Continuing Medical Education

After evaluating an article designated for Continuing Medical Education (CME) in the American Journal of Clinical Nutrition (AJCN), participants in the American Society for Clinical Nutrition (ASCN) CME program should be able to show that their knowledge of clinical nutrition has increased. Participants should also be able to evaluate whether the clinical information provided in the CME-designated article is relevant to the provision of patient care.

Accreditation and credits

The ASCN is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASCN designates each CME program for 1 hour of category 1 credit toward the American Medical Association (AMA) Physician’s Recognition Award. Each physician should claim only those hours of credit that he or she actually spent on the education program.

Instructions

{cmetexp}Each issue of the AJCN will usually include at least 2 articles designated for CME credit. After reading the CME-designated article, select the best answer to each exam question listed below and complete the evaluation. To receive CME credit, you should return the exam and evaluation pages along with the CME Participant Response Form by August 31, 2006. Please fax the pages to the ASCN at 301-634-7350 or mail them to the following address: American Society for Clinical Nutrition, CME Program, 9650 Rockville Pike, Bethesda, MD 20814. Note that all responses must be prepaid. Answers to the questions will be mailed to all participants, and certificates of credit will be sent to participants who successfully complete each exam. Please be sure to make a photocopy of the exam for your records before submitting it to the ASCN.

Article:

Tucker KL, Qiao N, Scott T, Rosenberg I, Spiro A III. High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am J Clin Nutr 2005;82:627–35.

Article:

Ravaglia G, Forti P, Maioli F, et al. Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr 2005;82:636–43.

One hour of category 1 credit will be issued for successful completion of this entire exam.

CME exam

1. Which one of the following statements best describes relations among homocysteine concentrations and dementia?

1. Persons with elevated homocysteine concentrations of any cause are at no greater risk of development of dementia or Alzheimer disease.
   
2. An elevated homocysteine concentration in a healthy elderly person increases the likelihood of development of dementia or Alzheimer disease with further aging.
   
3. Lowering homocysteine concentrations with folate, vitamin B-12, or vitamin B-6 has been shown to prevent dementia in aging persons.
   
4. Fortification of the US diet with folic acid has been shown to have a positive effect on decreasing the incidence of dementia in aging persons.
   

2. Which one of the following statements is most likely to be true regarding mechanisms of worsening brain function in aging persons with elevated serum homocysteine concentrations?

1. Subclinical cerebrovascular disease is widely accepted as the cause of dementia in aging persons with high homocysteine concentrations.
   
2. Elevated brain homocysteine concentrations may increase neurotoxicity through activation of N-methyl-D-aspartate receptors.
   
3. Low concentrations of vitamin B-12, vitamin B-6, and folate are proven causes of dementia regardless of homocysteine concentrations.
   
4. There is no evidence of an association of elevated serum homocysteine and risk of dementia.
   

CME exam evaluation

1. Were the CME program objectives successfully met?

1. Yes
   
2. No
   
3. Partially (please explain)
   

2. Did you find this article and its CME questions relevant to your practice?

1. Yes
   
2. No
   
3. Partially (please explain)
   

3. Will completion of this CME exam affect the way that you treat your patients?

1. Yes (please explain)
   
2. No
   

4. Was the information presented in this article objective, balanced, and free of commercial bias?

1. Yes
   
2. No
   
3. Comments