuo-spatial skills mood/personality Folstein Mini Mental State Exam: Clock Drawing test Why is early identification important? 1. cure is possible 2. medications to slow progression are available 3. there is a therapeutic window of efficacy for treatment 4. identification allows for anticipatory guidance 5. it isn t 4

7 > 67% of individuals are moderately demented at the time of diagnosis! Gifford DR & Cummings JL1999 Neurology;52: Measures to Predict Progression to AD Cognitive Domains Amnestic Mild Cognitive Impairment Subtype Apolipoprotein E4 (ApoE4): carrier status in several studies was shown to be a risk factor 1 Inability to benefit from semantic clues may indicate more rapid progression 2 Structural Neuroimaging: studies suggest that atrophy of hippocampal formation predicts the rate of progression from MCI to AD 3 Memory Executive function Visual spatial perception Verbal functioning Attention Information processing speed Motor skills Executive functioning 1. Aggarwal NT et al. Neurocase2005;11:3-7; Peterson RC et al. Ann NY AcadSci1996;802: Dubois B, Albert ML. Lancet Neurol 2004;3: Jack CR, Petersen et al. Neurology 1999;52: ; Jack CR et al. Neurology 2005;65:

8 Verbal Memory Forming new associations between items is critical for establishing episodic memory 10 pairs of words to study followed by a recognition test Tests immediate recognition memory and delayed recognition memory Adapted from Mindstreams TM Cognitive Health Assessment Version 2.1 NeuroTrax Corporation 2003 dish - bird dog - candle pillow - key tree - icicle deer - rug cat - lamp lake - plug date - rug piano - pinecone bottle - chair lake 1. house 2. plug 3. jeep 4. soup Non-verbal Memory Better predictor of early AD than verbal tests (Kawas, Corrada et al 2003) Immediate recognition, delayed recognition memory Eight simple geometric patterns note their orientation Recognition test consists of four possible alternatives Adapted from Mindstreams TM Cognitive Health Assessment Version 2.1 NeuroTrax Corporation

9

10 Visual Spatial Imagery Test Assesses abstract spatial ability Computer-generated everyday scene containing a red pillar (rectangle) Four views of the scene are presented at the bottom of the screen Which of the four views corresponds to the view of the scene from the location of the pillar? Adapted from Mindstreams TM Cognitive Health Assessment Version 2.1 NeuroTrax Corporation Stroop Interference Well-established cognitive test (MacLeod, 1991) Measures facility with which an individual can shift perceptual set to conform to changing demands Shown to discriminate among brain-damaged individuals, those with schizophrenia, Parkinson s and Huntington s disease Interference effect is greater for those with frontal lobe damage than for other groups cat 8

11 red red

12 Verbal Rhyming Impairment in verbal fluency is a telltale sign of dementia Test assesses higher-order verbal skill Which word rhymes with the object presented Language skills, semantic knowledge Adapted from Mindstreams TM Cognitive Health Assessment Version 2.1 NeuroTrax Corporation ring 2. art 3. spoon 4. gold 1. choose 2. pin 3. bench 4. rabbit 10

13 Verbal Naming Assesses basic verbal skills Language skills, semantic knowledge Adapted from Mindstreams TM Cognitive Health Assessment Version 2.1 NeuroTrax Corporation ring 2. shell 3. heart 4. gold CERAD * Word Battery 1. piano 2. pinecone 3. wrench 4. winch dream score bowl pillow bell game snow peacock rice harmonica * Consortium for Establishing A Registry for Alzheimer Disease 11

14 Mild Cognitive Impairment Clinical Trials Sponsor Compound n Duration (yr) Primary Outcome Rate of Prog (%) Result ADCS Donepezil Vitamin E AD 16 Partially positive Novartis Rivastigmine AD 9 Negative J & J 2 trials Galantamine CDR 5 Negative Merck Rofecoxib AD 5 Negative Adapted from Peterson RC. Semin Neurol 2007; 27(1):22-31 How do you rate your memory now? 1. excellent 2. very good 3. fair 4. poor 5. I d rather not say 12

SHARED CARE OF MCI/EARLY DEMENTIA

SHARED CARE OF MCI/EARLY DEMENTIA SHARED CARE OF MCI/EARLY DEMENTIA BY DR. OLUFEMI BANJO MD, DTM, DCP, DIPA&DS, DHM, M.Med.Sc, FRCP(C) GERIATRIC PSYCHIATRIST. ASSISTANT MEDICAL DIRECTOR, ADULT MENTAL HEALTH AND ADDICTION, GRAND RIVER HOSPITAL

More information

Mild Cognitive Impairment (MCI)

Mild Cognitive Impairment (MCI) October 19, 2018 Mild Cognitive Impairment (MCI) Yonas E. Geda, MD, MSc Professor of Neurology and Psychiatry Consultant, Departments of Psychiatry & Psychology, and Neurology Mayo Clinic College of Medicine

More information

3/14/2016. *Group 2 DOs *Review of core. *Group 1 MDs *Basic review with MDs * Anatomy * Screening * Pathophysiology * Theory behind

3/14/2016. *Group 2 DOs *Review of core. *Group 1 MDs *Basic review with MDs * Anatomy * Screening * Pathophysiology * Theory behind Shirin Clark DO To outline a limited curriculum for teaching basic OPP/OMT to allopathic physicians to be used for programs seeking osteopathic recognition To provide a framework for teaching OPP/OMM to

More information

Form D1: Clinician Diagnosis

Form D1: Clinician Diagnosis Initial Visit Packet Form D: Clinician Diagnosis NACC Uniform Data Set (UDS) ADC name: Subject ID: Form date: / / Visit #: Examiner s initials: INSTRUCTIONS: This form is to be completed by the clinician.

More information

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics.

DISCLAIMER: ECHO Nevada emphasizes patient privacy and asks participants to not share ANY Protected Health Information during ECHO clinics. DISCLAIMER: Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this

More information

Cognitive Screening in Risk Assessment. Geoffrey Tremont, Ph.D. Rhode Island Hospital & Alpert Medical School of Brown University.

Cognitive Screening in Risk Assessment. Geoffrey Tremont, Ph.D. Rhode Island Hospital & Alpert Medical School of Brown University. Cognitive Screening in Risk Assessment Geoffrey Tremont, Ph.D. Rhode Island Hospital & Alpert Medical School of Brown University Outline of Talk Definition of Dementia and MCI Incidence and Prevalence

More information

Overview. Case #1 4/20/2012. Neuropsychological assessment of older adults: what, when and why?

Overview. Case #1 4/20/2012. Neuropsychological assessment of older adults: what, when and why? Neuropsychological assessment of older adults: what, when and why? Benjamin Mast, Ph.D. Associate Professor & Vice Chair, Psychological & Brain Sciences Associate Clinical Professor, Family & Geriatric

More information

Test Assessment Description Ref. Global Deterioration Rating Scale Dementia severity Rating scale of dementia stages (2) (4) delayed recognition

Test Assessment Description Ref. Global Deterioration Rating Scale Dementia severity Rating scale of dementia stages (2) (4) delayed recognition Table S. Cognitive tests used in the Georgia Centenarian Study. Test Assessment Description Ref. Mini-Mental State Examination Global cognitive performance A brief screening of orientation, memory, executive

More information

AMNESTIC MINIMAL COGNITIVE IMPAIRMENT: BEYOND MEMORY

AMNESTIC MINIMAL COGNITIVE IMPAIRMENT: BEYOND MEMORY AMNESTIC MINIMAL COGNITIVE IMPAIRMENT: BEYOND MEMORY R. Balachandar 1,, R. Tripati 2, S. Bharath 1, S. Sadanand 1, P. T. Sivakumar 1, K. Kumar 2, S. Loganathan 1, S. R. Chandra 3, M. Vargese 1 1 Dept.

More information

Erin Cullnan Research Assistant, University of Illinois at Chicago

Erin Cullnan Research Assistant, University of Illinois at Chicago Dr. Moises Gaviria Distinguished Professor of Psychiatry, University of Illinois at Chicago Director of Consultation Liaison Service, Advocate Christ Medical Center Director of the Older Adult Program,

More information

DSM-5 MAJOR AND MILD NEUROCOGNITIVE DISORDERS (PAGE 602)

DSM-5 MAJOR AND MILD NEUROCOGNITIVE DISORDERS (PAGE 602) SUPPLEMENT 2 RELEVANT EXTRACTS FROM DSM-5 The following summarizes the neurocognitive disorders in DSM-5. For the complete DSM-5 see Diagnostic and Statistical Manualof Mental Disorders, 5th edn. 2013,

More information

HOW TO PREVENT COGNITIVE DECLINE.AT MCI STAGE?

HOW TO PREVENT COGNITIVE DECLINE.AT MCI STAGE? EAMA CORE CURRICULUM HOW TO PREVENT COGNITIVE DECLINE.AT MCI STAGE? Sofia Duque Orthogeriatric Unit São Francisco Xavier Hospital Occidental Lisbon Hospital Center University Geriatric Unit, Faculty of

More information

Mild Cognitive Impairment

Mild Cognitive Impairment Mild Cognitive Impairment Victor W. Henderson, MD, MS Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences Stanford University Director, Stanford Alzheimer s

More information

3/6/2019 DIAGNOSIS OF DEMENTIA IN THE OUTPATIENT SETTING FINANCIAL DISCLOSURES LEARNING OBJECTIVES

3/6/2019 DIAGNOSIS OF DEMENTIA IN THE OUTPATIENT SETTING FINANCIAL DISCLOSURES LEARNING OBJECTIVES DIAGNOSIS OF DEMENTIA IN THE OUTPATIENT SETTING MILTA LITTLE, DO, CMD DUKE UNIVERSITY SCHOOL OF MEDICINE FINANCIAL DISCLOSURES Dr. Little has no relevant financial disclosures to report Dr. Little will

More information

THE ROLE OF ACTIVITIES OF DAILY LIVING IN THE MCI SYNDROME

THE ROLE OF ACTIVITIES OF DAILY LIVING IN THE MCI SYNDROME PERNECZKY 15/06/06 14:35 Page 1 THE ROLE OF ACTIVITIES OF DAILY LIVING IN THE MCI SYNDROME R. PERNECZKY, A. KURZ Department of Psychiatry and Psychotherapy, Technical University of Munich, Germany. Correspondence

More information

Joint Session ACOFP and AOASM: Exercise Induced Asthma. Bruce Dubin, DO, JD, FCLM, FACOI

Joint Session ACOFP and AOASM: Exercise Induced Asthma. Bruce Dubin, DO, JD, FCLM, FACOI Joint Session ACOFP and AOASM: Exercise Induced Asthma Bruce Dubin, DO, JD, FCLM, FACOI ACOFP FULL DISCLOSURE FOR CME ACTIVITIES Please check where applicable and sign below. Provide additional pages as

More information

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient

WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient DEMENTIA WHAT IS DEMENTIA? An acquired syndrome of decline in memory and other cognitive functions sufficient to affect daily life in an alert patient Progressive and disabling Not an inherent aspect of

More information

CHAPTER 5 NEUROPSYCHOLOGICAL PROFILE OF ALZHEIMER S DISEASE

CHAPTER 5 NEUROPSYCHOLOGICAL PROFILE OF ALZHEIMER S DISEASE CHAPTER 5 NEUROPSYCHOLOGICAL PROFILE OF ALZHEIMER S DISEASE 5.1 GENERAL BACKGROUND Neuropsychological assessment plays a crucial role in the assessment of cognitive decline in older age. In India, there

More information

Understanding Dementia

Understanding Dementia Understanding Dementia Dr. Dallas Seitz MD FRCPC Assistant Professor, Department of Psychiatry, Queen s University, Kingston, Ontario, Canada What s Next Information about Dementia, Elder Care and Supports

More information

Alzheimer s Disease without Dementia

Alzheimer s Disease without Dementia Alzheimer s Disease without Dementia Dr Emer MacSweeney CEO & Consultant Neuroradiologist Re:Cognition Health London Osteopathic Society 13 September 2016 Early diagnosis of Alzheimer s Disease How and

More information

CSF Aβ1-42 predicts cognitive impairment in de novo PD patients

CSF Aβ1-42 predicts cognitive impairment in de novo PD patients CSF Aβ1-42 predicts cognitive impairment in de novo PD patients Mark Terrelonge MPH *1, Karen Marder MD MPH 1, Daniel Weintraub MD 2, Roy Alcalay MD MS 1 1 Columbia University Department of Neurology 2

More information

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada

Dementia Update. October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Dementia Update October 1, 2013 Dylan Wint, M.D. Cleveland Clinic Lou Ruvo Center for Brain Health Las Vegas, Nevada Outline New concepts in Alzheimer disease Biomarkers and in vivo diagnosis Future trends

More information

Dementia Update. Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota

Dementia Update. Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Dementia Update Daniel Drubach, M.D. Division of Behavioral Neurology Department of Neurology Mayo Clinic Rochester, Minnesota Nothing to disclose Dementia Progressive deterioration in mental function

More information

Clinical Diagnosis. Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV)

Clinical Diagnosis. Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV) Step 1: Dementia or not? Diagnostic criteria for dementia (DSM-IV) A. The development of multiple cognitive deficits manifested by both 1 and 2 1 1. Memory impairment 2. One (or more) of the following

More information

NEUROPSYCHOMETRIC TESTS

NEUROPSYCHOMETRIC TESTS NEUROPSYCHOMETRIC TESTS CAMCOG It is the Cognitive section of Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) The measure assesses orientation, language, memory, praxis, attention, abstract

More information

Out of Proportion Portions. Tiffany Jessee, DO. ACOFP 55th Annual Convention & Scientific Seminars

Out of Proportion Portions. Tiffany Jessee, DO. ACOFP 55th Annual Convention & Scientific Seminars Out of Proportion Portions Tiffany Jessee, DO 8 ACOFP 55th Annual Convention & Scientific Seminars ACOFP FULL DISCLOSURE FOR CME ACTIVITIES Please check where applicable and sign below. Provide additional

More information

Form A3: Subject Family History

Form A3: Subject Family History Initial Visit Packet NACC Uniform Data Set (UDS) Form A: Subject Family History ADC name: Subject ID: Form date: / / Visit #: Examiner s initials: INSTRUCTIONS: This form is to be completed by a clinician

More information

DEMENTIA, THE BRAIN AND HOW IT WORKS AND WHY YOU MATTER

DEMENTIA, THE BRAIN AND HOW IT WORKS AND WHY YOU MATTER OVERCOMING THE CHALLENGES OF MANAGING CHRONIC DISEASES IN PERSONS WITH DEMENTIA DEMENTIA, THE BRAIN AND HOW IT WORKS AND WHY YOU MATTER LEARNING OBJECTIVES Be familiar with the diagnostic criteria for

More information

Alzheimer s disease dementia: a neuropsychological approach

Alzheimer s disease dementia: a neuropsychological approach Alzheimer s disease dementia: a neuropsychological approach Dr. Roberta Biundo, PhD Neuropsychology Coordinator at Parkinson s disease and movement disorders unit of San Camillo rehabilitation hospital

More information

After the Diagnosis: Rehabilitation & Support Options for Mild Dementia

After the Diagnosis: Rehabilitation & Support Options for Mild Dementia After the Diagnosis: Rehabilitation & Support Options for Mild Dementia Dr. Toni Nicholls, Clinical Neuropsychologist Peronne Village, cottage #20, Worthing, Christ Church 621-2022 Say these aloud Dog

More information

An estimated half a million

An estimated half a million Darcy Cox, PsyD, RPsych, ABPP The role of neuropsychological testing in the care of older adults The standardized administration of cognitive tests and the individualized interpretation of results can

More information

Neuropsychological Evaluation of

Neuropsychological Evaluation of Neuropsychological Evaluation of Alzheimer s Disease Joanne M. Hamilton, Ph.D. Shiley-Marcos Alzheimer s Disease Research Center Department of Neurosciences University of California, San Diego Establish

More information

Non Alzheimer Dementias

Non Alzheimer Dementias Non Alzheimer Dementias Randolph B Schiffer Department of Neuropsychiatry and Behavioral Science Texas Tech University Health Sciences Center 9/11/2007 Statement of Financial Disclosure Randolph B Schiffer,,

More information

Imaging of Alzheimer s Disease: State of the Art

Imaging of Alzheimer s Disease: State of the Art July 2015 Imaging of Alzheimer s Disease: State of the Art Neir Eshel, Harvard Medical School Year IV Outline Our patient Definition of dementia Alzheimer s disease Epidemiology Diagnosis Stages of progression

More information

Why Cognition Matters: Impact of Cognitive Impairment on Safety and Independent Living Skills

Why Cognition Matters: Impact of Cognitive Impairment on Safety and Independent Living Skills Why Cognition Matters: Impact of Cognitive Impairment on Safety and Independent Living Skills Presented by: Dr. William Mansbach CEO & Founder Mansbach Health Tools, LLC www.thebcat.com Highlights on Prevalence

More information

UDS version 3 Summary of major changes to UDS form packets

UDS version 3 Summary of major changes to UDS form packets UDS version 3 Summary of major changes to UDS form packets from version 2 to VERSION 3 february 18 final Form A1: Subject demographics Updated question on principal referral source to add additional options

More information

Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders. William L. Bograkos, MA, DO, FACOEP

Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders. William L. Bograkos, MA, DO, FACOEP Commi ee Lecture: Neurocogni ve Disorders TBI : Trauma c Brain Disorders Toxic Brain Disorders William L. Bograkos, MA, DO, FACOEP TBI: Traumatic Brain Injury / Toxic Brain Injury (Trauma and Substance

More information

DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD

DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD DEMENTIA 101: WHAT IS HAPPENING IN THE BRAIN? Philip L. Rambo, PhD OBJECTIVES Terminology/Dementia Basics Most Common Types Defining features Neuro-anatomical/pathological underpinnings Neuro-cognitive

More information

Mild cognitive impairment A view on grey areas of a grey area diagnosis

Mild cognitive impairment A view on grey areas of a grey area diagnosis Mild cognitive impairment A view on grey areas of a grey area diagnosis Dr Sergi Costafreda Senior Lecturer Division of Psychiatry, UCL Islington Memory Service, C&I NHS FT s.costafreda@ucl.ac.uk London

More information

Capacity and Older Adults. Kenneth I. Shulman

Capacity and Older Adults. Kenneth I. Shulman Capacity and Older Adults Kenneth I. Shulman Increased Requests for Contemporaneous Assessments of Testamentary Capacity Increase in challenges to testamentary capacity Demographics/Economics Prevalence

More information

Evaluation and Treatment of Dementia

Evaluation and Treatment of Dementia Evaluation and Treatment of Dementia Jeffrey M. Burns, MD Edward H. Hashinger Professor of Neurology Co-Director, KU Alzheimer s Disease Center Director, Clinical and Translational Science Unit Disclosures

More information

Alzheimer s Disease Update: From Treatment to Prevention

Alzheimer s Disease Update: From Treatment to Prevention Alzheimer s Disease Update: From Treatment to Prevention Jeffrey M. Burns, MD Edward H. Hashinger Professor of Medicine Co-Director, KU Alzheimer s Disease Center Director, Clinical and Translational Science

More information

Delirium & Dementia. Nicholas J. Silvestri, MD

Delirium & Dementia. Nicholas J. Silvestri, MD Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural pathways relating to consciousness Encephalopathy Stupor Coma Dementia Delirium vs. Dementia Delirium Abrupt onset Lasts

More information

Symposia on Mild Cognitive Impairment

Symposia on Mild Cognitive Impairment *Artwork by permission of Memories in the Making art program. Indiana alzheimer Disease center Friday, April 18 and Saturday, April 19, 2008 Indiana Historical Society 450 West Ohio Street Indianapolis,

More information

PD ExpertBriefing: Cognition and PD: What You ve Always Wanted to Know But Were Too Afraid to Ask. Presented By: Tuesday, March 22, 2011 at 1:00 PM ET

PD ExpertBriefing: Cognition and PD: What You ve Always Wanted to Know But Were Too Afraid to Ask. Presented By: Tuesday, March 22, 2011 at 1:00 PM ET PD ExpertBriefing: Cognition and PD: What You ve Always Wanted to Know But Were Too Afraid to Ask Presented By: Alexander I. Tröster, PhD, ABPP University of North Carolina, Chapel Hill, NC Tuesday, March

More information

Dementia and Alzheimer s disease

Dementia and Alzheimer s disease Since 1960 Medicine Korat โรงพยาบาลมหาราชนครราชส มา Dementia and Alzheimer s disease Concise Reviews PAWUT MEKAWICHAI MD DEPARTMENT of MEDICINE MAHARAT NAKHON RATCHASIMA HOSPITAL 1 Prevalence Increase

More information

A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies

A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies A Fresh View of Cognitive Disorders in Older Adults: New Classification and Screening Strategies Lynda Mackin, PhD, AGPCNP-BC, CNS University of California San Francisco School of Nursing 1 Alzheimer s

More information

Drug Update. Treatments for Cognitive Impairment in the Older Adult. William Solan, M.D. Karen Sanders, Ph.D. Northwest Hospital Seattle

Drug Update. Treatments for Cognitive Impairment in the Older Adult. William Solan, M.D. Karen Sanders, Ph.D. Northwest Hospital Seattle Drug Update Treatments for Cognitive Impairment in the Older Adult William Solan, M.D. Karen Sanders, Ph.D. Northwest Hospital Seattle Current Drug Treatments for Alzheimer s Disease Cholinesterase Inhibitors:

More information

WEBINAR SERIES: AGING IN INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

WEBINAR SERIES: AGING IN INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES WEBINAR SERIES: AGING IN INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 1 CMS Medicare-Medicaid Coordination Office (MMCO) Established by Section 2602 of the Affordable Care Act Purpose:

More information

Diagnosis and Treatment of Alzhiemer s Disease

Diagnosis and Treatment of Alzhiemer s Disease Diagnosis and Treatment of Alzhiemer s Disease Roy Yaari, MD, MAS Director, Memory Disorders Clinic, Banner Alzheimer s Institute 602-839-6900 Outline Introduction Alzheimer s disease (AD)Guidelines -revised

More information

DISCLOSURES. Objectives. THE EPIDEMIC of 21 st Century. Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia NONE TO REPORT

DISCLOSURES. Objectives. THE EPIDEMIC of 21 st Century. Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia NONE TO REPORT Clinical Assessment of Cognition: New & Emerging Tools for Diagnosing Dementia DISCLOSURES NONE TO REPORT Freddi Segal Gidan, PA, PhD USC Keck School of Medicine Rancho/USC California Alzheimers Disease

More information

Practical Matters in the Care of A Person with Dementia

Practical Matters in the Care of A Person with Dementia Practical Matters in the Care of A Person with Dementia 7 th Annual Neurology Update for Primary Care Deborah S. Hoffnung, PhD, ABPP CN November 16, 2018 1 Typical Aging, MCI/CIND, dementia Common Dementia

More information

Mental Health Disorders Civil Commitment UNC School of Government

Mental Health Disorders Civil Commitment UNC School of Government Mental Health Disorders 2017 Civil Commitment UNC School of Government Edward Poa, MD, FAPA Chief of Inpatient Services, The Menninger Clinic Associate Professor, Baylor College of Medicine NC statutes

More information

Memory Loss, Dementia and Alzheimer's Disease: The Basics

Memory Loss, Dementia and Alzheimer's Disease: The Basics Memory Loss, Dementia and Alzheimer's Disease: The Basics What is memory loss? What is age-related memory loss? Typical changes Typical age-related changes involve: Making a bad decision once in a while

More information

Neurocognitive Disorders Research to Emerging Therapies

Neurocognitive Disorders Research to Emerging Therapies Neurocognitive Disorders Research to Emerging Therapies Edward Huey, MD Assistant Professor of Psychiatry and Neurology The Taub Institute for Research on Alzheimer s Disease and the Aging Brain Columbia

More information

The ABCs of Dementia Diagnosis

The ABCs of Dementia Diagnosis The ABCs of Dementia Diagnosis Dr. Robin Heinrichs, Ph.D., ABPP Board Certified Clinical Neuropsychologist Associate Professor, Psychiatry & Behavioral Sciences Director of Neuropsychology Training What

More information

ORIGINAL ARTICLE Neuroscience INTRODUCTION MATERIALS AND METHODS

ORIGINAL ARTICLE Neuroscience INTRODUCTION MATERIALS AND METHODS ORIGINAL ARTICLE Neuroscience DOI: 10.46/jkms.2010.25.7.1071 J Korean Med Sci 2010; 25: 1071-1076 Seoul Neuropsychological Screening Battery-Dementia Version (SNSB-D): A Useful Tool for Assessing and Monitoring

More information

Cognitive Assessment 4/29/2015. Learning Objectives To be able to:

Cognitive Assessment 4/29/2015. Learning Objectives To be able to: Supporting the Desire to Age in Place: Important Considerations for the Aging Population AGENDA 8:45 9:00 AM Geriatric Principles Robert L. Kane, MD *9:00 9:55 AM Cognitive Assessments Ed Ratner, MD 10:00

More information

Assessing and Managing the Patient with Cognitive Decline

Assessing and Managing the Patient with Cognitive Decline Assessing and Managing the Patient with Cognitive Decline Center of Excellence For Alzheimer s Disease for State of NY Capital Region Alzheimer s Center of Albany Medical Center Earl A. Zimmerman, MD Professor

More information

Managing Patients with Dementia using a Collaborative and Strength-based Approach

Managing Patients with Dementia using a Collaborative and Strength-based Approach Managing Patients with Dementia using a Collaborative and Strength-based Approach Therapy Network Seminars, Inc. Nicole Dawson, PT, PhD, GCS Learning Objectives The Participant will be able to: Identify

More information

February 8, Prepared By: Glen M. Doniger, PhD Director of Scientific Development NeuroTrax Corporation

February 8, Prepared By: Glen M. Doniger, PhD Director of Scientific Development NeuroTrax Corporation 1 February 8, 2007 Prepared By: Glen M. Doniger, PhD Director of Scientific Development 2...3...3...3...5...6...6...7!" #"...7 ""...8...9 $#%&#$%'#...11!...12 "# $...14!...15 %...18 3 In the following

More information

What is dementia? What is dementia?

What is dementia? What is dementia? What is dementia? What is dementia? What is dementia? Dementia is an umbrella term for a range of progressive conditions that affect the brain. It has been identified that there are over 200 subtypes of

More information

MANAGING YOUR COGNITIVE SYMPTOMS. Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director

MANAGING YOUR COGNITIVE SYMPTOMS. Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director MANAGING YOUR COGNITIVE SYMPTOMS Dr. Valerie Suski University of Pittsburgh Medical Center HDSA COE Director The information provided by speakers in workshops, forums, sharing/networking sessions and any

More information

Dementia and Delirium

Dementia and Delirium Dementia and Delirium LPT Gondar Mental Health Group www.le.ac.uk Dementia and Delirium WTINP Chapter 4.6 Introduction - areas to be covered Delirium Definition and causes Clinical features Management

More information

Anxiety, Depression, and Dementia/Alzheimer Disease: What are the Links?

Anxiety, Depression, and Dementia/Alzheimer Disease: What are the Links? The 2016 Annual Public Educational Forum Anxiety, Depression, and Dementia/Alzheimer Disease: What are the Links? Mary Ganguli MD MPH Professor of Psychiatry, Neurology, and Epidemiology, University of

More information

P20.2. Characteristics of different types of dementia and challenges for the clinician

P20.2. Characteristics of different types of dementia and challenges for the clinician P20.2. Characteristics of different types of dementia and challenges for the clinician, professor Danish Dementia Research Center Rigshospitalet, University of Copenhagen (Denmark) This project has received

More information

Assessment Toolkits for Lewy Body Dementia

Assessment Toolkits for Lewy Body Dementia Study : Assessment Toolkits for Lewy Body Dementia There are two toolkits, depending on whether the patient is presenting with a primary cognitive problem or with cognitive decline in the context of established

More information

Dementia. Assessing Brain Damage. Mental Status Examination

Dementia. Assessing Brain Damage. Mental Status Examination Dementia Assessing Brain Damage Mental status examination Information about current behavior and thought including orientation to reality, memory, and ability to follow instructions Neuropsychological

More information

Baseline Characteristics of Patients Attending the Memory Clinic Serving the South Shore of Boston

Baseline Characteristics of Patients Attending the   Memory Clinic Serving the South Shore of Boston Article ID: ISSN 2046-1690 Baseline Characteristics of Patients Attending the www.thealzcenter.org Memory Clinic Serving the South Shore of Boston Corresponding Author: Dr. Anil K Nair, Chief of Neurology,

More information

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018

Improving diagnosis of Alzheimer s disease and lewy body dementia. Brain TLC October 2018 Improving diagnosis of Alzheimer s disease and lewy body dementia Brain TLC October 2018 Plan for this discussion: Introduction to AD and LBD Why do we need to improve diagnosis? What progress has been

More information

Cognitive Impairment - Parkinson's Disease Foundation (PDF)

Cognitive Impairment - Parkinson's Disease Foundation (PDF) Page 1 of 8 Cognitive Impairment Another troublesome symptom of Parkinson s is mild cognitive impairment. Many people with Parkinson s are surprised to find that they feel distracted or disorganized, or

More information

Changing diagnostic criteria for AD - Impact on Clinical trials

Changing diagnostic criteria for AD - Impact on Clinical trials Changing diagnostic criteria for AD - Impact on Clinical trials London, November 2014 Bruno Dubois Head of the Dementia Research Center (IMMA) Director of INSERM Research Unit (ICM) Salpêtrière Hospital

More information

Detecting neurocognitive impairment in HIV-infected youth: Are we focusing on the wrong factors?

Detecting neurocognitive impairment in HIV-infected youth: Are we focusing on the wrong factors? Detecting neurocognitive impairment in HIV-infected youth: Are we focusing on the wrong factors? Jennifer Lewis, PsyD; Mathew Hirsch, PsyD & Susan Abramowitz, PhD NYU School of Medicine, New York, NY Friday,

More information

PROJECTION: Worlds dementia population is expected to triple by 2050

PROJECTION: Worlds dementia population is expected to triple by 2050 DEMENTIA C L I S K C O N S U LTA N T P H Y S I C I A N I N A C U T E M E D I C I N E A N D G E R I AT R I C M E D I C I N E, B A R N E T H O S P I TA L, R O YA L F R E E N H S F O U N D AT I O N T R U

More information

Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases

Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases Role of TDP-43 in Non-Alzheimer s and Alzheimer s Neurodegenerative Diseases Keith A. Josephs, MD, MST, MSc Professor of Neurology 13th Annual Mild Cognitive Impairment (MCI) Symposium: Alzheimer and Non-Alzheimer

More information

Falls: Cognitive Motor Perspectives

Falls: Cognitive Motor Perspectives Falls: Cognitive Motor Perspectives Joe Verghese, MBBS, MS. Integrated Divisions of Cognitive & Motor Aging (Neurology) & Geriatrics (Medicine) Albert Einstein College of Medicine, Bronx, NY joe.verghese@einstein.yu.edu

More information

What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias

What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias What APS Workers Need to Know about Frontotemporal, Lewy Body and Vascular Dementias Presenter: Kim Bailey, MS Gerontology, Program & Education Specialist, Alzheimer s Orange County 1 1 Facts About Our

More information

AGED SPECIFIC ASSESSMENT TOOLS. Anna Ciotta Senior Clinical Neuropsychologist Peninsula Mental Health Services

AGED SPECIFIC ASSESSMENT TOOLS. Anna Ciotta Senior Clinical Neuropsychologist Peninsula Mental Health Services AGED SPECIFIC ASSESSMENT TOOLS Anna Ciotta Senior Clinical Neuropsychologist Peninsula Mental Health Services Issues in assessing the Elderly Association between biological, psychological, social and cultural

More information

The role of memory on patients with mild cognitive impairment. Sophia Vardaki, PhD National Technical University of Athens

The role of memory on patients with mild cognitive impairment. Sophia Vardaki, PhD National Technical University of Athens The role of memory on patients with mild cognitive impairment Sophia Vardaki, PhD National Technical University of Athens Athens, 26 June 2015 Objective-Presentation Structure Objective To explore the

More information

How can the new diagnostic criteria improve patient selection for DM therapy trials

How can the new diagnostic criteria improve patient selection for DM therapy trials How can the new diagnostic criteria improve patient selection for DM therapy trials Amsterdam, August 2015 Bruno Dubois Head of the Dementia Research Center (IMMA) Director of INSERM Research Unit (ICM)

More information

Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic Guidelines? The Debate Continues

Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic Guidelines? The Debate Continues Comments to this discussion are invited on the Alzforum Webinar page. Who Should Use the New Diagnostic s? The Debate Continues Ever since new criteria came out for a research diagnosis of prodromal/preclinical

More information

Nature, prevalence and clinical significance. Barcelona, Spain

Nature, prevalence and clinical significance. Barcelona, Spain Nature, prevalence and clinical significance Jaime Kulisevsky Barcelona, Spain 1 Non motor (neuropsychiatric) symptoms are an integral part of Parkinson s s disease (PD) Affective disorders And are associated

More information

I IADL. See Instrumental activities of daily living (IADL) Idiopathic rapid eye movement sleep behavior disorder (Idiopathic RBD), 136

I IADL. See Instrumental activities of daily living (IADL) Idiopathic rapid eye movement sleep behavior disorder (Idiopathic RBD), 136 A Abbreviated mental test (AMT) diagnostic performance, GPCOG, 205 screening instrument, 81 timescales, 214 ACE and revision (ACE-R). See also Addenbrooke s cognitive examination (ACE) clinical diagnosis,

More information

Cognitive disorders. Dr S. Mashaphu Department of Psychiatry

Cognitive disorders. Dr S. Mashaphu Department of Psychiatry Cognitive disorders Dr S. Mashaphu Department of Psychiatry Delirium Syndrome characterised by: Disturbance of consciousness Impaired attention Change in cognition Develops over hours-days Fluctuates during

More information

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey

ALZHEIMER S DISEASE. Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey ALZHEIMER S DISEASE Mary-Letitia Timiras M.D. Overlook Hospital Summit, New Jersey Topics Covered Demography Clinical manifestations Pathophysiology Diagnosis Treatment Future trends Prevalence and Impact

More information

Improving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan

Improving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan Improving the Methodology for Assessing Mild Cognitive Impairment Across the Lifespan Grant L. Iverson, Ph.D, Professor Department of Physical Medicine and Rehabilitation Harvard Medical School & Red Sox

More information

Piano playing skills in a patient with frontotemporal dementia: A longitudinal case study

Piano playing skills in a patient with frontotemporal dementia: A longitudinal case study International Symposium on Performance Science ISBN 978-94-90306-01-4 The Author 2009, Published by the AEC All rights reserved Piano playing skills in a patient with frontotemporal dementia: A longitudinal

More information

Dementia and Fall Geriatric Interprofessional Training. Wael Hamade, MD, FAAFP

Dementia and Fall Geriatric Interprofessional Training. Wael Hamade, MD, FAAFP Dementia and Fall Geriatric Interprofessional Training Wael Hamade, MD, FAAFP Prevalence of Dementia Age range 65-74 5% % affected 75-84 15-25% 85 and older 36-50% 5.4 Million American have AD Dementia

More information

DEMENTIA NEWSLETTER for PHYSICIANS

DEMENTIA NEWSLETTER for PHYSICIANS DEMENTIA NEWSLETTER for PHYSICIANS Vol. 6, No. 4 OTTAWA AND RENFREW COUNTY Winter 2008 In This Issue... Mild Cognitive Impairment Monitoring Patient Response to Cognitive Enhancers CDN Diagnostic Assessment

More information

January 18 th, 2018 Brixen, Italy

January 18 th, 2018 Brixen, Italy From Subjective Cognitive Decline to Alzheimer s Disease: the predictive role of neuropsychological, personality and cognitive reserve features. A 7-years Follow-Up study. S. Mazzeo *, V. Bessi *, S. Padiglioni

More information

Dementia is not normal aging!

Dementia is not normal aging! The Future of Alzheimer s Disease Treatment Adam L. Boxer, MD, PhD Director, Alzheimer s Disease Clinical Trials Program Memory and Aging Center Assistant Professor of Neurology University of California,

More information

The added value of the IWG-2 diagnostic criteria for Alzheimer s disease

The added value of the IWG-2 diagnostic criteria for Alzheimer s disease The added value of the IWG-2 diagnostic criteria for Alzheimer s disease Miami, January 2016 Bruno Dubois Head of the Dementia Research Center (IMMA) Director of INSERM Research Unit (ICM) Salpêtrière

More information

Regulatory Challenges across Dementia Subtypes European View

Regulatory Challenges across Dementia Subtypes European View Regulatory Challenges across Dementia Subtypes European View Population definition including Early disease at risk Endpoints in POC studies Endpoints in pivotal trials 1 Disclaimer No CoI The opinions

More information

Evaluations. Alzheimer s Disease A Public Health Response. Viewer Call-In. July 19, Guest Speakers. Thanks to our Sponsors:

Evaluations. Alzheimer s Disease A Public Health Response.   Viewer Call-In. July 19, Guest Speakers. Thanks to our Sponsors: Alzheimer s Disease A Public Health Response July 19, 2007 1 2 Guest Speakers Thanks to our Sponsors: Earl A. Zimmerman, M.D. Bender Endowed Chair of Neurology and Director of the Alzheimer s Center at

More information

Parkinsonian Disorders with Dementia

Parkinsonian Disorders with Dementia Parkinsonian Disorders with Dementia George Tadros Consultant in Old Age Liaison Psychiatry, RAID, Heartlands Hospital Professor of Dementia and Liaison Psychiatry, Aston Medical School Aston University

More information

21/05/2018. Today s webinar will answer. Presented by: Valorie O Keefe Consultant Psychologist

21/05/2018. Today s webinar will answer. Presented by: Valorie O Keefe Consultant Psychologist Today s webinar will answer. 1. What is the RBANS, and how is the updated version different than the original version? 2. What are the neurocognitive areas assessed by the RBANS and what scores are available?

More information

Mild Cognitive Impairment in the General Population: Occurrence and progression to Alzheimer s disease

Mild Cognitive Impairment in the General Population: Occurrence and progression to Alzheimer s disease Mild Cognitive Impairment in the General Population: Occurrence and progression to Alzheimer s disease, Marie Curie Fellow- EU Aging Research Center Department of Neurobiology, Care Sciences and Society

More information

Brain Health and Risk Factors for Dementia

Brain Health and Risk Factors for Dementia Welcome To Brain Health and Risk Factors for Dementia Presented by Kamal Masaki, MD Professor and Chair Department of Geriatric Medicine John A. Burns School of Medicine, UH Manoa April 4, 2018 10:00 11:00

More information

#CHAIR2015. Miami, Florida. September 24 26, JW Marriott Miami. Sponsored by

#CHAIR2015. Miami, Florida. September 24 26, JW Marriott Miami. Sponsored by #CHAIR2015 September 24 26, 2015 JW Marriott Miami Miami, Florida Sponsored by Case Challenge Workshop Alzheimer s Disease Anand Kumar, MD University of Illinois at Chicago, College of Medicine Chicago,

More information

The current state of healthcare for Normal Aging, Mild Cognitive Impairment, & Alzheimer s Disease

The current state of healthcare for Normal Aging, Mild Cognitive Impairment, & Alzheimer s Disease The current state of healthcare for Normal Aging, g, Mild Cognitive Impairment, & Alzheimer s Disease William Rodman Shankle, MS MD FACP Director, Alzheimer s Program, Hoag Neurosciences Institute Neurologist,

More information