Alzheimer's Definitions, Biomarkers, and Antibodies: Halima Amjad, Barak Gaster, and Heather Whitson
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 03/12/2026
GeriPal - A Geriatrics and Palliative Medicine Podcast
Can we prevent age-related cognitive decline, and perhaps even head off Alzheimer’s disease and related dementias before they start? Pharmaceutical companies are spending billions searching for a magic bullet pill to answer that question. But what if the solution requires more than a single drug? What if real prevention demands a multi-domain approach that combines targeted diet, exercise, social engagement, and vascular risk factor management among other things? On today’s episode, we explore multi-domain interventions for cognitive risk reduction with two leading experts: Laura D....
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In 1987, lovastatin became the first FDA-approved statin in the United States. Four decades later, statins are among the most frequently prescribed medications nationwide, with atorvastatin topping the overall list. Now, updated guidelines have expanded statin eligibility to cover nearly every older adult. On today’s episode, we are joined by experts Tim Anderson, Rita Redberg, and Mike Rich to discuss when to start, and when to stop, statin therapy in older adults. Topics we talk about on starting and stopping statins in older adults include: Updates and changes for statin use in older...
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When you think of palliative care pharmacotherapy, you probably think about the tried-and-true mainstays of our field like morphine, haloperidol, and senna. But the landscape of palliative symptom management is rapidly evolving, with hot new drug classes and rediscovered old-school opioids (and not just buprenorphine!) On today’s episode of the GeriPal Podcast, we sit down with three expert palliative care clinical pharmacists, Max Stevenson, Alex McPherson, and Nisha Iyer, to talk about 5 hot new drugs (or rediscovered): Suzetrigine: It works for bunions (at least as well as opioids,...
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Love the story Judy Solerno tells at the start of this podcast. The story is about how mapped out cases of Cholera in London in the year 1854. He was able to identify a concentration of cases near a neighborhood water pump. Simply removing the handle from the pump halted the outbreak. This is one of the earliest recorded uses of maps for public health purposes. Our guests today, Judy Salerno (President Emeritus of the ) and Lindsay Goldman (CEO of ) have done some wonderful work creating detailed, in-depth, interactive maps of aging in New York City. Go to and try it...
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Just in time for respiratory virus season, this episode of the podcast breaks down essential vaccine guidance for older adults. From flu, COVID-19, and RSV to an added bonus deep dive into shingles, we cover everything you need to know to protect older adults this season. Our expert guests include: Kenneth Schmader, MD: A geriatrician and vaccine researcher who helped develop the zoster vaccine. Ken serves on the Working Groups for the Herpes Zoster, Influenza, COVID-19, RSV and General Adult Immunization Guidelines for the US Centers for Disease Control (CDC) Advisory Committee on...
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Difficulty managing money is often one of the earliest signs of Alzheimer's disease and related dementias, frequently appearing years before an official diagnosis. This loss of financial capacity leaves individuals vulnerable to costly mistakes and exploitation, threatening the financial security and quality of life of entire families. In this episode, we sit down with Dr. Lauren Hersch Nicholas, Dr. Duke Han, and Dr. Jason Karlawish to examine the intersection of cognitive decline, financial decision-making, and patient protection. We covered a lot of topics, including these key ones: The...
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GLP-1 receptor agonists (the "Ozempics of the world") have been a truly revolutionary pharmacological advance in modern medicine. In randomized controlled trials (RCTs), these agents have been shown to do much more than just reduce weight, including significantly reducing cardiovascular events, lowering all-cause mortality in patients with type 2 diabetes, and even slowing the progression of chronic kidney disease. But as we see their use rapidly expand among older adults, we have to ask: at what cost? In geriatrics, weight loss is rarely simple. In older bodies, GLP1s carry increased risks,...
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As Diane Meier remarks to start today’s podcast, palliative care has come a long way from the days when we were the “brink of death” consult. We’re seeing patients earlier and earlier in the course of illness. In fact, the for specialist palliative care is arguably stronger in the outpatient setting than the inpatient setting. In some ways, as Eric remarked, we are a victim of our own success. We’ve pushed on the boundaries of seeing patients earlier in the course of illness, we’ve demonstrated remarkable value to our colleagues and health systems: now they want us to see...
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Up until just a couple years ago, an 85-year-old patient presenting with gradual, amnestic memory loss was almost automatically presumed to have Alzheimer’s disease. However, new biomakers and the recognition of conditions like Limbic-predominant age-related TDP-43 encephalopathy (LATE) are reshaping our understanding of cognitive decline in older adults. It’s looking more clear that pure Alzheimers dementia is rare in older adults, and co-occurring pathologies that may include Alzheimer's, LATE, Lewy Body, and vascular neuropatholigies, are the rule rather than the exception. In...
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Can simple, evidence-based video decision aids—paired with structured clinician training—improve Advance Care Planning (ACP) documentation and goal-concordant care? That’s the question we pose in this week's podcast with Dr. Joshua Lakin and Dr. Kei Ouchi. We break down the methodologies behind two major clinical trials in which they were involved that implemented this video-enhanced approach. The f was a multicenter, parallel randomized trial of 598 seriously ill older adults in emergency departments (EDs). It tested whether watching a 5-minute video and having a short, 10-minute...
info_outlineIt’s an era of breakthroughs in Alzheimer’s research, yet for many clinicians, it’s also a time of profound uncertainty. We are currently navigating competing definitions of the disease, multiple new biomarkers coming on market seemingly every week, and the clinical rollout of new amyloid antibodies.
How do we translate this rapid-fire science into daily practice? On this week’s GeriPal podcast, we sit down with dementia experts Halima Amjad, Barak Gaster, and Heather Whitson. We dive deep into:
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The evolving definitions of Alzheimer’s disease. Does someone have Alzheimer's disease if you have only an abnormal biomarker as defined by the Alzheimer's Association, or is amyloid pathology necessary but not sufficient to define Alzheimer's as per the International Working Group (IWG) recommendations?
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Where do blood-based biomarkers for Alzheimer's fit into the diagnostic workup, and should they be used at all in primary care? FYI - here is my take on that question in a recent JAMA IM article titled “The Limited Role of Alzheimer's Disease Blood-Based Biomarkers in Primary Care.”
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What’s the role of amyloid antibodies in the care of individuals with Alzheimer's disease, including who to use them on?
We covered a lot and discussed some of these resources that you can do a deeper dive on:
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Blood-based biomarker resources
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JAMA article on Blood-Based Biomarkers for Alzheimer's Disease: Preventing Unintended Consequences
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Alzheimer's Dementia article on Blood-based biomarkers for detecting Alzheimer's disease pathology in cognitively impaired individuals within specialized care settings: A systematic review and meta-analysis
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JAMA IM article on The Limited Role of Alzheimer Disease Blood-Based Biomarkers in Primary Care
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Appropriate use recommendations for amyloid antibodies
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Primary Care Resources
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A JAGS article on “Large Health System Quality Improvement Intervention Providing Training and Tools to Improve Detection of Cognitive Impairment in Primary Care”
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Other resources
By Eric Widera