The DETECT Initiative in Early Alzheimer’s Disease: Optimizing Collaboration and Multidisciplinary Care to Facilitate Timely Diagnosis
Podcast 3: Neurologists
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Harry is a 61-year-old male attorney with 20 years of education. He has memory loss, difficulty concentrating, loses focus in the middle of important meetings, and exhibits a shortened attention span. He shows signs of depression, anxiety, and lack of insight. Lately he has become more impulsive and disinhibited, with increased hostility and selfishness. His primary care physician has referred him to you. He scores 29 out of 30 on the MMSE. An MRI showed hippocampal atrophy in the medial temporal lobe, but otherwise age-appropriate atrophy in the frontal, parietal, temporal, and occipital lobes. What is the next test you order?
CSF for P-tau
Amyloid PET scan
CT imaging
Based on the significantly high levels of amyloid seen on the PET scan, Harry is diagnosed with early onset Alzheimer’s disease. His genetic test returns positive for two copies of APOE4. Which therapy should be administered with great caution?
Aducanumab
Memantine
Cholinesterase inhibitors (ChEIs)
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