DETECT— Navigating a New Era in Alzheimer’s Disease: Integrating Disease-Modifying Therapies into Clinical Practice
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Which of the following is true regarding the continuum of cognitive impairment when diagnosing and staging Alzheimer’s disease.
In mild cognitive impairment, there is some degree of interference with activities of daily living
In patients with MCI, roughly 1/3 will develop dementia each year
Mild cognitive impairment is not a known risk factor for dementia
Moderate dementia is associated with impairment in either one or two cognitive functions
Which of the following are considered disease-modifying therapies for Alzheimer’s disease?
Acetylcholinesterase inhibitors and memantine
Antidepressants and anti-anxiety medications
Donanemab and lecanemab
Over-the-counter medications and supplements
A 66-year-old woman started an anti-amyloid monoclonal antibody 1 month ago for mild dementia associated with Alzheimer’s disease. She reports with her son today with severe headache, confusion, and dizziness. MRI confirms symptomatic amyloid-related imaging abnormalities (ARIA). What should you do for this patient?
Continue current treatment and re-evaluate in 2 months
Suspend treatment for the time being and repeat MRI monthly
Lower the dose
Switch to a different anti-amyloid therapy
Which of the following is true regarding access/costs associated with anti-amyloid therapies?
Nearly all private insurers cover anti-amyloid therapies
Travel to infusion centers is not a cost/time consideration, as these medications can be taken at home
They are not available for patients under 65 years of age
The manufacturers of both donanemab and lecanemab have patient assistance programs to alleviate drug access and costs
A 67-year-old man is diagnosed with mild dementia likely due to AD. His wife and caregiver are concerned about cognitive decline and ask about anti-amyloid therapy. When discussing these disease modifying therapies with the patient and his wife, which of the following would you say?
A positive amyloid status is not necessary to consider these agents
These agents wouldn’t be appropriate as they haven’t shown the ability to slow cognitive decline
These agents can lower amyloid plaques substantially, with 70% to 80% of patients becoming amyloid negative within 12 to 18 months
These agents generally wouldn’t be appropriate given the patient’s current diagnosis of mild dementia
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