48 - The cardiometabolic-dementia connection (21 min)
Cognitive decline is not an isolated brain disease but is deeply intertwined with systemic vascular and metabolic health. In this episode, Maeson Latsko, PhD, is joined by cardiologist Dr Marc Penn and neurologist Dr Michael Racke to break down the physiological links between cardiometabolic conditions and dementia. They discuss why primary care providers are the frontline defense in preventing cognitive decline, outlining a practical, 5-pillar diagnostic framework to identify at-risk patients. The conversation covers the clinical gaps in current screening, the utility of ruling out secondary causes of dementia, and how advanced Alzheimer's biomarkers can streamline specialist referrals and enable earlier intervention.
This episode will
Examine how cardiometabolic diseases like diabetes and hypertension contribute to neurodegeneration and cognitive decline (1:40)
Detail a 5-pillar framework for a comprehensive cognitive assessment that addresses nutritional, thyroid, inflammatory, metabolic, and circulatory health (8:20)
Discuss the role of advanced blood-based biomarkers for both identifying secondary causes of dementia and confirming Alzheimer's disease pathology (14:40)
Speakers: Maeson Latsko, PhD; Michael Racke, MD; Marc Penn, MD, PhD
Contributors: Maeson Latsko, PhD; Michael Racke, MD; Marc Penn, MD, PhD; Natalie Cuttic; Kathryn Morales; Trisha Winchester, PhD, MBA; Millicent Kee, MSN, APRN, FNP-BC; Rebecca Johnson Wheeler, MS, CGC
Ordering information
Cognitive Assessment Panel
AD-Detect™ ABeta 42/40 and p-tau217 Evaluation, Plasma
Additional resources
Podcast - Empowering primary care in the new era of Alzheimer’s disease diagnostics (25 min)
Podcast - Instant insights: Blood-based biomarkers for Alzheimer’s Disease (8 min)
Podcast - The Cardiometabolic approach: A solution to modern disease risk assessment (20 min)
References
Centers for Medicare & Medicaid Services. Cognitive assessment & care plan services. Medicare.gov. Accessed September 22, 2026. https://www.medicare.gov/coverage/cognitive-assessment-care-plan-services
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Jack CR Jr, Bennett DA, Blennow K, et al. NIA-AA Research Framework: toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14(4):535-562. doi:10.1016/j.jalz.2018.02.018
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Atri A, Dickerson BC, Clevenger C, et al. Alzheimer's Association Clinical Practice Guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): executive summary of recommendations for primary care. Alzheimers Dement. 2025;21(6):e14333. doi:10.1002/alz.14333
Kramer ES, Johnson MN, Winslow B. Evaluation of suspected dementia. Am Fam Physician. 2025;112(6):657-667. Accessed September 29, 2026. https://www.aafp.org/afp/2025/1200/suspected-dementia-evaluation
Galvin JE, Sadowsky CH; NINCDS-ADRDA. Practical guidelines for the recognition and diagnosis of dementia. J Am Board Fam Med. 2012;25(3):367-382. doi:10.3122/jabfm.2012.03.100181
Woodward M, Brodaty H, McCabe M, et al. Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment. J Alzheimers Dis. 2022;89(3):803-809. doi:10.3233/JAD-220288