Activity One: Advancing Early Diagnosis and Treatment of Alzheimer’s Disease (AD) and Mild Cognitive Impairment (MCI): Integrating Biomarkers, Imaging, Diagnostics, and Therapeutics

Format: Interactive VR/Online Enduring Activity (with integrated knowledge checks)

Estimated Time to Complete: 15 minutes

Release Date: December 1, 2025

Expiration Date: December 1, 2026

Fee: No Fee

Provider: UAB Division of Continuing Medical Education, in collaboration with EmbodyXR, Inc.

ACCME Credit: .25

Target Audience

Primary care clinicians, neurologists, psychiatrists, geriatricians, radiologists, advanced practitioners, and other clinicians involved in the evaluation and management of cognitive concerns in adults.

Learning Objectives (Activity 1)

Upon completion of this activity, participants should be able to:

Knowledge-Based Outcomes

1. Describe the role of blood-based biomarkers in Alzheimer’s detection

    o Identify key plasma biomarkers (e.g., p-tau217, p-tau231, Aβ42/40 ratio) and their relevance in early detection.

    o Explain how biomarkers may contribute to staging and inform the clinical picture, including preclinical phases.

2. Recognize characteristic neuroimaging findings in Alzheimer’s disease

    o Describe MRI patterns commonly associated with AD (e.g., hippocampal/cortical atrophy).

    o Understand diagnostic limitations of structural imaging in early disease and the complementary role of fluid/plasma biomarkers.

3. Summarize the mechanisms of emerging anti-amyloid therapies

    o Outline mechanisms of action of amyloid-targeting agents (e.g., lecanemab, donanemab).

    o Describe immune-mediated pathways relevant to amyloid clearance and safety considerations (e.g., ARIA).

4. Distinguish between common dementia subtypes

    o Recognize core clinical/anatomical differences among AD, FTD (including PPA variants), Parkinson’s disease dementia, and dementia with Lewy bodies.

    o Identify visual tools (e.g., brain models/imaging summaries) that aid subtype differentiation.

Competence-Based Outcomes

5. Apply early cognitive screening tools in primary care

    o Topline review and appropriate use of validated tools (e.g., Mini-Cog™, MoCA) to screen for MCI and early AD during routine visits.

6. Integrate risk-reduction counseling into routine care

    o Incorporate counseling on modifiable risk factors (e.g., metabolic health, environmental exposures, nutrition, physical activity, sleep) associated with cognitive decline.

Accreditation Statement

The University of Alabama at Birmingham (UAB) Division of Continuing Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation Statement

UAB designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Participation and How to Claim Credit

1. Review the learning objectives and complete all required program sections, including the pre- and post-tests.

2. Achieve a minimum passing score of 80% on the post-test.

3. Complete the activity evaluation to provide feedback on the educational content and overall learning experience.

4. Upon successful completion of all requirements, access your UAB CME learner account to download or print your certificate of credit.

Credit Designation Statement:

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Faculty and Roles

· Matthew Macaluso, DO — Bee McWane Reid Professor and Vice Chair of Clinical Affairs, Department of Psychiatry, UAB Heersink School of Medicine

· Allan Anderson, MD — Geriatric Psychiatrist and former Medical Director, Toole Family Memory Center, Banner Alzheimer’s Institute

Full faculty biographies are available on the “Faculty” page.

Disclosure of Relevant Financial Relationships and Mitigation

In accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education, the University of Alabama at Birmingham (UAB) Division of CME

ensures that all individuals in a position to control the content of this educational activity disclose all relevant financial relationships with ineligible companies.

All disclosed relationships are identified, reviewed, and mitigated prior to the start of the activity to ensure the content is evidence-based, balanced, and free from commercial bias. Any relevant relationships will be listed on the activity landing page.

Conflicts of interest are addressed through independent peer review, adherence to current clinical evidence and guidelines, and strict separation of educational content from marketing or promotional influence.

Evidence Base & Clinical Guidance Notes

· Biomarkers: Plasma p-tau217 and Aβ1-42 (and related ratios such as Aβ42/40) show strong concordance with amyloid PET/CSF and can support evaluation of symptomatic adults when used within a comprehensive clinical assessment. The first FDA-cleared blood-based IVD (pTau217/Aβ1-42 Plasma Ratio) is intended for symptomatic adults being evaluated for AD and should not be used for asymptomatic population screening. U.S. Food and Drug Administration+2Fujirebio+2

· Therapeutics: Lecanemab preferentially binds soluble Aβ protofibrils, and donanemab targets amyloid plaque (including N3pG/pGlu3-modified Aβ) with immune-mediated clearance; both have been studied in early symptomatic AD and require appropriate safety monitoring for ARIA. Alzheimer's Journals+3New England Journal of Medicine+3PubMed+3

· Frameworks: Diagnostic thinking should reference the NIA-AA AT(N) biological framework while integrating clinical syndrome, functional status, and differential diagnosis. Alzheimer's Journals+1

· Screening Tools: Mini-Cog™ and MoCA are validated tools when administered and interpreted per standard instructions; results should be contextualized and are not stand-alone diagnoses. Alzheimer’s Association+1

· Safety: When considering monoclonal antibodies, review ARIA-E/H risks (e.g., in the setting of CAA), obtain baseline MRI, and monitor per product labeling/trial protocols. PubMed

Off-Label / Investigational Use

In this program, there is no off-label content.

Technical Requirements

· VR: Meta Quest 3 or equivalent.

· Desktop/Mobile: Modern browser + audio.

· Accessibility: Captions and keyboard navigation available.

ADA & Privacy Statements

UAB CME complies with ADA requirements and uses learner data only for accreditation and quality improvement. Contact [UAB CME Support Email/Phone] for assistance.

Contact

Sean Moloney, General Inquiries

Email: smoloney@embodyxr.com

Phone: (908) 432-9604

Ronan O'Beirne, Director, UAB CME

Email: ronan@uab.edu

Bibliography

1. Nasreddine ZS, et al. (2005). The Montreal Cognitive Assessment (MoCA): A brief screening tool for mild cognitive impairment. J Am Geriatr Soc, 53(4), 695–699.

2. Chertkow H, et al. (2011). MoCA: Cognitive domains and neural correlates. Alzheimer’s & Dementia.

3. Trzepacz PT, et al. (2015). Comparison of the MoCA and MMSE in detecting MCI and Alzheimer’s disease. BMC Geriatrics.

4. Freitas S, et al. (2012). Construct validity of the MoCA. Archives of Clinical Neuropsychology.

5. Carson N, Leach L, Murphy KJ. (2018). Re-examination of MoCA cutoff scores. Int J Geriatr Psychiatry.

6. Ismail Z, et al. (2010). Role of orientation and attention in differentiating dementia subtypes.

7. Sperling RA, et al. (2011). Toward defining the preclinical stages of Alzheimer’s disease: Recommendations from the NIA-AA workgroups. Alzheimer’s & Dementia. 8. Jack CR Jr, et al. (2018). NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia. 9. Cummings J, et al. (2022). Alzheimer’s disease drug development pipeline: 2022. Alzheimer’s & Dementia (N Y).

10. Rabinovici GD. (2019). Contemporary evaluation and management of Alzheimer’s disease. JAMA, 322(8), 750–760.

11. Borson S, Scanlan J, Brush M, et al. (2000). The Mini-Cog™: A cognitive “vital signs” measure for dementia screening in multilingual elderly. Int J Geriatr Psychiatry, 15(11), 1021–1027.

12. Galvin JE, Sadowsky CH. (2012). Practical guidelines for the recognition and diagnosis of dementia. J Am Board Fam Med, 25(3), 367–382.

13. Petersen RC, et al. (2018). Practice guideline update summary: Mild cognitive impairment. Neurology, 90(3), 126–135. 14. MoCA Test Official Website. The Montreal Cognitive Assessment (MoCA) and Certification Information. 15. Mini-Cog™ Official Website. Administration and Scoring Guidelines.