Valerie T Cotter

Associate Professor Johns Hopkins School of Nursing, Nurse Practitioner Johns Hopkins Memory & Alzheimer's Treatment Center, Sojourns Scholar Cambia Foundation

[Valerie T Cotter @ValCottervt]

Congratulations @VanessaBattist4 so deserved!!

[Hospice and Palliative Nurses Association (HPNA) @HPNAinfo]

Congratulations to the following 2025 award recipients who were recognized today! 🎉

Carol Gallo
2025 HPNA Champion Award

Vanessa Battista, DNP, MBA, MS, CPNP-PC, CHPPN®, FPCN®, FAAN
2025 HPNA Distinguished Nursing Practice Award

Judy Paice, PhD, RN, ACHPN®, FAAN, FASCO
2025 HPNA Vanguard Award

Nancy Dias, PhD, MSN, RN, FPCN®
2025 HPNA Volunteerism Award

[Hospice and Palliative Nurses Association (HPNA) @HPNAinfo]

Congratulations to the following 2025 award recipients who were recognized today! 🎉

Carol Gallo
2025 HPNA Champion Award

Vanessa Battista, DNP, MBA, MS, CPNP-PC, CHPPN®, FPCN®, FAAN
2025 HPNA Distinguished Nursing Practice Award

Judy Paice, PhD, RN, ACHPN®, FAAN, FASCO
2025 HPNA Vanguard Award

Nancy Dias, PhD, MSN, RN, FPCN®
2025 HPNA Volunteerism Award

[Valerie T Cotter @ValCottervt]

Fly Eagles fly! 🦅

[Suzanne E Schindler @SuzanneESchind1]

Having started my career in basic neuroscience research, I have always understood Alzheimer disease to mean the pathophysiology associated with amyloid plaques and tau tangles. As a clinician, I appreciate that the relationship between Alzheimer disease and cognitive impairment is complex.

1. Clinically diagnosing the cause of cognitive impairment is different than diagnosing that the patient has Alzheimer disease (pathology). Many of my patients with cognitive impairment have multiple diagnoses (e.g., sleep apnea, medication-related cognitive dysfunction, depression, previous cerebral infarction), and sometimes have Alzheimer disease (based on biomarker testing). I do what I can to mitigate the effects of all of these conditions, and when Alzheimer disease is present I do not assume that it is the sole or even the primary cause of cognitive impairment. This is true across multiple potential etiologies: for example, I may diagnose someone with cerebrovascular disease and a prior infarct based on MRI findings, but determine that this condition is asymptomatic and not contributing to their cognitive impairment.

2. Given the simplicity of some biomarker tests and the difficulty of clinical assessment, there is a risk that clinicians may diagnose the etiology of cognitive impairment as Alzheimer disease without doing a full work-up. This is why appropriate use recommendations for biomarkers always mandate that biomarker results must be integrated with a clinical evaluation and not used as a “stand-alone.”

3. Alzheimer disease pathology accumulates silently for ~10-20 years before the onset of cognitive impairment. However, during this pre-clinical phase the accumulation of amyloid pathology is associated with many other biomarker changes that appear pathological (e.g., abnormal CSF synaptic biomarkers, brain atrophy, brain hypometabolism). While the brain is remarkably resilient to damage and individuals may or may not develop symptoms, the brain is sick and the pre-clinical phase is a disease state.

4. Suggesting that a disease only exists when organs are severely damaged and failing (dementia) seems counter to what we have learned in other areas of medicine. For example, patients diagnosed with hypertension or asymptomatic coronary artery disease may change their diet and medications to avoid a heart attack. Individuals with asymptomatic chronic kidney disease may or may not go on to require dialysis, but they can be monitored and sometimes treated.

5. There are valid concerns about the stigma and risks of asymptomatic individuals being labeled as having Alzheimer disease given that they may or may not develop cognitive impairment. The solution is simple—we don’t perform biomarker testing in asymptomatic individuals outside of research studies or clinical trials. Again, this has been mandated by appropriate use recommendations for biomarkers.

We can help patients by promoting accurate understanding and appropriate use of biomarkers. #EndAlz

[Valerie T Cotter @ValCottervt]

Congratulations! @ShanshanWang108

[Shanshan Wang @ShanshanWang108]

Honored to have been awarded the Distinguished Educator in Gerontological Nursing from @NHCGNE

[Valerie T Cotter @ValCottervt]

Congratulations Trish!!

[Caleb Ferguson @calebferg]

Congratulations Trish, well deserved!

[Valerie T Cotter @ValCottervt]

Congratulations Emma! @JHpsychNP

[Valerie T Cotter @ValCottervt]

Congratulations @JoanGCarpenter

[Carpenter Collaborative @CarpenterCoLab]

Our PI’s relentless dedication and passion for research continue to inspire all of us. Last week, her remarkable contributions were recognized by the GAPNA, awarding her the Excellence in Research Award! 🏆 congrats, @JoanGCarpenter! 🏆 #GAPNA24

[Pope Francis – ARCHIVE @Pontifex266Arch]

If good things exist and endure in this world, it is only because so many times love has prevailed over hate, solidarity over indifference, generosity over selfishness. Nothing that lasts can exist or grow without love. #ApostolicJourney

[Valerie T Cotter @ValCottervt]

Very proud of our recent pub Feasibility of Using Simulation to Evaluate Implementation Fidelity in an Advance Care Planning... - https://t.co/6RzaGV4KoF #ScholarAlerts

[Eric Widera, MD @EWidera]

Who do you want on a work group revising the definition of #Alzheimer’s disease? The system is broken when Pharma and diagnostic companies are the ones defining who is sick. @NIHAging knew this when NIH told them to take their name off the workgroup title
https://t.co/94maF4x7p4

[Valerie T Cotter @ValCottervt]

Congratulations @ShanshanWang108 🌟🌟

[Patricia Davidson @DrPMDavidson]

Congratulations @ShanshanWang108 🙌

[Eric Widera, MD @EWidera]

Alzheimer’s Association now saying the quiet part out loud in their grand plan to attempt to both rename asymptomatic individuals with amyloid as having Stage 1 Alzheimers disease and arguing that access to amyloid antibodies “should not be delayed at ANY stage”.

[Valerie T Cotter @ValCottervt]

Congratulations @SherryGPhD

[Sherry Greenberg (she/her/hers) @SherryGPhD]

Thank you @Hunter_College I am looking forward to this exciting new opportunity!

[Pope Francis – ARCHIVE @Pontifex266Arch]

We do not weave the fabric of human history by lumping together unverified information, repeating banal and falsely persuasive speeches, and shocking others with declarations of hatred. These actions strip people of their dignity. #NoToHate

[Valerie T Cotter @ValCottervt]

Congratulations @hailey_n_miller

[Johns Hopkins ICTR @ictrjhu]

Congratulations @hailey_n_miller! 🥳👏 #Hypertension #Research #HeartHealth

[Hopkins Nursing @JHUNursing]

The "DNP Role Development for Doctoral Advanced Nursing Practice" textbook, Co-edited by @ValCottervt and co-authored by @bvangra1, @DebBuschPNP, @tmslaterACN, @gbdouglass3, Dr. Jessica Peters, and several #JSHON DNP students, is available now! https://t.co/aDnFl64xZK

[Valerie T Cotter @ValCottervt]

Congratulations @ShanshanWang108 💐

[Patricia Davidson @DrPMDavidson]

Congratulations @ShanshanWang108

[Valerie T Cotter @ValCottervt]

Congratulations @AnessaFoxwell 💐🥂💐

[Penn Nursing @PennNursing]

Anessa Foxwell, our PhD student speaker, delivers an inspiring address at the 2024 #PennNursing Commencement. Join us in celebrating her success and the Class of 2024!

[Madhav Thambisetty @MadhavThambiset]

New JAMA viewpoint with @ProfRobHoward "Conveying information from incomplete reporting of clinical trials risks endangering patients, undermines faith in clinicians & eventually betrays the hope that scientific advances will translate into safe & effective Rx for #Alzheimer's