Finding the Path in Alzheimer’s Disease: Early Diagnosis to Ongoing Collaborative Care

By Sharon Cohen, MD, FRCPC and R. Scott Turner, MD, PhD

AD is a common neurodegenerative condition that results in a range of profoundly disabling cognitive, affective, and behavioral symptoms. It affects approximately 5.8 million Americans. Barring significant clinical efforts and medical breakthroughs that prevent or slow disease development, current estimates suggest that by 2050, AD will afflict 14 million patients in the United States. PCPs are on the front lines of early diagnosis of AD, yet many say they feel unprepared and their community lacks adequate specialists in this area. Signs and symptoms of mild cognitive impairment (MCI) and even early AD are often conflated with normal aging, leading to late or missed diagnosis. This is compounded by the lack of a sense of urgency for early, accurate diagnosis because there are no disease-modifying therapies to treat MCI or AD. This eHealth Source activity reviews the pathophysiology of AD, early signs and symptoms, diagnosis first steps, referral patterns, more-complex diagnostic procedures, and existing nonpharmacologic and pharmacologic management strategies. Drs Cohen and Turner provide expert insight into how PCPs can tailor their practice to better care for these patients.

• Language: English
• Publisher: Integritas Communications
• Release date: Nov 19, 2020

Book preview

Faculty

Dr Sharon Cohen is a behavioral neurologist known for her excellence in patient care, teaching, and clinical research. She completed her neurology residency and behavioural neurology fellowship at the University of Toronto. She is the medical director and site principal investigator (PI) of the Toronto Memory Program, a community-based medical facility she established in 1996 for the purpose of enhancing diagnosis, medical care, and therapeutic options for individuals with, or at risk for, AD and related disorders. Her memory clinic and research site are among the most active in Canada.

Dr Cohen has more than 28 years of experience in clinical research and has been a site PI for more than 100 pharmacological trials. In addition to her focus on AD, she has also participated in pharmacological trials for acute stroke, frontotemporal dementia, Parkinson’s disease dementia, Lewy body disease, Huntington’s disease, and vascular dementia. Her research site has been credited as a go-to center for AD trials and has been awarded for superior performance and quality in clinical research.

Dr Cohen represents Canada on international advisory boards and steering committees and is a consultant to a wide range of stakeholders in dementia, including government organizations and patient advocacy groups. She is a frequent lecturer and contributes to media events, including those on medical ethics. She is known for her advocacy for individuals with neurodegenerative diseases.

Despite holding academic and hospital appointments, Dr Cohen chooses to practice in the community, in keeping with her belief that dementia care and clinical research are best offered in the real-world setting.

Dr Turner is Vice Chair for Clinical Research, Professor of Neurology, and Director of the Memory Disorders Program at Georgetown University, Washington, DC. Before his recruitment to Georgetown in 2008, he was Chief of the Neurology Service at the VA Ann Arbor Healthcare System and Associate Professor and Associate Chair in the Department of Neurology, University of Michigan. He was awarded PhD and MD degrees from Emory University in Atlanta, and completed his internship, residency, and fellowship at the University of Pennsylvania in Philadelphia. He is board certified in psychiatry and neurology.

Dr Turner has received numerous prestigious awards, including a fellowship from the Howard Hughes Medical Institute and a Paul Beeson Scholarship. He lectures widely, serves as a reviewer for granting agencies and biomedical journals, and has published more than 100 peer-reviewed papers, editorials, and book chapters. He most recently published a single-site phase 2 clinical trial of a repositioned drug, nilotinib, for patients with mild to moderate dementia due to AD (Turner RS, et al. Ann Neurol. 2020;88[1]:183-194).

The mission of the Georgetown University Memory Disorders Program is to prevent and treat AD and related dementias by conducting innovative research, educating and training healthcare professionals and the public on research advances, and offering state-of-the-art clinical care. To advance the field, Dr Turner and his colleagues seek older volunteers who are cognitively normal or at risk for AD, or have MCI or early dementia due to AD.

Preamble

Target Audience

The educational design of this activity addresses the needs of primary care providers (PCPs) and other clinicians who manage patients with Alzheimer’s disease (AD).

Statement of Need/Program Overview

AD is a common neurodegenerative condition that results in a range of profoundly disabling cognitive, affective, and behavioral symptoms. It affects approximately 5.8 million Americans.¹ Barring significant clinical efforts and medical breakthroughs that prevent or slow disease development, current estimates suggest that by 2050, AD will afflict 14 million patients in the United States.¹ PCPs are on the front lines of early diagnosis of AD, yet many say they feel unprepared and their community lacks adequate specialists in this area.¹ Signs and symptoms