How to Make an Alzheimer's Diagnosis in Primary Care: A Podcast with Nathaniel Chin
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
47 min
3 speakers
8 chapters
transcribed 9 hours ago
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What new advances are changing Alzheimer’s diagnosis in primary care?
Welcome to the Jerry PAL podcast, is Eric Wadero. This is Alex Smith. And Alex, we got a live in-person guest with us.
Live guest, Nate Chin, who is our visiting professor for grand rounds and has got a full day and is joining us for the podcast to start things off. Nate's a returning guest. He is associate professor at the University of Wisconsin and medical director of their Alzheimer's Disease Research Center. Nate, welcome back to the Jerry Powell podcast.
Oh, thanks for having me. Great to be back. So we're gonna be talking about making the diagnosis of Alzheimer's disease in a primary care setting. Not specialty care, but maybe we could talk a little bit about that. But before we do, we always start off with a song request. Nate, what is your song request for Alex? Jungle Land, Bruce Springstein.
Why did you pick this song? This is in honor of my father-in-law, Steve Hoppe, who passed away last fall. He was a diehard Bruce Springsteen fan, and he went to, I think, over thirty concerts. And my wife went to over, I want to say twenty concerts. Have you been to a concert? I went to one in Milwaukee, Wisconsin, and I'm so glad I did. I loved it. And this was his favorite song. That's why I wanted to do it.
And Bruce Springsteen did a stage dive. We were talking about this before. Very
healthy man.
Very healthy man. I wonder how old he is now. And he's stage diving. And he's incredible. All right, here's a little bit.
The Rangers had a homecomin'. In Horlem late last night. And the magic rat drove his sleek machine over the Jersey state line. Barefoot girl sitting on the hood of a dodge drinking warm beer in the soft summer rain. The rat pulls in a town, rolls up his pants. Together they take a stab at romance, disappear down Flamingo Lane.
Will Maximum Lawman run down Flamingo chasing the rat and the barefoot girl? And the kids round here look just like shadows, always quiet. Holding hand. From the churches to the jails, tonight all is silence in the world. As we take our stand Down in jungle.
It just goes on and on and on, verse after verse at verse. It's a beautiful story, and it just reminds me how much of a storyteller it is. Okay, non-sequitour. I just saw that movie, A Complete Unknown about Bob Dylan. Incredible movie. Um, I loved it. Timothy Chalamet did a good job. A lot of the uh co-stars did a great job. And I would say that one thing I wish it did better was show how Bob Dylan told stories with his. his songs in much the same way that Bruce Springsteen does and someday there'll be a great documentary about Bruce Springsteen.
I think this is just a plug for future guests that Alex wants more Bob Dylan songs. Don't let 'em fool you, future guests. All right, let's jump into the topic. W things are like changing real fast in a in the Alzheimer's world. So we we now have blood tests that can reasonably approximate the degree of amyloid buildup in the brain. You got two new FDA-approved meds that you can give to shrink that amyloid all away. How much has this changed? How much should it change how we think about making a diagnosis? of Alzheimer's disease in primary care. What
do you think? I don't think it changes anything about what we should be doing in primary care. And that's because the syndrome of mild cognitive impairment and dementia doesn't change. Right. So We need to know if a person's having symptoms. We need to know if people are forgetful, if they're losing their attention, if they're struggling to solve problems like cook or clean or do any of those things. So knowing if it's amyloid or if it's tau or if it's Louis body disease or vascular disease, that doesn't really matter because we need to know what people are experiencing. And so I don't think The biology is incredibly important, so don't get me wrong. Yeah. But what people are experiencing, which is fundamental and what we really care about, that hasn't changed.
And so in primary care, which they're they're perfectly situated to address, that hasn't changed.
Sure. Uh that that's fascinating. So it sounds like what you're saying is like making a diagnosis of cognitive impairment.
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Chapters
8 chapters
1
What new advances are changing Alzheimer’s diagnosis in primary care?
0:00–6:16
2
How should primary‑care clinicians screen for cognitive impairment?
6:16–12:51
3
Why is a detailed history and functional assessment still essential?
12:51–19:07
4
When and how should blood‑based amyloid biomarkers be used?
19:07–24:28
5
What is the role of FDA‑approved amyloid‑targeting antibodies in early disease?
24:28–30:36
6
How do clinical trials and surrogate outcomes impact treatment decisions?
30:36–37:12
7
What resources and support does primary care need to manage Alzheimer’s?
37:12–42:09
8
What are the key take‑aways and future directions for geriatricians?
42:09–47:50
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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