Patient Introduction

Hello, my name is John, and I’m 69 years old. My wife, Anita, has been showing a handful of early signs of dementia, and we’re both pretty worried about it. She sometimes forgets words when she’s talking and loses her train of thought completely. Not all the time, but enough to notice. She sometimes forgets people’s names, even close friends who she sees regularly. She has a busy schedule with volunteering at an elementary school and local library, and the last time we went to our doctor she said her symptoms were likely related to stress. We managed okay for a while, but at a recent outing with friends, Anita forgot one of her friend’s names. She became really frustrated and we ended up leaving. Anita was really embarrassed. We told our doctor, who referred us to a neurologist and a geriatric psychiatrist. I’m here to provide you with a sample of a discussion we recently had with one of Anita’s clinicians on how she’s doing and what steps we’re taking going forward.

Question #1

The test results showed amyloid plaques in your wife’s brain and she’s been diagnosed with early stage Alzheimer’s disease. How do you feel about this diagnosis?

Answer

Question #2

Well, let me start by saying that it’s encouraging to have found this at an early stage. That’s a good thing. And hats off to you for seeing a problem and doing something about it. Not everybody does.

Answer

Question #3

We usually start with things like regular exercise, healthy diet, cognitive training, and maintaining social engagement. These are all important aspects of treatment.

Answer

Question #4

Yes, any treatment plan will focus on her quality of life. We’ll keep asking what we can do to provide benefit and maintain autonomy while slowing progression. Are either of you aware of the medications for early-stage Alzheimer’s disease?

Answer

Question #5

There are several medications to help manage her symptoms. Two new agents – donanemab and lecanemab – were specifically approved recently early stage Alzheimer’s disease to potentially slow disease progression: donanemab and lecanemab.

Answer

Question #6

Yes. I’ll give advice on things that may be a good fit. But the biggest part is understanding what matters most to you and your wife. And I most certainly won’t make Anita take anything she doesn’t want to take.

Answer

Question #7

Well, for one thing, they’re disease-modifying when given at sufficient doses for sufficient durations. This means that they actually remove plaques in the brain in patients with early-stage Alzheimer’s disease, rather than just manage symptoms.

Answer

Question #8

They’re generally very safe. They’re given through IV infusion so sometimes mild infusion reactions occur. There is also something called amyloid-related imaging abnormalities, or ARIA. This is usually asymptomatic and resolves on its own.

Answer

Question #9

Serious symptoms – seizures, for example – are rare. We’d monitor Anita closely with MRIs, especially in the first months. We’ll address any significant issues by pausing the agent and re-evaluating. There are recommendations for safe and appropriate use of these agents.

Answer

This activity is provided by Med Learning Group.
This activity is supported by an educational grant from Lilly.
Scroll to Top

Scientific Council

Marc Agronin, MD

Chief Medical Officer
Frank C. and Lynn Scaduto MIND Institute and Behavioral Health
Miami Jewish Health
Miami, FL

Liana G. Apostolova, MD, MSc, FAAN

Associate Dean of Alzheimer’s Disease Research
Indiana University Distinguished Professor
Barbara and Peer Baekgaard Professor of Alzheimer's Disease Research
Professor in Neurology, Radiology, Medical and Molecular Genetics
Indiana University School of Medicine
Department of Neurology
Indianapolis, IN

Alireza Atri, MD, PhD

Chief Medical Officer, Banner Research
Banner Alzheimer’s and Research Institutes
Pheonix, Sun City, and Tucson, AZ
Director, Banner Sun Health Research Institute
Sun City, AZ

Frederik Barkhof, MD, PhD, FRCR

Professor of Neuroradiology
Department of Radiology and Nuclear Medicine
Amsterdam UMC (location VU mc)
Amsterdam, The Netherlands
UCL Queen Square Institute of Neurology
UCL Hawkes Institute
London, United Kingdom

Sharon A. Brangman, MD, FACP, AGSF

Distinguished Service Professor
Chair, Department of Geriatrics
Director, Upstate Center of Excellence for Alzheimer’s Disease
SUNY Upstate Medical University
Syracuse, New York

Christopher Chen, BM BCh, MRCP, FAMS, FRCP

Professor, Department of Pharmacology
Director, Memory Aging and Cognition Centre
Yong Loo Lin School of Medicine
National University of Singapore
Singapore

Choong Chih Ching, MBChb NZ, FRCR UK

Senior Consultant, Department of Diagnostic Imaging
RadLink, Singapore
Visiting Consultant, National University Hospital and National Cancer Centre of Singapore

Anupama Roy Chowdhury, MBBS, MRCP, FAMS

Head and Senior Consultant
Department of Geriatric Medicine
Singapore General Hospital
Singapore

Natalie Christian, MD

Assistant Professor, Geriatrics
Program Director, Geriatric Medicine Fellowship
Tulane University School of Medicine
Southeast Louisiana Veterans Healthcare System
New Orleans, LA

Petrice M. Cogswell, MD, PhD

Associate Professor
Mayo Clinic
Rochester, Minnesota

Ariel F. Cole, MD, FAAFP

Program Director, AdventHealth Geriatric Fellowship
Winter Park, FL

Brad Dickerson, MD, MMSc, FAAN, FANPA

Professor of Neurology, Harvard Medical School
Director, Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital
Boston, MA

Richard M. Dupee, MD, MACP, AGSF

Clinical Professor of Medicine
Tufts University School of Medicine
Clinical professor, Department of Public Health and Community Medicine, Tufts University
Chief, Geriatrics Service, Tufts Medical Center
Senior Physician, Pratt Diagnostic Center
Dean ex officio, Office of International Affairs, Tufts University School of Medicine
Boston, MA

Fanny Elahi, MD, PhD

Associate Professor of Neurology, Neuroscience, and AI and Human Health
Icahn School of Medicine
Mount Sinai
New York, NY

James M. Ellison, MD, MPH

Professor of Psychiatry and Human Behavior
Sidney Kimmel Medical College
Co-Director, Comprehensive Alzheimer’s Center
Vickie & Jack Farber Institute for Neuroscience
Thomas Jefferson University
Philadelphia, PA

Juan Fortea, MD, PhD

Professor of Neurology
Director, Alzheimer-Down Unit
Hospital de la Santa Creu i Sant Pau
Sant Pau Biomedical Research Institute
Barcelona, Spain

Ana M. Franceschi, MD, PhD

Associate Professor of Radiology
Director of Dementia Imaging
Director of Molecular Neuroimaging
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Lenox Hill Hospital
New York, New York

Giovanni B. Frisoni, MD

Professor of Clinical Neuroscience
University of Geneva
Director, Memory Clinic
Geneva University Hospitals
Geneva, Switzerland

Samuel Gandy, MD. PhD

Professor of Neurology & Psychiatry
Icahn School of Medicine at Mount Sinai
James J Peters VA Medical Center
New York, New York

James E. Galvin, MD, MPH

Professor of Neurology
University of Miami Miller School of Medicine
Miami, FL

David S. Geldmacher, MD

Professor and Director
Division of Memory Disorders and Behavioral Neurology
Department of Neurology
Heersink School of Medicine
University of Alabama at Birmingham
Birmingham, AL

George T. Grossberg, MD

Henry & Amelia Nasrallah Endowed Professor
Director of Geriatric Psychiatry
Department of Psychiatry & Behavioral Neuroscience
Saint Louis University School of Medicine
St. Louis, MO

M. Atsushi Iwata, MD, PhD

Professor of Neurology
Department of Neurology
The University of Tokyo
Tokyo, Japan

Scott A. Kaiser, MD

Director of Geriatric Cognitive Health
Pacific Neuroscience Institute
Santa Monica, CA
Adjunct Professor
USC Leonard Davis School of Gerontology
Los Angeles, CA

Lynn E. Kassel, PharmD, BCPS

Associate Professor of Pharmacy Practice
Drake University College of Pharmacy & Health Sciences
Des Moines, IA

Diana R. Kerwin, MD, CPI

President, Kerwin Medical Center
Chief, Geriatric Medicine, Texas Health Presbyterian Hospital
Dallas, TX

Alka Khera, MD

Assistant Professor
UT Southwestern Neurology
Dallas, TX

Sumeet Kumar, MBBS, DNB, FRCR, EDiNR

Senior Consultant, Department of Neuroradiology
National Neuroscience Institute of Singapore
Clinical Assistant Professor, Duke-NUS Medical School
Adjunct Director for Advanced Magnetic Resonance Imaging Research
Radiological Sciences Academic Clinical Program (RADSC ACP)
SingHealth Duke-NUS Academic Medical Centre
Singapore

Rosemary D. Laird, MD, MHSA, AGSF

Chief Medical Officer, My Memory Clinic
Principal Investigator, ClinCloud Clinical Trials
Viera, Florida

Chi-Ying (Roy) Lin, MD, MPH, FAAN

Director, CurePSP Center of Care for PSP, CBD, and MSA
Assistant Professor of Neurology
Alzheimer's and Parkinson's Disease Centers
Baylor College of Medicine
Houston, TX

Catherine A. Madison, MD

Founding Director Ray Dolby Brain Health Center
San Francisco, CA

Scott McGinnis, MD

Assistant Professor of Neurology, Harvard Medical School
Center for Alzheimer Research and Treatment
Brigham and Women's Hospital
Frontotemporal Disorders Unit
Massachusetts General Hospital
Boston, MA

Kristin S. Meyer, PharmD, BCGP, FASCP

Professor of Pharmacy Practice
Drake University College of Pharmacy and Health Sciences
Des Moines, IA

Charles Montano, MD

Owner, Principal Investigator
CT Clinical Research
Cromwell, CT

Mary Norman, MD

Geriatrician
Cedars-Sinai Medical Group
Los Angeles, CA

Tiago Gil Oliveira, MD, PhD

Associate Professor
Life and Health Sciences Research Institute
School of Medicine
University of Minho
Neuroradiologist
Hospital de Braga
Braga, Portugal

Monica Parker, MD

Associate Professor of Neurology
Lead, Outreach, Recruitment, and Engagement Core
Goizueta Alzheimer's Disease Research Center
Goizueta Brain Health Institute
Emory University
Atlanta, Georgia

Lucilla Parnetti, MD

Professor of Neurology
Department of Medicine and Surgery
University of Perugia
Perugia, Italy

Manisha Parulekar, MD, FACP, AGSF, CMD

Director, Division of Geriatrics
Co-director, Center for Memory Loss and Brain Health
Hackensack University Medical Center
Hackensack, NJ

Giulio Maria Pasinetti, MD, PhD

The Saunders Family Chair in Neurology, Professor in Neurology
Director, Mount Sinai Center in Advance Botanical Research in Molecular Integrative Neuroresilience
Icahn School of Medicine at Mount Sinai
New York, NY
Director, Basic and Biomedical Research and Training Program, Geriatric Research and Clinical Center
James J. Peters Department of Veterans Affairs Medical Center
Bronx, NY

Robert Perneczky, MD

Professor of Psychiatry
Department of Psychiatry and Psychotherapy
Ludwig-Maximilians-University Munich
German Center for Neurodegenerative Diseases
Munich, Germany

Anton P. Porsteinsson, MD

William B. and Sheila Konar Professor of Psychiatry, Neurology,
Neuroscience, and Medicine
Director, Alzheimer’s Disease Care, Research and Education
Program (AD CARE)
University of Rochester School of Medicine and Dentistry
Rochester, NY

Michael S. Rafii, MD, PhD

Professor of Clinical Neurology
Medical Director, Alzheimer’s Therapeutic Research Institute
Keck School of Medicine of USC
Los Angeles, California, USA

William D. Rhoades, DO, FACP

Chief Medical Officer
Advocate Good Samaritan Hospital
Downers Grove, IL

Barry W. Rovner, MD

Professor, Departments of Psychiatry & Neurology
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, PA

Marwan Noel Sabbagh, MD, FAAN, FANA

Moreno Family Chair for Alzheimer’s Research
Vice Chairman for Research and Professor
Department of Neurology
Barrow Neurological Institute
Phoenix, AZ

Martin J. Sadowski, MD, PhD

Zachary and Elizabeth M. Fisher Professor of Neurodegeneration and Alzheimer's Disease
Professor of Neurology, Psychiatry, and Biochemistry & Molecular Pharmacology
New York University Grossman School of Medicine Director, Fisher Center Alzheimer’s Clinical Trials Program
New York, NY

Stephen Salloway, MD, MS

Professor, Psychiatry and Human Behavior
Professor of Neurology, Alpert Medical School of Brown University
Providence, Rhode Island

Angela Sanford, MD, CMD

Associate Professor of Internal Medicine-Geriatrics
Saint Louis University School of Medicine
Ballwin, MO

Philip Scheltens, MD, PhD

Professor Emeritus of Neurology
Amsterdam University Medical Center
Head Dementia Fund at EQT Life Sciences
Amsterdam, Netherlands

Suzanne E. Schindler, MD, PhD

Associate Professor of Neurology
Division of Neurology
Washington University School of Medicine in St. Louis
Investigator, Knight Alzheimer Disease Research Center
St. Louis, Missouri, USA

Paul E. Schulz, MD

Rick McCord Professor of Neurology
Umphrey Family Professor of Neurodegenerative Disorders
Director, Memory Disorders and Dementia Clinic
UTHealth Houston
Houston, TX

Sharon J. Sha, MD, MS

Clinical Professor
Clinical Professor Neurology and Neurological Sciences Stanford University Chief, Stanford Memory Disorders Center Stanford Medicine Health Care
Palo Alto, CA

Jiong Shi, MD

Professor of Neurology
Department of Neurology
Huashan Hospital
Fudan University
Shanghai, China

Neil Skolnik, MD

Professor of Family and Community Medicine
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, PA

Sandra Swantek, MD

Director, Section of Geriatric Psychiatry
RUSH University Medical Center
Chicago, IL

R. Scott Turner, PhD, MD

Professor of Neurology
Director of the Memory Disorders Program
Georgetown University
Washington, DC

Lawren VandeVrede, MD, PhD

Assistant Professor of Neurology
Memory and Aging Center
Department of Neurology
University of California, San Francisco
San Francisco, California, USA

Chuck Vega, MD, FAAFP

Health Sciences Clinical Professor
UC Irvine Department of Family Medicine
Director, UCI Program in Medical Education for the Latino Community
University of California Irvine
Irvine, CA

Nicolas Villain, MD, PhD

Professor of Neurology
Department of Neurology
Sorbonne University
Neurologist, Pitié-Salpêtrière Hospital
Assistance Publique – Hôpitaux de Paris
Paris, France

Geoffrey C. Wall, PharmD, FCCP, BCPS

John R. Ellis Distinguished Chair of Pharmacy Practice
Professor of Clinical Sciences
Director, Drake Drug Information Center
Drake University College of Pharmacy and Health Sciences
Internal Medicine Clinical Pharmacist
Iowa Methodist Medical Center
Des Moines, IA

David A. Wolk, MD, FAAN

Professor of Neurology
Director, Penn Alzheimer’s Disease Research Center
University of Pennsylvania
Philadelphia, PA