Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
The adherence of memory clinics to consensus recommendations for dementia diagnosis: A multicentric study in Italy.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Festari Cristina, Singh Solorzano Claudio, Orini Stefania, Castagna Eleonora, Cotta Ramusino Matteo, D'Antonio Fabrizia, Di Crosta Adolfo, Masòtino Alessia, Massa Federico, Mazzonetto Alice, Panigutti Massimiliano, Ravì Noemi, Pievani Michela, Bonanni Laura, Bruno Giuseppe, Cagnin Annachiara, Gatta Roberto, Frisoni Giovanni Battista
Аннотация
INTRODUCTION: Quantitative evaluations of how recommendations influence clinical practice are limited. This study assessed changes in the diagnostic pathways after the 2020 Italian Intersocietal Consensus Recommendations (IICR) for biomarker-based dementia diagnosis.
METHODS: Medical charts of new patients referred to three Italian memory clinics were reviewed for 2018 and 2019 (pre-IICR) and 2022 and 2023 (post-IICR). Sociodemographic and clinical data were extracted. Adherence to IICR was measured using an adherence index (AI, range 0-5). Deviations from recommended pathways were analyzed.
RESULTS: We analyzed 601 pathways in pre-IICR and 434 in post-IICR. Biomarker-based diagnoses increased from 23% to 41% post-IICR, with a significant redistribution of diagnostic categories and greater biomarker use. The AI increased modestly (2.09 ± 1.04 to 2.28 ± 1.04; p = 0.04), driven by improved neuropsychological assessment and biomarker selection (p < 0.001). Deviation analyses showed that adherence remained heterogeneous, with reduced biomarker use in older patients.
DISCUSSION: Diagnostic practices partially aligned with IICR, reflecting a progressive shift toward standardized, biologically informed dementia diagnosis in Italian expert centers.
METHODS: Medical charts of new patients referred to three Italian memory clinics were reviewed for 2018 and 2019 (pre-IICR) and 2022 and 2023 (post-IICR). Sociodemographic and clinical data were extracted. Adherence to IICR was measured using an adherence index (AI, range 0-5). Deviations from recommended pathways were analyzed.
RESULTS: We analyzed 601 pathways in pre-IICR and 434 in post-IICR. Biomarker-based diagnoses increased from 23% to 41% post-IICR, with a significant redistribution of diagnostic categories and greater biomarker use. The AI increased modestly (2.09 ± 1.04 to 2.28 ± 1.04; p = 0.04), driven by improved neuropsychological assessment and biomarker selection (p < 0.001). Deviation analyses showed that adherence remained heterogeneous, with reduced biomarker use in older patients.
DISCUSSION: Diagnostic practices partially aligned with IICR, reflecting a progressive shift toward standardized, biologically informed dementia diagnosis in Italian expert centers.