European consensus for the diagnosis of MCI and mild dementia: Preparatory phase

Cristina Festari, Federico Massa, Matteo Cotta Ramusino, Federica Gandolfo, Valentina Nicolosi, Stefania Orini, Dag Aarsland, Federica Agosta, Claudio Babiloni, Merce Boada, Barbara Borroni, Stefano Cappa, Bruno Dubois, Kristian S. Frederiksen, Lutz Froelich, Valentina Garibotto, Jean Georges, Alexander Haliassos, Oskar Hansson, Frank JessenAnita Kamondi, Roy P. C. Kessels, Silvia Morbelli, John T. O'Brien, Markus Otto, Armand Perret-Liaudet, Francesca B. Pizzini, Craig W. Ritchie, Philip Scheltens, Mathieu Vandenbulcke, Ritva Vanninen, Frans Verhey, Meike W. Vernooij, Tarek Yousry, Wiesje M. Van der Flier, Flavio Nobili, Giovanni B. Frisoni

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Introduction
Etiological diagnosis of neurocognitive disorders of middle-old age relies on biomarkers, although evidence for their rational use is incomplete. A European task force is defining a diagnostic workflow where expert experience fills evidence gaps for biomarker validity and prioritization. We report methodology and preliminary results.

Methods
Using a Delphi consensus method supported by a systematic literature review, 22 delegates from 11 relevant scientific societies defined workflow assumptions.

Results
We extracted diagnostic accuracy figures from literature on the use of biomarkers in the diagnosis of main forms of neurocognitive disorders. Supported by this evidence, panelists defined clinical setting (specialist outpatient service), application stage (MCI-mild dementia), and detailed pre-assessment screening (clinical-neuropsychological evaluations, brain imaging, and blood tests).

Discussion
The Delphi consensus on these assumptions set the stage for the development of the first pan-European workflow for biomarkers’ use in the etiological diagnosis of middle-old age neurocognitive disorders at MCI-mild dementia stages.

Highlights
Rational use of biomarkers in neurocognitive disorders lacks consensus in Europe.
A consensus of experts will define a workflow for the rational use of biomarkers.
The diagnostic workflow will be patient-centered and based on clinical presentation.
The workflow will be updated as new evidence accrues.

Original languageEnglish
JournalAlzheimer's & Dementia: The Journal of the Alzheimer's Association
Early online date9 Oct 2022
DOIs
Publication statusE-pub ahead of print - 9 Oct 2022

Keywords / Materials (for Non-textual outputs)

  • consensus
  • Delphi procedure
  • etiological diagnosis
  • imaging
  • major neurocognitive disorder
  • MCI
  • mild dementia
  • biomarker
  • neurocognitive disorders

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