Activity Expiration
Please note: This activity has expired.
This activity is supported by an educational grant from Eisai, Inc.
Release date: July 2009
Expiration date: July 2010
Estimated time to complete activity: 15 minutes
Target Audience
This activity has been designed to meet the educational needs of family practitioners and primary care providers involved in the management of patients with dementia.
Program Overview
By current estimates, 1 in 7 older Americans suffer from dementia—clinical syndromes that result from heterogeneous disorders of the brain—causing cognitive, behavioral and functional impairments. Alzheimer’s disease (AD) is the most prevalent form of dementia, accounting for approximately 60% of all dementias, followed by vascular dementia and dementia with Lewy bodies, Parkinson’s disease dementia, frontotemporal dementia, and mixed dementias. Distinguishing characteristics of the common dementias will be identified in this activity. Early and differential diagnosis of dementia is critical to patient care and management because AD medications are efficacious and safe for some dementias but ineffective and unsafe for others. Additionally, existence of mixed dementia pathology has important clinical implications since prognosis, treatment, and patient management will require individualized patient care.
Primary care practitioners (PCPs) are in a unique position to interact with their dementia patients over time and often throughout the course of their disease. Simple office-based strategies and evidence-based diagnostic methodologies will be provided enabling the PCPs to integrate dementia case findings, routine screening, and individualized treatment into their practices. The goal of treatment for dementia is to preserve function, maintain activities of daily living, delay cognitive decline, and reduce emergence of behavioral and psychological symptoms. Potential benefits and evidence-based significance of several approaches will be explored including, early and persistent pharmacological therapy, the use of combination therapy, treating vascular risk-factors, non-pharmacological interventions, and caregiver well-being.
This is a 3-Part Series:
Click here for Part 2.
Click here for Part 3.
Educational Objectives
After completing this activity, the participant should be better able to:
1. Administer one evidence-based tool to improve early recognition of dementia
2. Explain one potential value of a timely and accurate diagnosis of dementia
Faculty
Malaz Boustani MD, MPH
Assistant Professor of Medicine
Indiana University Medical Center
Research Scientist, Regenstrief Institute
Center Scientist, Indiana University Center for Aging Research
Indiana University School of Medicine
Indianapolis, Indiana
Gary W. Small, MD
Parlow-Solomon Professor on Aging
Professor of Psychiatry & Biobehavioral Sciences
Director, UCLA Center on Aging
Director, Memory & Aging Research Center
Director, Geriatric Psychiatry Division
Semel Institute for Neuroscience & Human Behavior
David Geffen School of Medicine at UCLA
Los Angeles, California
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Independent Medical Education, LLC. PIM is accredited by the ACCME to provide continuing medical education for physicians.
Credit Designation
Postgraduate Institute for Medicine designates this educational activity for a maximum of .25 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Malaz Boustani, MD, MPH
Fees for Non-CME: Pfizer
Contracted Research: Forest Pharmaceuticals
Speakers Bureau: Pri-Med/Scienta
Gary W. Small, MD
Royalty: Radica Games
Intellectual Property Rights/Patent Holder: UCLA Patent on FDDNP-PET (co inventor)
Consulting Fees: Dakim, Pfizer, Eisai, Forest, Novartis, Medivation
Fees for Non-CME: Pfizer, Eisai, Novartis, Forest
Ownership Interest: Dakim, Inc.
The following IME planners and managers, Nimish Mehta, Tara Herrmann, PhD, Megan Swartz, and Reha Kamdar hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interested related to the content of this activity of any amount during the past 12 months.
The following PIM planners and managers, Linda Graham, RN, BSN, BA, Jan Hixon, RN, BSN, MA, Trace Hutchison, PharmD, Julia Kirkwood, RN, BSN and Jan Schultz, RN, MSN, CCMEP hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.
Method of Participation
There are no fees for participating and receiving CME credit for this activity. During the period July 2009 through July 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the posttest by recording the best answer to each question in the online answer key; 4) complete the online evaluation form; 5) an online statement of credit will be issued immediately upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.
Media
Internet
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Independent Medical Education, LLC (IME) and Eisai, Inc. do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, IME and Eisai, Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Bibliography
1. Barker WW, Luis CA, Kashuba A, et al. Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer Dis Assoc Disord. 2002;16:203-212.
2. Cummings JL, Schneider E, Tariot PN, Graham SM. Behavioral effects of memantine in Alzheimer disease patients receiving donepezil treatment. Neurology. 2006;67:57-63.
3. Holsinger T, Deveau J, Boustani M, Williams JW, Jr. Does this patient have dementia? JAMA. 2007;297:2391-2404.
4. Langa KM, Foster NL, Larson EB. Mixed dementia: emerging concepts and therapeutic implications. JAMA. 2004;292:2901-2908. 5. Lleo A, Greenberg SM, Growdon JH. Current pharmacotherapy for Alzheimer’s disease. Annu Rev Med. 2006;57:513-533.
6. Plassman BL, Langa KM, Fisher GG, et al. Prevalence of Dementia in the United States: The Aging, Demographics, and Memory Study. Neuroepidemiology. 2007;29:125-132.
7. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007;69:2197-2204.
8. Seltzer B. Cholinesterase inhibitors in the clinical management of Alzheimer’s disease: importance of early and persistent treatment. J Int Med Res. 2006;34:339-347.
9. Small GW, Kepe V, Ercoli LM, et al. PET of brain amyloid and tau in mild cognitive impairment. N Engl J Med. 2006;355:2652-2663.
10. Tariot PN, Farlow MR, Grossberg GT, et al. Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: a randomized controlled trial. JAMA. 2004;291:317-324.
Technical Requirements
A broadband internet connection
Operating system: Microsoft Windows 98 or later; Mac OS X
Web browser: Microsoft Internet Explorer 6.0 or later; Mozilla
Firefox 1.5 or later; Apple Safari
Adobe Flash Player 9.0 or later
(Available at: Get.adobe.com/flashplayer/)
