Focusing on Brain Health: Managing Cognitive Impairment in Primary Care Settings


Eric G. Tangalos, MD, FACP, AGSF, CMD
Professor of Medicine
Division of Primary Care Internal Medicine, Geriatrics and Palliative Care
Mayo Clinic
Rochester, MN
Eric G. Tangalos, MD, FACP, AGSF, CMD

Dr. Eric Tangalos is Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. He served as Chair of Primary Care Internal Medicine from 1997 to 2006. Dr. Tangalos received his undergraduate training from the University of Michigan, is a graduate of the Loyola University Stritch School of Medicine in Chicago, and was a resident and fellow in Internal Medicine at Mayo.

He is a past president of AMDA, The Society for Post-Acute and Long-Term Care Medicine, and is a fellow and past governor of the American College of Physicians. He is a past director of the American Geriatrics Society and serves on their Foundation for Health in Aging. Dr. Tangalos served 8 years on the national board of the Alzheimer’s Association and was a member of their executive committee. He also served as Chair of the Omnicare P&T Committee for 20 years.

Dr. Tangalos was Medical Director at the Samaritan Bethany nursing home from 1981 until his retirement from Mayo in 2019.  His certification as a medical director is current and will be approved again by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) in June 2022.  He is currently recredentialed by Mayo for continuing service both to the Rochester campus and the Health Care System in Minnesota.  Over the past 3 years he has worked face-to-face with patients in Austin and has provided in-basket coverage to Austin, Albert Lea, Faribault, and Owatonna.

Dr. Tangalos has been an investigator with the Mayo Clinic Alzheimer’s Disease Research Center since 1987 and is currently active with the Alzheimer’s Association as course director for a Project ECHO seminar series. Additionally, Dr. Tangalos continues to review NIH SBIR/STTR grant applications while working as a founding member of the American Telemedicine Association.

Sharon Cohen, MD, FRCPC
Behavioural Neurologist, Founder and Medical Director, Toronto Memory Program, Toronto, Canada
Sharon Cohen, MD, FRCPC

r. Sharon Cohen, MD, FRCP, is a behavioural neurologist and the medical director of the Toronto Memory Program, a community-based medical facility which she established in 1996 for the purpose of enhancing diagnosis and treatment for individuals with Alzheimer’s disease and related disorders. Her memory clinic and dementia research site are among the most active in Canada. Dr. Cohen has over 28 years of experience in clinical research and has been a site primary investigator for over 180 pharmacological trials in dementia, including phase 1 trials. She represents Canada on international advisory boards and steering committees and is a consultant to a wide range of stakeholders including government organizations and patient advocacy groups. She is a frequent lecturer and contributes to media events including those on medical ethics. Additionally, she is known for her advocacy of individuals with neurodegenerative diseases.

Despite holding academic and hospital appointments, Dr. Cohen chooses to practice in the community, in keeping with her belief that dementia care and clinical research are best offered in the real-world setting.

Tatiana Sadak, PhD, PMHNP, ARNP; RN, FAAN, FGSA
Associate Dean of Academic Affairs (interim), University of Washington School of Nursing
Executive Director, Dementia Palliative Education Network, Neurodegenerative Disorders Specialist, Psychiatric Wellness & Dementia Care, Seattle, WA
Tatiana Sadak, PhD, PMHNP, ARNP; RN, FAAN, FGSA

Tatiana Sadak, PhD, PMHNP, ARNP, RN, FAAN, FGSA, is an Interim Associate Dean of Academic Affairs and a Director of the Dementia Palliative Education Network (DPEN) at the University of Washington School of Nursing, Seattle. She is a Certified Psychiatric Mental Health Nurse Practitioner specializing in Geriatric Psychiatry and Neurodegenerative Disorders. Her research and scholarship focus on informing health care delivery for people living with dementia and their care partners by generating evidence, measurement tools, and interventions aimed to support clinicians and families working together to prevent avoidable health crises and enable care partners to manage care recipients’ health without sacrificing their own wellness.

This work has been recognized with Tatiana’s selection as a fellow of the American Academy of Nursing and the Gerontological Society of America. Dr. Sadak has received awards as a Distinguished Educator in Gerontological Nursing, a Top Doctor/Nurse Practitioner in Psychiatry, and was recognized for a distinguished single research manuscript addressing Gerontological Nursing. Dr. Sadak currently serves on the Board of Directors of the de Tornyay Center for Healthy Aging and the National Hartford Center of Gerontological Excellence.

Statement of Need

Primary care professionals (HCPs) are key to the early identification of Alzheimer’s disease (AD) and other cognitive impairments (CIs). Brain health discussions and cognitive screening are critical, as recent American Heart Association (AHA)/American Stroke Association (ASA) statements/guidelines have reaffirmed that U.S. dementia cases are estimated to triple by 2050. However, there is currently a lack of standard practice protocols for how HCPs should engage patients and families in brain health discussions and conduct cognitive assessments in primary care settings. Consequently, CI often goes unrecognized more than 50% of the time in patients age > 70, with a delay of 3 years from start of symptoms to diagnosis of AD. Clinicians should optimize discussions on brain health early and routinely and screen for CI as part of annual wellness exams to detect CI onset while mild.

Please join expert faculty for this CMEO video webcast on best practices for diagnosing CIs. The activity will include strategies for engaging patients in discussions on brain health, integrating cognitive screenings into wellness visits, employing appropriate follow-up and referral, and implementing a coordinated care approach.

Learning Objectives

At the end of this CME/CE activity, participants should be able to:

  • Integrate discussions of brain health and cognitive screenings into wellness visits with patients and caregivers.
  • Employ appropriate follow-up assessment and referral for specialized diagnosis for patients with mild cognitive impairment (MCI).
  • Implement a coordinated care approach within the treatment team for the ongoing management of patients with CI.

Financial Support

Supported by an educational grant from Genentech, a member of the Roche Group.

Target Audience

Physicians, physician associates (PAs), nurse practitioners (NPs), nurses, pharmacists, and psychologists specializing in primary care

Credit Information

Jointly Accredited Provider

In support of improving patient care, CME Outfitters, LLC, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

Interprofessional (IPCE) 1.0

This activity was planned by and for the healthcare team, and learners will receive 1.0 Interprofessional Continuing Education (IPCE) Credit for learning and change.

Physicians (ACCME) 1.0

CME Outfitters, LLC, 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.

Nurses (ANCC) 1.0

This activity is designated for 1.0 contact hour.

Note for California Nurses

This continuing nursing education activity was approved by the California Board of Registered Nursing. CME Outfitters, LLC’s provider number is CEP15510.

Pharmacists (ACPE) 1.0

This application-based activity is approved for 1.0 contact hour (0.10 CEUs) of continuing pharmacy credit.
Activity UAN: JA0007185-0000-22-152-H01-P

Physician Assistants (AAPA): 1.0

CME Outfitters, LLC, has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until the expiration date listed above. PAs should only claim credit commensurate with the extent of their participation.

Psychologists (APA) 1.0

Continuing Education (CE) credits for psychologists are provided through the co-sponsorship of the American Psychological Association (APA) Office of Continuing Education in Psychology (CEP). The APA CEP Office maintains responsibly for the content of the programs.


Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC point in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

MIPS Improvement Activity

Completion of this accredited CME activity meets the expectations of an Accredited Safety or Quality Improvement Program (IA_PSPA_28) for the Merit-based Incentive Payment Program (MIPS). Clinicians should submit their improvement activities by attestation via the CMS Quality Payment Program website.

Royal College MOC

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of their CE activities. Faculty must disclose to the participants any relationships with commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CE activity. CME Outfitters, LLC, has evaluated, identified, and mitigated any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process.

Dr. Tangalos reports the following financial relationships: Research Support: National Institutes of Health (NIH); Consultant: Acadia Pharmaceuticals Inc.; Biogen; Eisai Inc.; and Genentech, Inc.; Stock Shareholder (direct purchase): AbbVie Inc.; Johnson & Johnson; and Pfizer Inc. Other Financial or Material Support: Alzheimer’s Association (Project ECHO course director); Cyclo Therapeutics, Inc. Data and Safety Monitoring Board (DSMB); and Prothena DSMB

Dr. Cohen reports no financial relationships to disclose.

Dr. Sadak reports the following financial relationships: Advisory Board: Board of Directors, National Hartford Center of Gerontological Nursing Excellence; Board of Directors, DeTornyay Center for Healthy Aging; WA State Nursing Care Quality Assurance Commission, Critical Gaps in LTC; and WA Dementia Action Collaborative. Grants and Research Support: National Institutes of Health (NIH); Health Resources & Services Administration (HRSA); Washington Department of Social & Health Services/Health Care Authority (WA DSHS/HCA).

Dr. Hempstead (content reviewer) reports the following financial relationships: Financial and Material Support: Alzheimer’s Association ISTAART Nonpharmacologic Intervention (Professional Interest Area Chair International); Neuropsychological Society (Chair of Continuing Education Committee); Oxford University Press (book royalties); and Soterix Medical Inc. (Licensed neuromodulation headgear device)

Disclosures were obtained from the CME Outfitters, LLC staff: No disclosures to report.

  • Marlon (Tony) Graham, MD
  • Evan Luberger (planning committee)
  • Kellie Busby, PharmD (planning committee)
  • Susan H. Yarbrough, CHCP (planning committee)
  • Sandra Caballero, PharmD (planning committee)
  • Sharon Tordoff (planning committee)

Faculty of this CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices.

Obtaining Credits

Post-tests, credit request forms, and activity evaluations must be completed online (requires free account activation), and participants can print their certificate or statement of credit immediately (75% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit our Privacy & Confidentiality page.

Questions about this activity?

Call us at (877) CME-PROS or (877) 263-7767.



Focusing on Brain Health: Managing Cognitive Impairment in Primary Care Settings
Event Date: 12/07/2022 at 5:00 am EST