OBJECTIVES: To understand the diagnostic journey of patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia in Europe and specialists’ perceptions on utilizing biomarker testing in diagnosis.

METHODS: Data were drawn from the Adelphi Real World AD Disease Specific Program™, a cross-sectional survey of primary care physicians (PCPs) and specialists (neurologists / geriatric psychiatrists / geriatricians / psychiatrists / neuropsychiatrists) conducted in France, Germany, Italy, Spain, and the United Kingdom (UK) between December 2022-June 2023. Full data is reported for Germany, Italy, Spain and interim for France and the UK. Analyses were descriptive, summarized as percentages or median [interquartile range (IQR)]. Sample sizes varied between variables; missing data were not imputed.

RESULTS: 193 PCPs and 226 specialists reported data on 2953 patients (1073 with MCI and 1880 with AD dementia). Initially 77% of patients first consulted a PCP, but 74% of these patients were subsequently diagnosed by a specialist. The median time from first consultation with a PCP to specialist diagnosis was 23 [IQR: 12, 48] weeks. Patients diagnosed by specialists had their diagnosis primarily aided by behavioral/cognitive tests (94%), particularly Mini-Mental State Examination (87%), and feedback from patients/relatives (89%). Despite 74% of specialists reporting that biomarker testing will be ‘important’/’extremely important’ for identifying AD in MCI patients in the future, few patients diagnosed by specialists underwent AD-specific biomarker testing including cerebrospinal fluid (13%) and amyloid positron emission tomography scan (5%). 25% of patients diagnosed by specialists experienced a diagnosis time lag due to lack of access to specialized diagnostic services.

CONCLUSIONS: Improved access to specialized diagnostic services is key to accelerate the diagnostic journey of MCI/AD patients and early management. Despite the perceived future importance of biomarker testing in identifying AD in MCI patients, few patients undergo such testing today.