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 Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699. doi:10.1111/j.1532-5415.2005.53221.x Cummings J, Aisen P, Apostolova LG, Atri A, Salloway S, Weiner M. Aducanumab: appropriate use recommendations. J Prev Alzheimers Dis. 2021;8(4):398-410. doi:10.14283/jpad.2021.41 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 Gottesman RF, Stern Y, Provencio-Dean N, et al. The American Heart Association’s seven core metrics of cardiovascular health (Life’s Simple 7) and cognitive health. Stroke. 2017;48(5):1414-1421. doi:10.1161/STROKEAHA.116.015093 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