Caring for the Dementia Caregiver

1.5 CE Credits

Presented by: 
Maureen K. O'Connor, Psy.D., ABPP-CN
Director of Neuropsychology, Bedford Veterans Hospital
Assistant Professor of Neurology, Boston University School of Medicine
Director, Research Education Component, Boston University Alzheimer’s Disease Research Center





Andrew E. Budson, M.D.
Chief, Cognitive & Behavioral Neurology and
Associate Chief of Staff for Education, VA Boston Healthcare System







This webinar will focus on describing the experience of caregivers for individuals with dementia. We will present information that will help you understand the ways in which we can help caregivers be better prepared for their journey. You will learn how to help families build a care team and we will explain approaches to managing common problems in dementia that can be shared with patients’ families. Additionally, given that individuals with dementia and their caregivers benefit from the relationships they have with one another, we will present ways to help caregivers sustain their relationships with their loved one with dementia. Lastly, we will discuss how to help caregivers prepare for the future.

After the webinar, participants will be able to:
1. Describe the elements of a care team for dementia caregivers
2. List approaches to managing common behavioral problems in dementia
3. Discuss ways to help individuals with dementia and their caregivers sustain their relationship
4. Identify strategies to help caregivers prepare for the future

Target Audience:  Psychologists
Instructional Level:  Intermediate

Dr. Maureen O'Connor is a board-certified neuropsychologist engaged in clinical work, research, and teaching. She received her doctorate in psychology from Indiana University of Pennsylvania, focusing her dissertation on the differentiation of depression versus Alzheimer's disease. She attended Yale University School of Medicine for her predoctoral internship, where she conducted outpatient and inpatient memory evaluations for adults with a broad range of diagnostic presentations. She went on to complete one year of postdoctoral residency at Cornell Weil Medical Center/Sloan Kettering Cancer Center and two additional years of residency at the Bedford VA Hospital/Boston University School of Medicine. In 2005 she accepted an appointment at the Bedford VA Hospital as the Director of Neuropsychology. In that role she established the Bedford Memory Diagnostic Clinic, specifically designed to evaluate and treat older Veterans with memory loss. In 2009 she accepted the Young Alumni Achievement Award from the College of Natural Sciences and Mathematics at Indiana University of Pennsylvania. She has served on the boards of the Massachusetts Neuropsychological Society and the National Academy of Neuropsychology. Dr. O’Connor is currently an Assistant Professor in the Department of Neurology at Boston University (BU) School of Medicine. In 2019 she was appointed the Director of the Research Education Training Component at BU in the Alzheimer's Disease Research Center. Dr. O'Connor's research interests include understanding and developing interventions to improve the lives of adults with memory loss and the lives of the family members that help provide care. She has been the recipient of foundation, philanthropic, and federal funding. Most recently the National Institute of Health and National Institute of Aging provided Dr. O’Connor and colleagues with $3.2 million of funding to support a 5-year research project examining how relationship factors impact couples navigating a diagnosis of Alzheimer’s disease. In addition to her ongoing research activities, Dr. O'Connor continues to evaluate and treat individuals with memory loss while teaching doctoral students, interns, and residents in neuropsychology.

Dr. Andrew E. Budson, a board-certified cognitive behavioral neurologist, is on a crusade to empower individuals, families, and doctors with the knowledge they need surrounding memory loss and dementia. His co-authored textbook, Memory Loss, Alzheimer's Disease, and Dementia: A Practical Guide for Clinicians, now in its 3rd edition, has been translated into Spanish, Portuguese, and Japanese. His award-winning, co-authored book, Seven Steps to Managing Your Memory: What’s Normal, What’s Not, and What to Do About It, explains how individuals can distinguish changes in memory due to Alzheimer's versus normal aging; what medications, diets, and exercise regimes can help; and the best habits, strategies, and memory aids to use. It is being translated into Chinese and Korean. His latest co-authored book, Six Steps to Managing Alzheimer’s Disease and Dementia: A Guide for Families, helps families manage issues with memory, language, vision, behavior, driving, incontinence, sleep, and more. Educated at Haverford College and Harvard Medical School, he is Chief of Cognitive & Behavioral Neurology at the Veterans Affairs Boston Healthcare System, Associate Director of the Boston University Alzheimer’s Disease Research Center, Professor of Neurology at Boston University School of Medicine, and Lecturer in Neurology at Harvard Medical School.

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Chronic Traumatic Encephalopathy (CTE): What We Think We Know and What We Need to Know Next

1.5 CE Credits

Presented by:
Robert A. Stern, Ph.D.
Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology
Clinical Core Director, BU Alzheimer’s Disease Center
Director of Clinical Research, BU CTE Center
Boston University School of Medicine

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease found in individuals with a history of exposure to repetitive head impacts (RHI), such as former American football players and boxers. Referred to as “punch drunk” or dementia pugilistica since the early 20th century, the term “CTE” has been used since the 1950s to describe the clinical and neuropathological changes seen in individuals with RHI exposure. However, it is only in the past 8-10 years that CTE has received increased attention due to a growing number of deceased former NFL players being diagnosed with the disease postmortem. The tremendous growth in media attention to CTE, however, has outpaced the growth in scientific understanding of CTE. As with other neurodegenerative diseases, at this time CTE can only be diagnosed by neuropathological examination. However, provisional clinical research diagnostic criteria have been proposed and studies are underway to develop neuroimaging and fluid biomarkers to detect and diagnose CTE during life. This webinar will provide an overview of what is currently known about CTE, as well as current and future directions in research.

After the webinar, participants will be able to:

  1. Describe the neuropathological and clinical features of chronic traumatic encephalopathy (CTE).
  2. Describe the possible fluid and neuroimaging biomarkers for CTE.
  3. Explain the current limitations of making a clinical diagnosis of CTE.

Target Audience: The target audience includes practicing neuropsychologists and clinical neuroscience researchers, as well as advanced trainees.

Instructional Level: Intermediate

Robert A. Stern, Ph.D. received his PhD in Clinical Psychology from the University of Rhode Island. He completed his predoctoral internship training under Dr. Edith Kaplan at the Boston VA Medical Center and his post-doctoral fellowship at the University of North Carolina School of Medicine. He is currently Professor of Neurology, Neurosurgery, and Anatomy & Neurobiology at Boston University (BU) School of Medicine, where he is also Director of the Clinical Core of the NIH-funded BU Alzheimer’s Disease Center, and Director of Clinical Research for the BU Chronic Traumatic Encephalopathy (CTE) Center.  A major focus of his research involves the long-term effects of repetitive head impacts in athletes, including the neurodegenerative disease, CTE.  He is the lead co-principal investigator of a $16 million NIH grant for a multi-center, longitudinal study to develop methods of diagnosing CTE during life as well as examining potential risk factors of the disease. Dr. Stern’s other current major area of funded research involves the diagnosis and treatment of Alzheimer’s disease. He has published on various aspects of cognitive assessment and is the senior author of the Neuropsychological Assessment Battery (NAB), as well as the Boston Qualitative Scoring System for the Rey-Osterreith Complex Figure.  He has received numerous NIH and other national grants and he is a Fellow of both the NAN and the American Neuropsychiatric Association. Dr. Stern has over 175 peer-reviewed publications, is on several journal editorial boards, and is the co-editor of two upcoming books: Sports Neurology (part of the Handbook in Clinical Neurology series published by Elsevier), and The Oxford Handbook of Adult Cognitive Disorders. He is a member of the medical advisory boards of several biotech/pharma companies as well as the Mackey-White Health and Safety Committee of the NFL Players Association and the Medical Scientific Committee for the NCAA Student-Athlete Concussion Injury Litigation.

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Diversity and Inclusion in Clinical Trials and the Impact on the Development of Effective Interventions: Spotlight on Alzheimer’s Disease

1.5 CE Credit


Presented by:
Laurie M. Ryan, Ph.D.
Chief of the Clinical Interventions and Diagnostics Branch
Division of Neuroscience at the National Institute on Aging
National Institutes of Health

Lack of diversity in clinical trial participants in biomedical research is long established, yet building an evidence base for clinical interventions that benefits the whole population and does not extend health disparities requires diversity among research participants. Diversity is considered broadly to include heterogeneity of age, race, ethnicity, sex, education, socioeconomic status, geographic location, comorbidities, and cognitive status. All of these factors can impact disease risk and expression and thus the development of effective treatments. In the area of Alzheimer’s disease (AD), clinical evidence that reflects population diversity is critical given disease heterogeneity. Data suggest, for example, that African Americans have a greater risk of AD than non-Hispanic whites, and that differences in risk factors and disease presentation may also be present. Higher rates of dementia are also found in Latino populations as compared to non-Hispanic whites, and understanding dementia risk is further complicated by diversity within the Latino population. These high-risk populations, however, are less likely to be recruited to participate in AD and other clinical trials, thus potentially skewing the results and undermining the generalizability of the interventions developed. Multiple factors have been identified that can serve as barriers to diverse recruitment and inclusion overall as well as specifically for Alzheimer’s and other dementia trials. Study design is one such factor, as inclusion/exclusion criteria including cognitive screening criteria, participant burden, and the requirement for a study partner can all negatively impact recruitment and retention of participants. Strategies to overcome these barriers and improve diverse recruitment are being developed and implemented.

Learning Objectives
After the session, participants will be able to:
1. Define “health disparities” and describe the impact of these on the development of effective interventions. 
2. Discuss Alzheimer’s disease complexity and risk.
3. Identify barriers to diverse clinical trial recruitment and inclusion.
4. List strategies to improve diverse clinical trial recruitment.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate  

Dr. Laurie Ryan is Chief of the Clinical Interventions and Diagnostics Branch in the Division of Neuroscience at the National Institute on Aging, part of the National Institutes of Health. The branch supports research on the prevention, treatment, and management of individuals with or at-risk for cognitive decline, Alzheimer's disease and related dementias. As branch chief, she oversees the development, coordination, and implementation of the division’s clinical therapeutics and diagnostics research programs and infrastructure. Dr. Ryan also directs the pharmacological clinical interventions research portfolio.Dr. Ryan received her BA in human development from St. Mary’s College of Maryland in 1986 and her MA in psychology from Loyola College in Maryland in 1991. She obtained her PhD in clinical psychology with specialty focus in neuropsychology from Louisiana State University in 1997. She completed her post-doctoral clinical neuropsychology fellowship at Thomas Jefferson University, Philadelphia in 1999.After completing her fellowship, Dr. Ryan joined the Defense and Veterans Brain Injury Center (DVBIC) at Walter Reed Army Medical Center in Washington, DC. In September 2005, Dr. Ryan joined the NIA as the Program Director for Alzheimer’s clinical trials. In December 2013, she was promoted to her branch chief position.

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Frontotemporal Dementia: The Behavioral Phenotype

1.5 CE Credits

Presented by:
Bruce L. Miller, M.D.
Director, Memory and Aging Center
University of California San Francisco

In this 90-minute presentation, Dr. Bruce Miller, director of the UC San Francisco Memory and Aging Center, will introduce the clinical syndromes of frontotemporal dementia (FTD) and discuss why it is such a highly prevalent and diagnosable disorder. He will detail the different cognitive and behavioral symptoms associated with FTD and relate them to the underlying networks and disease pathology. He will present the neuropsychological profile and testing approach for evaluating patients with FTD. He will provide a detailed look at reward, crime and emotion in patients with FTD, and how they differ from patients with Alzheimer’s disease and other degenerative and non-degenerative disorders. He will also describe the current symptomatic treatments and investigative directions for potentially disease-modifying therapies that are likely to emerge in the coming decade.

After the webinar, participants will be able to:

  1. Explain how frontotemporal dementia is evaluated in the clinic.
  2. Describe the basic biology of frontotemporal dementia, including genetics and pathology.
  3. Discuss the latest research into therapies for frontotemporal dementia.

Target Audience: This webinar is targeted for an audience of professional neuropsychologists who may or may not work in aging and neurodegenerative disease.

Instructional Level: This webinar will present predominantly advanced data and information for health care providers with some intermediate material.

Bruce L. Miller, M.D. holds the A.W. and Mary Margaret Clausen Distinguished Professorship in Neurology at the University of California, San Francisco (UCSF). He directs the busy UCSF dementia center where patients in the San Francisco Bay Area and beyond receive comprehensive clinical evaluations. His goal is the delivery of model care to all of the patients who enter the clinical and research programs at the UCSF Memory and Aging Center MAC). 

Dr. Miller is a behavioral neurologist focused on dementia with special interests in brain and behavior relationships as well as the genetic and molecular underpinnings of disease. His work in frontotemporal dementia (FTD) emphasizes both the behavioral and emotional deficits that characterize these patients, while simultaneously noting the visual creativity that can emerge in the setting of FTD. He is the principal investigator of the NIH-sponsored Alzheimer’s Disease Research Center (ADRC) and program project on FTD called Frontotemporal Dementia: Genes, Imaging and Emotions. He oversees a healthy aging program, which includes an artist-in-residence program. He helps lead two philanthropy-funded research consortia, the Tau Consortium and the Consortium for Frontotemporal Research, focused on developing treatments for tau and progranulin disorders, respectively. Additionally, he is a director for the Global Brain Health Institute, which works to reduce the scale and impact of dementia around the world by training and supporting a new generation of leaders to translate research evidence into effective policy and practice. Dr. Miller teaches extensively, runs the Behavioral Neurology Fellowship at UCSF, and oversees visits of more than 50 foreign scholars every year.

Dr. Miller has received many awards, including the Potamkin Award from the American Academy of Neurology, the Raymond Adams Award from the American Neurological Association, the Gene D. Cohen Research Award in Creativity and Aging from the National Center for Creative Aging, the UCSF Academic Senate Distinction in Mentoring Award and the Wallace Wilson Distinguished Alumni Award from the University of British Columbia. Dr. Miller is the current President of the International Society for Frontotemporal Dementias (ISFTD), and in 2016, he was elected to the National Academy of Medicine. He has authored The Human Frontal Lobes, The Behavioral Neurology of Neurology, Frontotemporal Dementia and over 700 other publications regarding dementia. He has been featured in Fortune magazine and the New York Times, as well as on Charlie Rose, PBS NewsHour and other media. For more than three decades, Dr. Miller has been the scientific director for the philanthropic organization The John Douglas French Alzheimer’s Foundation, a private philanthropic organization that funds basic science research in Alzheimer’s disease.

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How Do We Diagnose Alzheimer’s Disease in 2021?

1.0 CE Credit


Presented by:
Ronald C. Petersen, Ph.D., M.D.
Professor of Neurology
Cora Kanow Professor of Alzheimer’s Disease Research
Director, Mayo Alzheimer’s Disease Research Center
Mayo Clinic College of Medicine
Rochester, MN

The diagnosis of Alzheimer’s disease (AD) is undergoing a major change. For several decades, the diagnosis of AD has been a clinical-pathological exercise. This has involved gathering the history and then completing a clinical evaluation and rule-out tests to exclude other causes of the symptoms; if no alternative cause is found and the history and examination are typical, the person is then diagnosed with probable AD. This has been our clinical approach for many years. However, with the advent of biomarkers for the underlying disease processes, several expert groups have been empaneled over the years to incorporate biomarkers into the diagnostic process. Most recently, an expert group from the National Institute on Aging and the Alzheimer’s Association has recommended that AD be defined biologically, by the presence of amyloid neuritic plaques and tau neurofibrillary tangles. In this proposal, clinical features will be used to stage the disease but will not be essential to the diagnosis. This presentation will review the variety of biomarkers that have been used for AD, including imaging and fluid measures. Fluid biomarkers may offer a relatively efficient opportunity to detect the disease process in its pre-clinical state as well as following it through all degrees of clinical severity. Ultimately, clinicians will be required to evaluate the clinical subtleties of the symptom presentation, with the underlying biological features offered through biomarkers used as the basis for making a definitive diagnosis of AD. As more biomarkers become available, multiple pathological processes will manifest themselves.

After the session, participants will be able to:
1. Explain the role of the clinician in making the diagnosis of Alzheimer’s disease.
2. Describe the role of biomarkers for Alzheimer’s disease in the current landscape.
3. Discuss the combination of underlying neurodegenerative diseases and the complex interactions that arise.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate  

Dr. Ronald C. Petersen received a Ph.D. in Experimental Psychology from the University of Minnesota and graduated from Mayo Medical School in 1980. He completed an internship in Medicine at Stanford University Medical Center and returned to the Mayo Clinic to complete a residency in Neurology. That was followed by a fellowship in Behavioral Neurology at Harvard University Medical School/Beth Israel Hospital in Boston, Massachusetts. Dr. Petersen joined the staff of the Mayo Clinic in 1986 and became a Professor of Neurology in 1996. In 2000 he was named the Cora Kanow Professor of Alzheimer’s Disease Research and Mayo Clinic Distinguished Investigator in 2011. He is currently the Director of the Mayo Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging and has authored over 1000 peer-reviewed articles on memory disorders, aging, and Alzheimer’s disease.Dr. Petersen is one of the recipients of the 2004 MetLife Award for Medical Research in Alzheimer’s Disease and the 2005 Potamkin Prize for Research in Picks, Alzheimer’s and Related Disorders of the American Academy of Neurology. In 2012 he received the Khachaturian Award and the Henry Wisniewski Lifetime Achievement Award in 2013 from the Alzheimer’s Association. In 2011 he was appointed by the Secretary of Health and Human Services to serve as the Chair of the Advisory Committee on Research, Care and Services for the National Alzheimer’s Disease Plan, and in 2014, he was appointed to the World Dementia Council by the UK government.

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Limbic-predominant Age-related TDP-43 Encephalopathy (LATE): A common pathology of the oldest old

1.5 CE Credit

 

Presented by:
Caitlin Shannon Latimer, MD, PhD
University of Washington, Seattle WA


This course will introduce the recently defined “Limbic-predominant Age-related TDP-43 Encephalopathy (LATE)” including both the clinical and neuropathologic manifestations.  The course will begin with some historical perspective on TDP-43 as a pathologic protein in neurodegenerative disease, starting with its initial association with frontotemporal lobar degeneration (FTLD) and motor neuron disease (MND) and culminating with the recent studies describing its pervasiveness in the brains of the oldest-old and its intersection with Alzheimer’s disease (AD).  The pathology and diagnostic approach will be described and compared with that of FTLD and MND, particularly focusing on the debate as to whether LATE is a distinct entity or on a continuum with these other TDP-43 proteinopathies. Finally, we will discuss the clinical consequences of LATE, including the clinicopathologic correlation, the potential impact on diagnosis and patient management, and the effects on research efforts to understand AD pathophysiology, particularly genetic studies (GWAS) and clinical trials.

 

After the webinar, participants will be able to:
1. Compare the brain regions most commonly affected in LATE, FTLD, and MND and explain the clinical similarities and differences between these three entities.
2. Recognize the clinical associations of LATE and describe the clinical overlap with AD.
3. Discuss the challenges in making a diagnosis of LATE and the potential consequences for both treatment and research in neurodegenerative disease.

Target Audience: An audience of professional neuropsychologists who may or may not work in aging and neurodegenerative disease.

Instructional Level: Intermediate - Assumes a basic understanding of dementia syndromes but a very limited understanding of the underlying neuropathology.   

Dr. Latimer is an acting instructor and neuropathologist in the division of Neuropathology at the University of Washington with a research focus on the mechanisms of resistance and resilience to Alzheimer’s disease. She completed her combined MD PhD at the University of Kentucky followed by residency and fellowship in anatomic pathology and neuropathology at the University of Washington. As a co-investigator in the University of Washington Neuropathology Core she has participated in the neuropathologic evaluation of human brain tissue from several iconic autopsy cohorts, including the Nun study, the Honolulu Aging Asians study, and the Adult Changes in Thought Study.  Her recent work has specifically focused on defining the role of TDP-43 in the neuropathology of age-related neurodegenerative disease, both through observations in human post-mortem tissue and through models of proteotoxicity.

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Medication Overuse and Implications for Dementia

1.5 CE Credits

Presented by:
Laura A. Hart, PharmD, MS, BCPS, BCGP
Assistant Clinical Professor
University of California, San Diego 
Skaggs School of Pharmacy and Pharmaceutical Sciences


This presentation will review the evidence linking commonly used medications with risk of dementia. Medications discussed will include benzodiazepines, anticholinergics, and proton pump inhibitors. The presentation will also describe risks of medication use in patients with dementia and provide strategies to optimize medication use in this patient population. Participants will have the opportunity to apply the concepts learned through a patient case.

After the session, participants will be able to:

1. Describe evidence linking commonly used medications with dementia risk, with a focus on benzodiazepines, anticholinergics, and proton pump inhibitors.
2. Optimize medication safety in a patient with dementia.
3. Given a patient case, evaluate medications that could be potentially changed to reduce risk of cognitive impairment.

Target Audience:  Neuropsychologists across the career span
Instructional Level:  Intermediate
 

Laura Hart is an Assistant Clinical Professor at the University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) in the Division of Clinical Pharmacy. Prior to joining the faculty at SSPPS in September 2018, she completed a specialty residency and research fellowship in Geriatric Pharmacotherapy and served as an instructor in the Doctor of Pharmacy program at the University of Washington School of Pharmacy in Seattle, Washington. As part of her postgraduate training, she earned a Master of Science degree in Pharmaceutical Outcomes Research and Policy. Her research focuses in geriatrics, aiming to optimize medication use in older adults. In particular, her research has used pharmacoepidemiologic methods to examine risks and patterns of medication use in older adults. Her research to date has focused in the areas of dementia, central nervous system-active medications, falls. She is also interested in the implementation and evaluation of innovative pharmacy practice models in the care of older adults.

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Sleep and Cognition in Neurodegenerative Disease

1.5 CE Credits

Presented by:
Amy Amara, M.D., Ph.D.
University of Alabama at Birmingham
School of Medicine/Joint Health Services Foundation Faculty


 





Sleep dysfunction and cognitive decline are common features of neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease. Additionally, sleep disruption can negatively influence cognitive performance, even in healthy adults. This webinar will include an overview of normal sleep architecture, descriptions of common sleep disorders in older adults at risk for neurodegenerative disease, and information about the relationship between sleep and cognition in neurodegenerative disease.

After the webinar, participants will be able to: 
1. Describe normal sleep architecture
2. Discuss common sleep disorders experienced by persons with neurodegenerative disease
3. Analyze the relationships between sleep and cognition in neurodegenerative disease

Target Audience: Clinical and Research Neuropsychologists
Instructional Level: Introductory

Dr. Amy Amara is a physician scientist at the University of Alabama at Birmingham, Department of Neurology. She has fellowship training in both Movement Disorders and Sleep Medicine, with a particular interest in sleep dysfunction and other non-motor symptoms in patients with Parkinson’s disease (PD). Her main research focus includes investigation of non-pharmacological interventions, such as exercise, to improve sleep, cognition, vigilance, and safety in these patients.

 
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The Neuropsychology (Broadly Conceived) of MSA, PSP, and CBD

1.5 CE Credits

Presented by:
Adam Gerstenecker, Ph.D. 
Assistant Professor of Neurology
Division of Neuropsychology
The University of Alabama at Birmingham

The primary objective of this presentation will be to review the cognitive and behavioral features of the different atypical parkinsonian syndromes in which motor symptoms dominate early clinical symptomatology: multiple systems atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD). The impact of cognitive and behavioral deficits on quality of life, associations between neuropsychological and neuropsychiatric findings and brain imaging, and cognitive and behavioral symptom management are also discussed. Information included in this presentation was acquired through review of the available MSA, PSP, and CBD literature, with emphasis given to studies investigating the cognitive and behavioral features of the syndromes.

After the webinar, participants will be able to:

  1. Describe the neuropsychological features of MSA, PSP, and CBD.
  2. Explain the impact of neuropsychological features on quality of life in MSA, PSP, and CBD.
  3. Describe the current strategies for symptom management in MSA, PSP, and CBD.

Target Audience: Clinicians and researchers interested in the cognitive, behavioral, and functional aspects of MSA, PSP, and CBD

Instructional Level: Intermediate

Adam Gerstenecker, Ph.D. is an Assistant Professor of Neurology at the University of Alabama at Birmingham (UAB). Dr. Gerstenecker has expertise in atypical parkinsonisms in both clinical and research settings. His research in PSP has been funded by NIH/NIA and CurePSP. He has published a number of peer-reviewed papers on the cognitive, behavioral, and functional features of PSP and authored review papers and book chapters on the neuropsychological aspects of atypical parkinsonian disorders.

 
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Risk and Protective Factors of Cognitive Aging in Older African Americans

1.5 CE Credits

Presented by
Lisa L. Barnes, PhD
Rush Alzheimer’s Disease Center and Department of Neurological Sciences
Rush University Medical Center

Older African Americans, a rapidly growing segment of the US population, bear a disproportionate burden of Alzheimer’s disease and cognitive impairment compared to non-Hispanic Whites, with some estimates suggesting that they may have more than a two-fold increased risk than their white counterparts. Recent studies have led to significant advances in our understanding of the underlying neurobiologic substrates and risk factors of Alzheimer’s disease. But because of challenges in recruitment of African Americans into research studies and a lack of clinical and biologic data in this population, knowledge of the drivers of the disparities has lagged behind. The ability to identify therapeutic targets and effective interventions for this population has become a public health imperative. This lecture will present data from longitudinal cohort studies conducted at Rush of older African Americans regarding how risk factors and protective markers influence cognitive aging.

After the session, participants will be able to:
Discuss evidence that suggests African Americans have greater risk of cognitive impairment and Alzheimer’s dementia.
Evaluate longitudinal studies of cognitive aging in older African Americans.
Identify risk and protective factors for cognitive decline in older African Americans.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate

Lisa L. Barnes, PhD is the Alla V. and Solomon Jesmer Endowed Professor of Gerontology and Geriatric Medicine, and a cognitive neuropsychologist within the Rush Alzheimer’s Disease Center at Rush University Medical Center in Chicago, IL. Dr. Barnes’ research focus is on the epidemiology of cognitive aging with an emphasis on understanding mechanisms of cognitive health disparities of chronic diseases of aging among older African Americans. As the Principal Investigator of the Minority Aging Research Study, known as MARS, a longitudinal clinical-pathologic study of more than 800 African Americans without dementia who have been followed for over 15 years, and the Clinical Core Leader of the African American Core of the Rush Alzheimer’s Disease Center, she is a leading expert on health disparities and minority aging. Dr. Barnes completed her BA in psychology from Clark Atlanta University, one of the Historically Black Colleges and Universities, and her PhD in biopsychology from the University of Michigan in Ann Arbor. Additionally, she completed a post-doctoral fellowship at the University of California, Davis in the field of cognitive neuroscience. She joined the Rush Alzheimer’s Disease Center as an assistant professor in July 1999. Dr. Barnes has made significant contributions to our understanding of cognitive aging, cognitive decline, and Alzheimer’s dementia in older African Americans. She has mentored numerous early career investigators, has published close to 200 peer-reviewed manuscripts, and has received a number of awards and honors from universities and community-based organizations throughout the US for her work in the African American community.

 
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Diagnosing Early Stage “Pre-clinical” Alzheimer’s Disease- Clinical Advances & Ethical Considerations

1 CE Credits

 
Presented by: 
Kathleen A. Welsh-Bohmer, PhD 
Professor, Departments of Psychiatry and Neurology
Duke University Health System
Director of Alzheimer’s Disease Interventional Trials
Duke Clinical Research Institute (DCRI)
& VP for Neurodegenerative Disorders at VeraSci


Description
Progress in understanding the biological expression of Alzheimer’s disease (AD) has led to the recent revision of the diagnostic criteria for the disease, which is defined by the biology present and, to a far lesser extent, the clinical phenomenology. These criteria recognize the full disease continuum and invite the possibility of arriving at an early diagnosis of AD when the condition is clinically silent and potentially at a point in the disease many years in advance of the emergence of any symptoms. Absent any effective treatment for either preventing the disease onset or slowing its rate of progression, a diagnosis of biomarker-determined preclinical (silent) AD poses a number of ethical considerations for the practicing clinician. In this session, we will: 1) review the recent advances in AD biomarkers and their implications for diagnosis and treatment; 2) consider the ethical issues that arise from an early diagnosis, including both the merits of early detection and the risks of having a diagnosis before symptoms have manifested; and, 3) conclude by discussing the implications of a biological diagnosis of AD for the practice of clinical neuropsychology, including the types of referral questions we might expect, the impact on our inferential approach, and the normative data we select.

After the session, participants will be able to:
Define the biomarkers used in diagnosing Alzheimer’s disease.
Explain the difference between diagnostic biomarkers and surrogate markers for measuring response to treatment.
Describe the ethical issues associated with an early biological diagnosis of Alzheimer’s disease.
Explain the impact of knowledge of AD biomarkers status on cognitive performance and psychological health.
List the types of referral questions clinical neuropsychologists can expect in the context of biologically defined Alzheimer’s disease.
Discuss the influences of AD biomarkers when drawing clinical inferences about normal or abnormal function.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate

Dr. Kathleen Welsh-Bohmer is a Professor of Psychiatry and Neurology at Duke University. Clinically trained as a neuropsychologist, her research activities have been focused around developing effective prevention and treatment strategies to delay the onset of cognitive disorders occurring in later life. She was the Principal Investigator of the Cache County Memory Study (2002-2013), an epidemiological study of an exceptionally long-lived population that established key environmental modifiers affecting Alzheimer’s disease onset and progression. Since 2006 she has directed the Joseph and Kathleen Bryan Alzheimer’s Center at Duke University, where she has led a large multidisciplinary team focused around the genetic determinants of Alzheimer’s disease and speeding drug discoveries to prevent and treat neurodegenerative diseases. She has served as the neuropsychology lead for the TOMMORROW program, a global clinical trial to delay the onset of mild cognitive impairment due to Alzheimer’s disease (Takeda Pharmaceutical Company). And very recently, she was appointed to the Duke Clinical Research Institute (DCRI), an academic clinical research organization, to oversee its interventional trials within the Alzheimer’s disease therapeutic area. Concurrently, she is leading science strategy for neurodegenerative disorders in VeraSci, a private company focused on improving the precision of endpoint measurements within clinical trial designs. The methods her team has been developing in collaboration with public and private partners help fill an information void in the measurement of preclinical dementias and has important implications for accelerating global clinical trials in Alzheimer’s disease prevention and in population health.
 
 
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Rehabilitating Cognition in Older Adults to Prevent Cognitive Decline and Dementia

1.5 CE Credit


Presented by:
George W. Rebok, PhD, MA
Professor
Johns Hopkins University Bloomberg School of Public Health

Older adults are more likely to fear losing their mental abilities than their physical abilities. Fortunately, a growing body of research suggests that mental decline isn’t inevitable for most people as they age, and may even be reversible through cognitive rehabilitation. However, controversy and confusion still surround the effectiveness of cognitive rehabilitation efforts with older adults and the impact of these interventions on everyday life function and psychological well-being. The goal of this workshop is to review the current state of cognitive aging and intervention research with older adults and its implications for practice in diverse community and clinical settings. The workshop will cover what the current research says about the effectiveness of various cognitive interventions and recommend specific ways in which older adults can maintain mental vitality with age. Particular attention will be paid to skill-based intervention approaches that target single or multiple cognitive abilities that are known to show significant age-related decline. We will also explore the use of multimodal interventions that combine different intervention approaches such as skill-based cognitive training with cognitive engagement or stimulation approaches as a way of promoting greater transfer. Because the needs of older adults differ, we will discuss how interventions can be adapted for older people presenting with different cognitive profiles, educational and cultural backgrounds, and motivational levels. The use of dementia risk reduction strategies along with cognitive intervention will be included in the discussion. We will also discuss how to increase the access, affordability, usability, and sustainability of cognitive interventions with older adults.

Learning Objectives
After the session, participants will be able to:
1. Identify the major modifiable risk factors for cognitive decline and dementia.
2. Explain the nature and scope of non-pharmacological intervention approaches that are most effective in slowing cognitive decline and reducing dementia risk in middle-aged and older adults.
3. Define cognitive training and explain how cognitive training interventions are applied to improve cognitive performance and everyday function.
4. Identify major challenges and opportunities for the development of non-pharmacological interventions for preventing or delaying cognitive decline and dementia.

Target Audience: Neuropsychologists and trainees
Instructional Level: Intermediate  

Dr. Rebok is a Professor at the Johns Hopkins University Bloomberg School of Public Health, and holds joint faculty appointments in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins School of Medicine, the Johns Hopkins Center on Aging and Health, and the Center on Innovative Care in Aging at the Johns Hopkins School of Nursing. He received his MA and PhD degrees in life-span developmental psychology at Syracuse University with a specialization in gerontology, and he completed postdoctoral training in cognitive neuropsychology, epidemiology, and biostatistics at Johns Hopkins. His research focuses on cognitive aging, prevention science, and public mental health, and has included studies on cognitive interventions with older adults, and the effects of aging and dementia on driving and other everyday functional tasks. Dr. Rebok currently serves as Co-Director of the NIA-funded Johns Hopkins Alzheimer’s Disease Resource Center for Minority Aging Research (JHAD-RCMAR). He has been the site Principal Investigator of the NIA/NINR-funded ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study where one of his roles has been to chair the national Steering Committee for this multi-site, randomized intervention trial. He also served as Principal Investigator for the NIA-funded randomized, controlled trial of a social engagement intervention called the Baltimore Experience Corps®. He has published numerous peer-reviewed articles, books, and book chapters on identification of early risk and protective factors on later life cognitive health and daily function; prevention of age-related cognitive decline, memory loss, depression, and disability; and the short- and long-term outcomes of cognitive intervention trials with normal and cognitively impaired older adults. He is a Fellow of the American Psychological Association, Association for Psychological Science, Gerontological Society of America, and the American Institutes for Research. In 2017 he received the American Psychological Association Division 20 award for Mentorship in Aging.

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Understanding the Latest in Dementia and the Science of Successful Brain Aging

1.5 CE Credits

Presented by: 
Maureen K. O'Connor, Psy.D., ABPP-CN
Director of Neuropsychology, Bedford Veterans Hospital
Assistant Professor of Neurology, Boston University School of Medicine
Director, Research Education Component, Boston University Alzheimer’s Disease Research Center





Andrew E. Budson, M.D.
Chief, Cognitive & Behavioral Neurology and
Associate Chief of Staff for Education, VA Boston Healthcare System







In this webinar we will begin by reviewing the differences between normal brain aging and dementia. We will present the latest updates on several common neurodegenerative diseases you may encounter in clinical practice, including advances in the clinical use of biomarkers and treatment considerations. We will offer the latest scientific evidence on lifestyle factors that are important to promoting successful brain aging so that you are able to provide practical advice and recommendations to your patients and their families.

After the webinar, participants will be able to:
1. Explain how the brain changes in normal aging
2. Discuss the presentation of several common neurodegenerative diseases
3. Identify the role of biomarkers in clinical use 
4. Assess various treatment considerations in Alzheimer’s disease and other dementias

Target Audience:  Psychologists
Instructional Level:  Intermediate

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