MCI; MCI due to AD; Prodromal AD; Questionnaire; Survey; Alzheimer Disease/diagnosis; Cognitive Dysfunction/diagnosis; Europe; Female; Humans; Male; Middle Aged; Neurology; Prodromal Symptoms; Surveys and Questionnaires; Attitude of Health Personnel; Alzheimer Disease; Cognitive Dysfunction; Neurology (clinical); Cognitive Neuroscience
Abstract :
[en] INTRODUCTION: The diagnosis of mild cognitive impairment (MCI) refers to cognitive impairment not meeting dementia criteria. A survey among members of the American Association of Neurology (AAN) showed that MCI was considered a useful diagnosis. Recently, research criteria have been proposed for the diagnosis of Alzheimer's disease (AD) in MCI based on AD biomarkers (prodromal AD/MCI due to AD). The aim of this study was to investigate the attitudes of clinicians in Europe on the clinical utility of MCI and prodromal AD/MCI due to AD criteria. We also investigated whether the prodromal AD/MCI due to AD criteria impacted management of MCI patients.
METHODS: An online survey was performed in 2015 among 102 members of the European Academy of Neurology (EAN) and the European Alzheimer's Disease Consortium (EADC). Questions were asked on how often criteria were used, how they were operationalized, how they changed patient management, and what were considered advantages and limitations of MCI and prodromal AD/MCI due to AD. The questionnaire consisted of 47 questions scored on a Likert scale.
RESULTS: Almost all respondents (92%) used the MCI diagnosis in clinical practice. Over 80% of the EAN/EADC respondents found a MCI diagnosis useful because it helped to label the cognitive problem, involve patients in planning for the future, and start risk reduction activities. These findings were similar to those reported in the AAN survey. Research criteria for prodromal AD/MCI due to AD were used by 68% of the EAN/EADC respondents. The most common reasons to use the criteria were increased certainty of diagnosis (86%), increased possibilities to provide counseling (51%), facilitation of follow-up planning (48%), start of medical intervention (49%), and response to patients' wish for a diagnosis (41%). Over 70% of the physicians considered that a diagnosis of prodromal AD/MCI due to AD had an added value over the MCI diagnosis.
CONCLUSIONS: The diagnostic criteria of MCI and prodromal AD/MCI due to AD are commonly used among EAN/EADC members. The prodromal AD/MCI due to AD were considered clinically useful and impacted patient management and communication.
Disciplines :
Neurology
Author, co-author :
Bertens, Daniela ; Alzheimer Centre, Department of Neurology, VU University Medical Centre, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. d.bertens@vumc.nl
Vos, Stephanie; Alzheimer Centre, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
Kehoe, Patrick; Learning and Research, Faculty of Health Sciences, University of Bristol, Bristol, UK
Wolf, Henrike; Department of Psychiatry, University of Zurich, Zürich, Switzerland
Nobili, Flavio; Clinical Neurology Unit, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
Mendonça, Alexandre; Department of Neurology and Laboratory of Neurosciences, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
van Rossum, Ineke; Alzheimer Centre, Department of Neurology, VU University Medical Centre, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
Hort, Jacub; Department of Neurology, 2nd Faculty of Medicine Charles University in Prague and Motol University Hospital, Prague, Czech Republic
Molinuevo, Jose Luis; BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain ; Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
HENEKA, Michael ; Clinical Neuroscience, Department of Neurology Clinical Neuroscience Unit, and German Center for Neurodegenerative Disease (DZNE), Bonn, Germany
Petersen, Ron; Mayo Clinic Alzheimer's Disease Research Center and the Mayo Clinic Study of Aging, Rochester, MN, USA
Scheltens, Philip; Alzheimer Centre, Department of Neurology, VU University Medical Centre, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
Visser, Pieter Jelle; Alzheimer Centre, Department of Neurology, VU University Medical Centre, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands. pj.visser@vumc.nl ; Alzheimer Centre, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands. pj.visser@vumc.nl
DB reports no disclosures. SV receives research support from ZonMW and from the Innovative Medicines Initiative Joint Undertaking under EMIF grant agreement no 115,372, resources that are composed of financial contributions from EU FP7 (FP7/2007-2013) and in-kind contributions from EFPIA. No conflicts of interest exist. PK reports no disclosures. HW reports no disclosures. FN received honoraria from Eli Lilly & Co for consultation. AM reports no disclosures. IvR reports no disclosures. JH received honoraria from Alzheon, Sotio, Axon, and Agora pharmaceuticals for consultation. JLM has provided scientific advice or has been an investigator or a data monitoring board member receiving consultancy fees from Novartis, Lundbeck, Roche, GE Health Care, Merz, MSD, Astra-Zeneca, Lilly, Boehringer-Ingelmein, Roche diagnostics, Piramal, Axovant, and IBL. MH reports no disclosures. RP received honoraria from Roche, Inc., Merck, Inc., Genetech, Inc., Biogen, Inc., and Eli Lilly and Company for consultation. PS has received grant support (for the institution) from GE Healthcare, Danone Research, Piramal, and MERCK. In the past 2 years, he has received consultancy/speaker fees (paid to the institution) from Lilly, GE Healthcare, Novartis, Forum, Sanofi, Nutricia, Probiodrug, and EIP Pharma. PJV serves as an advisory board member of Eli--Lilly and is a consultant for Janssen Pharmaceutica. He receives/received research grants from Biogen and GE Healthcare, European Commission 6th and 7th Framework programme, the Innovative Medicines Initiative (IMI), European Union Joint Programme—Neurodegenerative Disease Research (JPND), and ZonMw. All authors read and approved the final manuscript and are accountable for all aspects of the work.The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement no 115372, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in-kind contribution.
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