Clinical Training
The Mini Mental State Examination (MMSE)
The following is an excerpt from the Boston University Alzheimer’s Disease Center Publication titled, Mini Mental State Examination and Logical Memory scores for entry into Alzheimer’s disease trials
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Alzheimer’s disease (AD) clinical trials and diagnostic studies are responsible for the testing and development of therapeutics and diagnostic methods for AD. These large-scale, multi center studies must have strict inclusion criteria to accurately identify and discriminate normal cognition, mild cognitive impairment (MCI), and AD dementia and recruit the population of interest to facilitate internal and external validity. This, however, is no straightforward task. Although there have been great gains in the development of biomarkers for the accurate in vivo diagnosis and early detection of AD (e.g., lumbar puncture, positron emission tomography) [1–3], these are invasive procedures typically conducted following initial screening methods. Instead, investigators in AD clinical trials and diagnostic studies often initially rely on brief cognitive screening tests to detect cognitive impairment and classify patients, using a variety of research derived cut scores, as having normal cognition, MCI, or dementia. The Mini Mental State Examination (MMSE) [4] and the Wechsler Memory Scale (WMS) Logical Memory (LM) test [5] are two screening measures commonly used to determine inclusion in these studies.
Clinical Dementia Rating (CDR) Scale
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The following is an excerpt from the Washington University in St. Louis Alzheimer’s Disease Research Center’s website:
The CDR is a 5-point scale used to characterize six domains of cognitive and functional performance applicable to Alzheimer disease and related dementias: Memory, Orientation, Judgment & Problem Solving, Community Affairs, Home & Hobbies, and Personal Care. The necessary information to make each rating is obtained through a semi-structured interview of the patient and a reliable informant or collateral source (e.g., family member).
Legal Advisor: Advance Directives
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This course provides 1 AMA PRA Category I Credits for physicians who receive a score of 70% or better on the course.
According to the Massachusetts Medical Society, the course objectives are as follows:
-Define which Advance Directives documents are governed by Massachusetts law;
-Describe the impaired-driver reporting requirements in the state of Massachusetts;
-Contrast the limitations and scope of authority of a patient’s appointed health care agent;
-Identify the components of a health care proxy;
-Determine who has the authority to represent the patient’s wishes using different case scenarios.
The program meets the criteria of the Massachusetts Board of Registration in Medicine for risk management study.
Neuropsychiatric Inventory – Questionnaire (NPI-Q) Interviewer Certification Module
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The following is an excerpt from the National Alzheimer’s Coordinating Center (NACC)’s Uniform Data Set Coding Guidebook for Initial Visit Packets (Version 2.0, February 2008).
The Importance of Discussing End-of-Life Care with Patients
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This course provides 1 AMA PRA Category I Credits for physicians who receive a score of 70% or better on the course.
According to the Massachusetts Medical Society, the course objectives are as follows:
-Review some of the landmarks in the development of end-of-life legislation;
-Explore the concepts of living wills, health care proxies, power of attorney and DNR/DNI;
-Discuss the attributes of Medical Orders for Life-Sustaining Treatment forms (MOLST).
The program meets the criteria of the Massachusetts Board of Registration in Medicine for risk management study.