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December 27, 2017

Practice guideline update summary: Mild cognitive impairment
Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology

Ronald C. Petersen, MD, PhD, Oscar Lopez, MD, Melissa J. Armstrong, MD, MSc, Thomas S.D. Getchius, Mary Ganguli, MD, MPH, David Gloss, MD, MPH&TM, Gary S. Gronseth, MD, Daniel Marson, JD, PhD, Tamara Pringsheim, MD, Gregory S. Day, MD, MSc, Mark Sager, MD, James Stevens, MD, and Alexander Rae-Grant, MDAuthors Info & Affiliations
January 16, 2018 issue
90 (3) 126-135
https://doi.org/10.1212/WNL.0000000000004826
Letters to the Editor
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Abstract

Objective

To update the 2001 American Academy of Neurology (AAN) guideline on mild cognitive impairment (MCI).

Methods

The guideline panel systematically reviewed MCI prevalence, prognosis, and treatment articles according to AAN evidence classification criteria, and based recommendations on evidence and modified Delphi consensus.

Results

MCI prevalence was 6.7% for ages 60–64, 8.4% for 65–69, 10.1% for 70–74, 14.8% for 75–79, and 25.2% for 80–84. Cumulative dementia incidence was 14.9% in individuals with MCI older than age 65 years followed for 2 years. No high-quality evidence exists to support pharmacologic treatments for MCI. In patients with MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may improve cognitive measures.

Major recommendations

Clinicians should assess for MCI with validated tools in appropriate scenarios (Level B). Clinicians should evaluate patients with MCI for modifiable risk factors, assess for functional impairment, and assess for and treat behavioral/neuropsychiatric symptoms (Level B). Clinicians should monitor cognitive status of patients with MCI over time (Level B). Cognitively impairing medications should be discontinued where possible and behavioral symptoms treated (Level B). Clinicians may choose not to offer cholinesterase inhibitors (Level B); if offering, they must first discuss lack of evidence (Level A). Clinicians should recommend regular exercise (Level B). Clinicians may recommend cognitive training (Level C). Clinicians should discuss diagnosis, prognosis, long-term planning, and the lack of effective medicine options (Level B), and may discuss biomarker research with patients with MCI and families (Level C).

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Disclaimer

Clinical practice guidelines, practice advisories, systematic reviews, and other guidance published by the American Academy of Neurology (AAN) and its affiliates are assessments of current scientific and clinical information provided as an educational service. The information (1) should not be considered inclusive of all proper treatments, methods of care, or as a statement of the standard of care; (2) is not continually updated and may not reflect the most recent evidence (new evidence may emerge between the time information is developed and when it is published or read); (3) addresses only the question(s) specifically identified; (4) does not mandate any particular course of medical care; and (5) is not intended to substitute for the independent professional judgment of the treating provider, as the information does not account for individual variation among patients. In all cases, the selected course of action should be considered by the treating provider in the context of treating the individual patient. Use of the information is voluntary. The AAN provides this information on an “as is” basis and makes no warranty, expressed or implied, regarding the information. The AAN specifically disclaims any warranties of merchantability or fitness for a particular use or purpose. The AAN assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this information or for any errors or omissions.

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Letters to the Editor
14 February 2018
Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology
Alain Braillon, Senior consultant | University Hospital, 80000 Amiens, France

The Academy must be commended for its update summary on mild cognitive impairment (MCI). [1] Petersen et al. utilized the robust methodology of evidence classification criteria and recommendations were graded and clear to the reader: "Clinicians may choose not to offer cholinesterase inhibitors (Level B); if offering, they must first discuss lack of evidence (Level A)."

Issues surrounding MCI have been overlooked by many European publications. The Lancet Commission claimed, "drinking only a moderate amount of alcohol increases life expectancy and health in ageing" [2] despite evidence that drinking is a risk factor for cognitive decline [3] and a carcinogen beginning at a one drink/day level. In 2017, the French High Council for Public Health retrieved an 11-year-old finding that claimed, "the prescription of current anti-Alzheimer drugs remains a small tool for the possible improvement of the quality of life of a few patients at a modest annual cost for the health insurance scheme." The Council incorporated these outdated findings into the concluding paragraph on medical treatment as if the material was current. [5] The report also ignored that anticholinergic medications rank top among inappropriate medications prescribed in French nursing homes. [5] For both publications, corrections are warranted as soon as possible.

The Academy guideline is unequivocal, useful, and usable. It will be used for patient benefit.

Conflict of interest: AB is a member of the High Council for Public Health at the French Department of Health.

1. Petersen RC, Lopez O, Armstrong MJ et al. Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.

2. Livingston G, Sommerlad A, Orgeta V et al. Dementia prevention, intervention, and care. Lancet 2017;390:2673-2734.

3. Topiwala A, Allan CL, Valkanova V et al. Moderate alcohol consumption as risk factor for adverse brain outcomes and cognitive decline: longitudinal cohort study. BMJ 2017;357: j2353.

4. French High Council for Public Health. [Prevention of Alzheimer's disease and related diseases.] 31 Jan 2018. https://www.hcsp.fr/Explore.cgi/Telecharger?NomFichier=hcspr20171222_prv.... Accessed Feb 14, 2018.

5. Herr M, Grondin H, Sanchez S et al. Polypharmacy and potentially inappropriate medications: a cross-sectional analysis among 451 nursing homes in France. Eur J Clin Pharmacol 2017;73:601-608.

Disclosure: AB is a member of the High Council for Public Health at the French Department of Health.

For full disclosures, contact the editorial office at [email protected].

1 March 2018
Author response to Braillon: Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology
Ronald C. Petersen, Neurologist | Mayo Clinic
Oscar Lopez, Neurologist | University of Pittsburgh Medical Center
Melissa J. Armstrong, Neurologist | University of Florida College of Medicine
Thomas S.D. Getchius, Manager | Heart Rhythm Society
Mary Ganguli, Psychiatrist | Department of Psychiatry, University of Pittsburgh
David Gloss, Neurologist | Charleston Area Medical Center Neurology
Gary S. Gronseth, Neurologist | University of Kansas Medical Center
Daniel Marson, Clinical Neuropsychologist | University of Alabama at Birmingham
Tamara Pringsheim, Neurologist | Cumming School of Medicine, University of Calgary
Gregory S. Day, Neurologist | Knight Alzheimer Disease Research Center, Washington University School of Medicine
Mark Sager, Geriatrician | School of Medicine and Public Health, University of Wisconsin
James Stevens, Neurologist | Fort Wayne Neurological Center
Alexander D. Rae-Grant, Neurologist | Cleveland Clinic Neurological Institute at Lakewood Hospital

We thank Dr. Braillon for his thoughtful comments on our guideline. [1] We echo his concerns about the lack of awareness regarding MCI risk factors such as alcohol consumption and the lack of supporting evidence for use of pharmacologic agents for treating MCI, particularly anticholinergic medications. It is our hope that this guideline will play a key role in changing such misperceptions.

1. Petersen RC, Lopez O, Armstrong MJ et al. Practice guideline update summary: Mild cognitive impairment: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.

18 January 2018
Concerns about cholinesterase inhibitor recommendations
Michael Valenzuela, Professor of Regenerative Neuroscience | University of Sydney
Perminder Sachdev, Professor of Neuropsychiatry | University of New South Wales
Henry Brodaty, Professor of Ageing and Mental Health | University of New South Wales

We have some concerns about the recommendations on cholinesterase inhibitors in the recent guidelines on mild cognitive impairment (MCI). [1] Evidence in the guidelines, and in systematic reviews, [2-4] clearly show that cholinesterase inhibitors have no reliable benefit on cognition and do not reduce progression to dementia. At the same time, patients are exposed to risk: "side effects... are common, including gastrointestinal symptoms and cardiac concerns." [1] It is, therefore, curious that the message to practitioners is equivocal. They "may choose" not to use these medicines (recommendation B3a), or choose to actively prescribe them after, "first discuss[ing] with the patient the fact this is... not currently backed by empirical evidence" (recommendation B3b). [1] This is the first instance we recall of a learned academy legitimizing prescription of a class of drugs recognized to be ineffective. Given the guidelines' potential for influence, we are deeply concerned that patients--who often are ill-equipped to make judgments of this kind--may be unnecessarily exposed to harm, and health care systems to needless cost. More generally, we are anxious to avoid a precedent for evidence being viewed as "optional" in clinical decision-making. We call upon the AAN and authors to retract recommendation B3b and rewrite B3a to plainly recommend against use of cholinesterase inhibitors in MCI.

1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.

2. Russ TC, Morling JR. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev 2012:CD009132.

3. Cooper C, Li R, Lyketsos C, Livingston G. Treatment for mild cognitive impairment: systematic review. Br J Psychiatry 2013;203:255-264.

4. Fink HA, Jutkowitz E, McCarten JR, et al. Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review. Ann Intern Med 2018;168:39-51.

For disclosures, please contact the editorial office at [email protected].

14 January 2018
Reader response: Practice guideline update summary: MCI
Gang Wang, Neurologist | Ruijin Hospital, Shanghai Jiaotong University (Shanghai, China)
Hai-lun Cui, Graduate Student | Ruijin Hospital, Shanghai Jiaotong University (Shanghai, China)

The updated American Academy of Neurology guidelines on mild cognitive impairment (MCI) is essential both for clinical and research settings. [1] Dramatic changes in the definition of MCI over the past decades require a more dynamic and on-limits attitude towards newly-proposed diagnostic and treating methods, which lead to a few concerns that demand further explanation:

The guidelines mentioned a 14.4-55.6 percent reverting rate for patients with MCI to rehabilitate to normal cognitive status based on multiple Class-I studies. Could any subtle differences in clinical presentation be found during the course of disease among each subtype of MCI? For example, between MCI and MCI due to Alzheimer disease. If so, predicting prognosis could be made at an early stage. Further, we deem a more specific and detailed recommendation on nonpharmacologic treatments, which may include a variety of choices that were studied and validated throughout different research teams across the world (especially some unique and traditional types of exercise such as Tai Chi Chuan practice. [2-4] Meanwhile, since no cut-off points for diverse biomarkers, such as Amyloid beta and tau concentration in CSF, have been officially proposed, the documented value of these biomarkers in differential diagnosis remains uncertain. [5]

1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.

2. Tao J, Chen X, Egorova N, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults. Sci Rep 2017;7:41581.

3. Tao J, Liu J, Liu W, et al. Tai Chi Chuan and Baduanjin Increase Grey Matter Volume in Older Adults: A Brain Imaging Study. J Alzheimers Dis 2017;60:389-400.

4. Brasure M, Desai P, Davila H, et al. Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review. Ann Intern Med 2018;168:30-38.

5. Petersen RC, Caracciolo B, Brayne C, et al. Mild cognitive impairment: a concept in evolution. J Intern Med 2014;275:214-228.

For disclosures, please contact the editorial office at [email protected].

29 January 2018
Author response to Drs. Wang and Cui
Ron C. Petersen, Neurologist | Mayo Clinic
Oscar Lopez, Neurologist | University of Pittsburgh Medical Center
Melissa J. Armstrong, Neurologist | University of Florida College of Medicine
Thomas S.D. Getchius, Manager | Heart Rhythm Society
Mary Ganguli, Psychiatrist | Department of Psychiatry, University of Pittsburgh
David Gloss, Neurologist | Charleston Area Medical Center Neurology
Gary S. Gronseth, Neurologist | University of Kansas Medical Center
Daniel Marson, Clinical Neuropsychologist | University of Alabama at Birmingham
Tamara Pringsheim, Neurologist | Cumming School of Medicine, University of Calgary
Gregory S. Day, Neurologist | Knight Alzheimer Disease Research Center, Washington University School of Medicine
Mark Sager, Geriatrician | School of Medicine and Public Health, University of Wisconsin
James Stevens, Neurologist | Fort Wayne Neurological Center
Alexander D. Rae-Grant, Neurologist | Cleveland Clinic Neurological Institute at Lakewood Hospital

We thank Drs. Gang Wang and Hai-lun Cui for the comment on the recently published mild cognitive impairment (MCI) guideline. [1] We agree that there is a great deal of interest in predicting the patients with MCI who will revert to normal cognition, remain stable, or progress to dementia due to Alzheimer disease or other pathologies, whether using subtle differences in clinical presentation or emerging biomarkers. When participants are followed longitudinally, the reversion rates are substantially lower. [2,3] With regard to the suggested treatment studies, the 3 offered references were published after the time of the guideline's updated systematic review. [4-6] In reviewing these publications, we note that the publications did not focus on patients with MCI, an inclusion criterion for the therapeutic studies included in the guideline. We also agree with the uncertainty regarding the current role of biomarkers. This is reflected in recommendations A7a and A7b. [1] Recommendation A7a states that clinicians should counsel patients and families asking about biomarkers that there are no accepted biomarkers at this time. For interested patients, clinicians may discuss the option of biomarker research (recommendation A7b).

1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018;90:126-135.

2. Roberts RO, Knopman DS, Mielke MM, et al. Higher risk of progression to dementia in mild cognitive impairment cases who revert to normal. Neurology 2014;82:317–325.

3. Lopez OL, Becker JT, Chang YF, et al. Incidence of mild cognitive impairment in the Pittsburgh Cardiovascular Health Study-Cognition Study. Neurology 2012;79:1599–1606.

4. Tao J, Chen X, Egorova N, et al. Tai Chi Chuan and Baduanjin practice modulates functional connectivity of the cognitive control network in older adults. Sci Rep 2017;7:41581.

5. Tao J, Liu J, Liu W, et al. Tai Chi Chuan and Baduanjin Increase Grey Matter Volume in Older Adults: A Brain Imaging Study. J Alzheimers Dis 2017;60:389-400.

6. Brasure M, Desai P, Davila H, et al. Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review. Ann Intern Med 2018;168:30-38.

For disclosures, please contact the editorial office at [email protected].

20 February 2018
RE: Author response to Valenzuela et al.
Ronald C. Petersen, Neurologist | Mayo Clinic
Oscar Lopez, Neurologist | University of Pittsburgh Medical Center
Melissa J. Armstrong, Neurologist | University of Florida College of Medicine
Thomas S.D. Getchius, Manager | Heart Rhythm Society
Mary Ganguli, Psychiatrist | Department of Psychiatry, University of Pittsburgh
David Gloss, Neurologist | Charleston Area Medical Center Neurology
Gary S. Gronseth, Neurologist | University of Kansas Medical Center
Daniel Marson, Clinical Neuropsychologist | University of Alabama at Birmingham
Tamara Pringsheim, Neurologist | Cumming School of Medicine, University of Calgary
Gregory S. Day, Neurologist | Knight Alzheimer Disease Research Center, Washington University School of Medicine
Mark Sager, Geriatrician | School of Medicine and Public Health, University of Wisconsin
James Stevens, Neurologist | Fort Wayne Neurological Center
Alexander D. Rae-Grant, Neurologist | Cleveland Clinic Neurological Institute at Lakewood Hospital

The guideline panel thanks Valenzuela et al. for their thoughtful comments on the recommendations concerning the use of cholinesterase inhibitors for treating mild cognitive impairment (MCI). [1] The "may choose not" language resulted from the AAN guideline modified Delphi voting process. As stated in the rationale, the recommendation reflects the fact that some studies could not exclude an important effect of cholinesterase inhibitors on MCI outcomes. The recommendation is also consistent with the donepezil trial, which stated, "the observed relative reduction in the risk of progression to Alzheimer's disease of 58 percent at one year and 36 percent at two years in the entire cohort is likely to be clinically significant" and these data "could prompt a discussion between the clinician and the patient about this possibility." [2] Recommendation B3b reflects the reality that many patients with MCI are receiving cholinesterase inhibitors. [3] Guidelines do not tell clinicians what to do in a specific patient encounter. [4] Individual decisions should be based on shared decision making, which remains relevant in the context of MCI. In this situation, it is critical that clinicians help patients understand the evidence (Recommendation B3b) so that they can make an informed decision consistent with their priorities and preferences.

1. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 2018; 90:126-135.
2. Petersen RC, Thomas RG, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005; 352:2379-2388, 2465-2468.
3. Schneider LS, Insel PS, Weiner MW. Alzheimer's Disease Neuroimaging Initiative. Arch Neurol 2011; 68:58-66.
4. Armstrong MJ, Gronseth GS. Approach to assessing and using clinical practice guidelines. Neurol Clin Pract 2018; 8:1-4.

For disclosures, please contact the Editorial office at [email protected].

Information & Authors

Information

Published In

Neurology®
Volume 90 • Number 3 • January 16, 2018
Pages: 126-135
PubMed: 29282327

Copyright

Copyright © 2017 American Academy of Neurology.

Publication History

Received: February 24, 2017
Accepted: September 22, 2017
Published online: December 27, 2017
Published in print: January 16, 2018

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Authors

Affiliations & Disclosures

Ronald C. Petersen, MD, PhD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
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Mild Cognitive Impairment,Oxford University Press, 2003
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(1) Roche Incorporated, (2) Merck, (3) Genentech, (4) Biogen
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National Institute on Aging: U01-AG006786 (PI) (1986-present) P50-AG016574 (PI) (1990-present) U01-AG024904 (PI) (2004-present) U01 AG016976 (PI) (1989 ? present)
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NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Oscar Lopez, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
Lundbeck,Grifols
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NIA: P50 AG05133-29; 1P01-AG025204-04
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Melissa J. Armstrong, MD, MSc
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) Neurology, Level of Evidence Editorial Board, 2012- current
Patents:
1.
NONE
Publishing Royalties:
1.
(1) Parkinson's Disease: Improving Patient Care, Oxford University Press, 2014
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
(1) American Academy of Neurology Evidence-Based Medicine Methodology Consultant
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
(1) Medscape CME (2016 writing, speaking honoraria)
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) ARHQ, K08HS024159, PI, 2015-2020
Research Support, Academic Entities:
1.
(1) TBI Endpoints Development Initiative (2016-2017)
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Thomas S.D. Getchius
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
March 2017: Received reimbursement for faculty travel expenses to the New York Academy of Medicine.
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Mary Ganguli, MD, MPH
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
(1)DSMB for National Institute on Aging, grant # AG045157 to Indiana University,
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
(1) Alzheimer Association, travel to Alzheimer Association International Conference.
Editorial Boards:
1.
(1) Journal of the American Geriatrics Society, Associate Editor, 2008-present. (2) International Psychogeriatrics, Associate Editor, 1996-present. (3) Alzheimer Disease and Associated Disorders, Editorial Board member, 2011-present.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) National Institute on Aging, K07 AG044395, 2003-2013 (2) National Institute on Aging, R01 AG023651, 2013-2018
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
David Gloss, MD, MPH&TM
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Neurology, LOE Review Team
Patents:
1.
NONE
Publishing Royalties:
1.
(1) Neurology for the Specialty Boards, Lippincott Williams and Wilkins, 2006
Employment, Commercial Entity:
1.
(1) Charleston Area Medical Center, Charleston, WV 25311
Consultancies:
1.
(1) I am an Evidence-based medicine consultant for the American Academy of Neurology
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Gary S. Gronseth, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
(1) Neurology Now, Editorial advisory board, Inception- Present (2) Neurology, Associate Editor, 2013-Present
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
American Academy of Neurology
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Daniel Marson, JD, PhD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
Dr. Marson received an initial honoraria upon signing agreement for writing book entitled: (1) Clinical and Forensic Assessment of Financial Capacity; Publisher: Oxford University Press; Expected publication date 2018
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
(1) Consultant for Janssen Pharmaceuticals
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) NIH grant AG021927 (2004-present, PI) (2) Funded as ADNI site PI for AG24904 (2004-2016) (3) NIH grant AG045154; co-investigator (08/15/14-present)
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
(1) Inventor of Financial Capacity Instrument and Financial Capacity Instrument--Short Form which are both owned by UAB Research Foundation. Have received part of a licensing fee payment received by UABRF for providing the FCI-SF to a company in a clinical trial. (2) Co-inventor of CCTI assessment instrument which is owned by UAB Research Foundation. (1996-present).
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
Provided consultation: State Farm v. Kercinick (2015-2017)(expert witness for plaintiff) Fidelity National Title v. Whitley (2015)(expert witness of plaintiff)
View all articles by this author
Tamara Pringsheim, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Neurology Clinical Practice, Editorial Board Member, 2016, 2017 Canadian Journal of Psychiatry, Editorial Board Member, 2016, 2017
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) Canadian Institutes of Health Research, Principal Investigator 2014/2015; Co-investigator 2016-2018 (2) Sick Kids Foundation, Principal Investigator, 2013-2018 (3) Alberta Mental Health Strategic Clinical Network, 2014-2016
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Gregory S. Day, MD, MSc
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Serve as an ad-hoc Editor for DynaMed (online evidence- based medicine resource; 2016-ongoing) for content related to dementia.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Avid Pharmaceuticals (provision of radiotracer for ongoing research study).
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
1. Barnes Jewish Hospital Foundation
Research Support, Foundations and Societies:
1.
1. American Brain Foundation, Clinical Research Training Fellowship (2016-17) 2. Eugene M Johnson Jr, Weston Brain Institute Postdoctoral Fellowship (2015 Recipient) Stock/Stock Options, Medical Equipment & Materials: 1) Hold stocks (>$10,000) in ANI Pharmaceuticals (a generic pharmaceutical company; 2015 onward).
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Mark Sager, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
James Stevens, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Sanofi-Aventis, Biogen, Lilly, Flamel
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Alexander Rae-Grant, MD
From the Department of Neurology (R.C.P.), Mayo Clinic, Rochester, MN; Department of Neurology (O.L.), University of Pittsburgh Medical Center, PA; Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Psychiatry (M.G.), University of Pittsburgh, PA; Department of Neurology (D.G.), Charleston Area Medical Center, WV; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; Department of Neurology (D.M.), University of Alabama, Birmingham; Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences (T.P.), Cumming School of Medicine, University of Calgary, Canada; Knight Alzheimer Disease Research Center (G.S.D.), Washington University School of Medicine, St. Louis, MO; Wisconsin Alzheimer's Institute (M.S.), School of Medicine and Public Health, University of Wisconsin, Madison; Department of Neurology (J.S.), Fort Wayne Neurological Center, IN; and Department of Neurology (A.R.-G.), Cleveland Clinic, OH.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Neurology, Evidence Review Team, 2011-2017
Patents:
1.
NONE
Publishing Royalties:
1.
Handbook of Multiple Sclerosis, Springer Healthcare, 2010 Comprehensive review of clinical neurology, Wolters Kluwer, 2012 5 minute consult in neurology, Wolters Klower, 2012 Comprehensive review of clinical neurology second edition, LWW, 2016 Ultimate review of neurology DEMOS 2016 Multiple Sclerosis and Related disorders, DEMOS, 2014
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
I edit neurology chapters for dynamic medical, an online text book of medicine which is funded via library subscriptions and receive a fee for work provided. involved in a clinical trial of biotin for multiple sclerosis with MedDay (no personal remuneration)
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
CO-PI 4% effort FMRI as an imaging biomarker for preclinical Alzheimer's disease, 2013-2017 NIH grant #A6022304
Research Support, Academic Entities:
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Notes

Correspondence American Academy of Neurology [email protected]
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Approved by the Guideline Development, Dissemination, and Implementation Subcommittee on July 16, 2016; by the Practice Committee on August 22, 2016; and by the AAN Institute Board of Directors on October 5, 2017.
This guideline was endorsed by the Alzheimer's Association on May 1, 2017.

Author Contributions

Dr. Petersen: study concept and design, acquisition of data, analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content, study supervision. Dr. Lopez: study concept and design, analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content. Dr. Armstrong: analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content, study supervision. T.S.D. Getchius: study concept and design, study supervision. Dr. Ganguli: study concept and design, analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content. Dr. Gloss: analysis or interpretation of data, study supervision. Dr. Gronseth: analysis or interpretation of data. Dr. Marson: study concept and design, analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content. Dr. Pringsheim: analysis and interpretation of data, study supervision. Dr. Day: analysis and interpretation of data, study supervision. Dr. Sager: study concept and design, analysis or interpretation of data, critical revision of the manuscript for important intellectual content. Dr. Stevens: study concept and design, analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content. Dr. Rae-Grant: analysis or interpretation of data, drafting/revising the manuscript, critical revision of the manuscript for important intellectual content.

Conflict of Interest

The American Academy of Neurology (AAN) is committed to producing independent, critical, and truthful clinical practice guidelines (CPGs). Significant efforts are made to minimize the potential for conflicts of interest to influence the recommendations of this CPG. To the extent possible, the AAN keeps separate those who have a financial stake in the success or failure of the products appraised in the CPGs and the developers of the guidelines. Conflict of interest forms were obtained from all authors and reviewed by an oversight committee prior to project initiation. The AAN limits the participation of authors with substantial conflicts of interest. The AAN forbids commercial participation in, or funding of, guideline projects. Drafts of the guideline have been reviewed by at least 3 AAN committees, a network of neurologists, Neurology peer reviewers, and representatives from related fields. The AAN Guideline Author Conflict of Interest Policy can be viewed at aan.com. For complete information on this process, access the 2004 AAN process manual.7

Disclosure

R. Petersen has served as a consultant for Roche Inc., Merck Inc., Genentech Inc., and Biogen Inc.; receives publishing royalties from Oxford University Press; performs clinical procedures relating to mild cognitive impairment in his clinical neurology practice; and receives research support from the National Institute on Aging of the NIH. O. Lopez has been a consultant for Grifols Inc., Lundbeck, and Raman Technologies and has received grant support from the NIH. M. Armstrong serves on the Level of Evidence editorial board for Neurology® (but is not compensated financially) and serves as an evidence-based medicine methodologist for the American Academy of Neurology (AAN). T. Getchius was an employee of the AAN and has nothing to disclose. M. Ganguli has served on the data safety and monitoring board for Indiana University and on the advisory committee for Biogen Inc. and has received research support from the National Institute on Aging of the NIH. D. Gloss serves as an evidence-based medicine methodologist for the AAN. G. Gronseth serves as associate editor for Neurology, serves on the editorial advisory board for Neurology Now, and is compensated by the AAN for methodologic activities. D. Marson serves as a consultant for and received royalties from Janssen Pharmaceuticals and receives research support from the National Institute on Aging for the NIH. T. Pringsheim has received financial reimbursement for travel to attend the Movement Disorder Society Meeting from Allergan Canada and Teva Canada Innovation and has received research support from Shire Canada Inc. and the Canadian Institutes of Health Research. G. Day received honoraria for serving as faculty at the 2016 AAN annual meeting and holds stock (>$10,000) in ANI Pharmaceuticals (generic manufacturer). M. Sager, J. Stevens, and A. Rae-Grant report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.

Study Funding

This practice guideline was developed with financial support from the American Academy of Neurology. Authors who serve as AAN subcommittee members, methodologists, or employees, past or present (M.J.A., T.S.D.G., D.G., G.S.G., T.P., G.S.D, A.R.G.), were reimbursed by the AAN for expenses related to travel to subcommittee meetings where drafts of manuscripts were reviewed.

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