Diagnosis and management of mild cognitive impairment and mild Alzheimer's disease dementia: Findings from an Italian real-world survey
6 affiliations
- 1Eli Lilly Italy S.p.A., Sesto Fiorentino, Florence, Italy
- 2Department of Biomedical, Metabolic and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy
- 3Neurology Unit, Ospedale CTO, AORN “Ospedali Dei Colli” Naples, Naples, Italy
- 4UOSD Dementia Center, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
- 5Eli Lilly and Company, Bracknell, UK
- 6Adelphi Real World, Bollington, UK
Abstract
Background: The identification and early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia are critical for timely intervention, yet implementation of biomarker-based diagnostics in the Italian healthcare system remains limited.
Objective: To characterize the real-world diagnostic journey, barriers, and management pathways of MCI and mild AD dementia patients in Italy.
Methods: Data were drawn from the Adelphi Real World Dementia Disease Specific Programme™, a cross-sectional survey of Italian primary care physicians and specialists. Physicians reported on diagnostic assessments, biomarker testing, and treatment initiation for consulting patients with MCI/mild AD dementia.
Results: Physicians provided data on 325 patients (mean age: 74.1 years; 48.3% female). Patients aged ≥75 had lower Mini-Mental State Examination scores at survey (p = 0.0028) and diagnosis (p = 0.0223) than patients aged <75 years. Short-term memory loss (87.6%) was the most common symptom. Delays in diagnosis were most commonly attributed to limited specialist access (55.8%), prolonged interval between consultations (27.0%), and restricted diagnostic resources (20.4%). Magnetic resonance imaging was the primary imaging modality (65.7%), while biomarker testing such as cerebrospinal fluid and amyloid positron emission tomography were performed in 15.9% and 16.3% of cases, likely hindered by patient's reluctance and cost, respectively, as indicated by specialist-perceived challenges in using biomarkers for early symptomatic AD diagnosis. Patients whose treatment was initiated by specialists were commonly prescribed acetylcholinesterase inhibitors (72.8%).
Conclusions: Delays in MCI and mild AD dementia diagnosis persist alongside systemic barriers and limited biomarker use. Improving referral pathways and biomarker access is essential for timely diagnosis and management.
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BibTeX
@article{ippati2026diagnosis,
title = {{Diagnosis and management of mild cognitive impairment and mild Alzheimer's disease dementia: Findings from an Italian real-world survey}},
author = {Stefania Ippati and Federico Torelli and Giovanna Zamboni and Alessandro Iavarone and Alessandro Martorana and Brenda Botello and Sarah Cotton and Chloe Walker and Zoe Phillips and Arianna Avitabile},
journal = {Journal of Alzheimer's Disease},
year = {2026},
month = sep,
doi = {10.1177/13872877261490595},
url = {https://doi.org/10.1177/13872877261490595},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Diagnosis and management of mild cognitive impairment and mild Alzheimer's disease dementia: Findings from an Italian real-world survey
AU - Stefania Ippati
AU - Federico Torelli
AU - Giovanna Zamboni
AU - Alessandro Iavarone
AU - Alessandro Martorana
AU - Brenda Botello
AU - Sarah Cotton
AU - Chloe Walker
AU - Zoe Phillips
AU - Arianna Avitabile
PY - 2026
DA - 2026/09/28
JO - Journal of Alzheimer's Disease
DO - 10.1177/13872877261490595
UR - https://doi.org/10.1177/13872877261490595
AB - Background: The identification and early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia are critical for timely intervention, yet implementation of biomarker-based diagnostics in the Italian healthcare system remains limited. Objective: To characterize the real-world diagnostic journey, barriers, and management pathways of MCI and mild AD dementia patients in Italy. Methods: Data were drawn from the Adelphi Real World Dementia Disease Specific Programme™, a cross-sectional survey of Italian primary care physicians and specialists. Physicians reported on diagnostic assessments, biomarker testing, and treatment initiation for consulting patients with MCI/mild AD dementia. Results: Physicians provided data on 325 patients (mean age: 74.1 years; 48.3% female). Patients aged ≥75 had lower Mini-Mental State Examination scores at survey (p = 0.0028) and diagnosis (p = 0.0223) than patients aged <75 years. Short-term memory loss (87.6%) was the most common symptom. Delays in diagnosis were most commonly attributed to limited specialist access (55.8%), prolonged interval between consultations (27.0%), and restricted diagnostic resources (20.4%). Magnetic resonance imaging was the primary imaging modality (65.7%), while biomarker testing such as cerebrospinal fluid and amyloid positron emission tomography were performed in 15.9% and 16.3% of cases, likely hindered by patient's reluctance and cost, respectively, as indicated by specialist-perceived challenges in using biomarkers for early symptomatic AD diagnosis. Patients whose treatment was initiated by specialists were commonly prescribed acetylcholinesterase inhibitors (72.8%). Conclusions: Delays in MCI and mild AD dementia diagnosis persist alongside systemic barriers and limited biomarker use. Improving referral pathways and biomarker access is essential for timely diagnosis and management.
SN - 1387-2877
SN - 1875-8908
ER -