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

Cristina Festari¹, Federico Massa², Matteo Cotta Ramusino^{3

4}, Federica Gandolfo⁵, Valentina Nicolosi⁶, Stefania Orini^{7

8}, Dag Aarsland^{9

10

11}, Federica Agosta^{12

13

14}, Claudio Babiloni^{15

16

17}, Mercè Boada^{18

19}, Barbara Borroni^{20

21

22}, Stefano Cappa^{23

24

25}, Bruno Dubois²⁶, Kristian S Frederiksen^{14

27}, Lutz Froelich^{28

29}, Valentina Garibotto^{30

31

32

33}, Jean Georges³⁴, Alexander Haliassos^{35

36}, Oskar Hansson^{37

38}, Frank Jessen^{29

39

40

41}, Anita Kamondi^{17

42}, Roy P C Kessels^{25

43

44

45}, Silvia Morbelli^{46

47}, John T O'Brien^{11

48}, Markus Otto^{22

49}, Armand Perret-Liaudet^{36

50

51}, Francesca B Pizzini^{52

53}, Craig W Ritchie^{54

55}, Philip Scheltens⁵⁶, Mathieu Vandenbulcke^{57

58

59}, Ritva Vanninen^{53

60}, Frans Verhey^{59

61}, Meike W Vernooij^{62

63

64}, Tarek Yousry^{64

65}, Wiesje M Van Der Flier⁵⁶, Flavio Nobili^{2

46}, Giovanni B Frisoni^{66

67}

Affiliations

¹ Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
² Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
³ Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy.
⁴ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
⁵ Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy.
⁶ UOC Neurologia, Ospedale Magalini (ULSS 9 - Veneto), Villafranca di Verona (VR), Italy.
⁷ Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
⁸ Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy.
⁹ Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁰ Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway.
¹¹ European DLB Consortium.
¹² Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹³ Vita-Salute San Raffaele University, Milan, Italy.
¹⁴ European Academy of Neurology.
¹⁵ Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy.
¹⁶ Hospital San Raffaele of Cassino, Cassino (FR), Italy.
¹⁷ Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology.
¹⁸ Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain.
¹⁹ Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
²⁰ Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
²¹ Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy.
²² European FTLD network.
²³ Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy.
²⁴ Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy.
²⁵ Federation of the European Societies of Neuropsychology.
²⁶ Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), ICM, Salpetriere Hospital, AP-HP, University Paris 6, Paris, France.
²⁷ Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
²⁸ Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
²⁹ European Alzheimer Disease Consortium.
³⁰ NIMTLab, Faculty of Medicine, University of Geneva, Switzerland.
³¹ Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland.
³² Center for Biomedical Imaging, CIBM, Geneva, Switzerland.
³³ European Association of Nuclear Medicine.
³⁴ Alzheimer Europe.
³⁵ ESEAP-Proficiency Testing Scheme for Clinical Laboratories, Athens, Greece.
³⁶ International Federation of Clinical Chemistry.
³⁷ Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden.
³⁸ Memory Clinic, Skåne University Hospital, Malmo, Sweden.
³⁹ German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
⁴⁰ Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.
⁴¹ Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
⁴² Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
⁴³ Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
⁴⁴ Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.
⁴⁵ Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴⁶ IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁴⁷ Dept of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
⁴⁸ Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁴⁹ Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
⁵⁰ Laboratory of Neurobiology, Department of Biochemistry and Molecular Biology, Hospices civils de Lyon; Research and Resources Memory Centre, Lyon, France.
⁵¹ BioRan Team, Centre de Recherche en Neurosciences de Lyon, CNRS UMR5292, INSERM U1028, Lyon, France.
⁵² Verona University Hospital, Verona University, Dept. of Diagnostic and Public Health, Verona, Italy.
⁵³ European Union of Medical Specialists.
⁵⁴ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁵⁵ Brain Health Scotland, Edinburgh, UK.
⁵⁶ Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
⁵⁷ Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
⁵⁸ Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium.
⁵⁹ European Association of Geriatric Psychiatry.
⁶⁰ University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
⁶¹ Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
⁶² Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁶³ Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁶⁴ European Society of Neuroradiology.
⁶⁵ Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.
⁶⁶ Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.
⁶⁷ Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.

PMID: 36209379
DOI: 10.1002/alz.12798

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

Cristina Festari et al. Alzheimers Dement. 2023 May.

. 2023 May;19(5):1729-1741.

doi: 10.1002/alz.12798. Epub 2022 Oct 9.

Authors

Affiliations

¹ Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
² Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
³ Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy.
⁴ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
⁵ Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy.
⁶ UOC Neurologia, Ospedale Magalini (ULSS 9 - Veneto), Villafranca di Verona (VR), Italy.
⁷ Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
⁸ Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy.
⁹ Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹⁰ Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway.
¹¹ European DLB Consortium.
¹² Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
¹³ Vita-Salute San Raffaele University, Milan, Italy.
¹⁴ European Academy of Neurology.
¹⁵ Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy.
¹⁶ Hospital San Raffaele of Cassino, Cassino (FR), Italy.
¹⁷ Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology.
¹⁸ Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain.
¹⁹ Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
²⁰ Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
²¹ Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy.
²² European FTLD network.
²³ Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy.
²⁴ Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy.
²⁵ Federation of the European Societies of Neuropsychology.
²⁶ Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), ICM, Salpetriere Hospital, AP-HP, University Paris 6, Paris, France.
²⁷ Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
²⁸ Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
²⁹ European Alzheimer Disease Consortium.
³⁰ NIMTLab, Faculty of Medicine, University of Geneva, Switzerland.
³¹ Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland.
³² Center for Biomedical Imaging, CIBM, Geneva, Switzerland.
³³ European Association of Nuclear Medicine.
³⁴ Alzheimer Europe.
³⁵ ESEAP-Proficiency Testing Scheme for Clinical Laboratories, Athens, Greece.
³⁶ International Federation of Clinical Chemistry.
³⁷ Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden.
³⁸ Memory Clinic, Skåne University Hospital, Malmo, Sweden.
³⁹ German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
⁴⁰ Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany.
⁴¹ Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
⁴² Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.
⁴³ Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
⁴⁴ Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.
⁴⁵ Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
⁴⁶ IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁴⁷ Dept of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
⁴⁸ Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
⁴⁹ Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.
⁵⁰ Laboratory of Neurobiology, Department of Biochemistry and Molecular Biology, Hospices civils de Lyon; Research and Resources Memory Centre, Lyon, France.
⁵¹ BioRan Team, Centre de Recherche en Neurosciences de Lyon, CNRS UMR5292, INSERM U1028, Lyon, France.
⁵² Verona University Hospital, Verona University, Dept. of Diagnostic and Public Health, Verona, Italy.
⁵³ European Union of Medical Specialists.
⁵⁴ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁵⁵ Brain Health Scotland, Edinburgh, UK.
⁵⁶ Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
⁵⁷ Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
⁵⁸ Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium.
⁵⁹ European Association of Geriatric Psychiatry.
⁶⁰ University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
⁶¹ Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
⁶² Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁶³ Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
⁶⁴ European Society of Neuroradiology.
⁶⁵ Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK.
⁶⁶ Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.
⁶⁷ Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.

PMID: 36209379
DOI: 10.1002/alz.12798

Abstract

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.

Keywords: Delphi procedure; MCI; consensus; etiological diagnosis; imaging; major neurocognitive disorder; mild dementia - biomarker; neurocognitive disorders.

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References

REFERENCES

1. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria. Lancet Neurol. 2014;13:614-629. https://doi.org/10.1016/S1474-4422(14)70090-0
1. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia. 2011;7(3):263-269. Portico. https://doi.org/10.1016/j.jalz.2011.03.005
1. McKeith IG, Ferman TJ, Thomas AJ, et al. Research criteria for the diagnosis of prodromal dementia with Lewy bodies. Neurology. 2020;94:743-755. https://doi.org/10.1212/WNL.0000000000009323
1. Nobili F, Arbizu J, Bouwman F, et al. European Association of Nuclear Medicine and European Academy of Neurology recommendations for the use of brain 18 F-fluorodeoxyglucose positron emission tomography in neurodegenerative cognitive impairment and dementia: Delphi consensus. E J Neurol. 2018;25:1201-1217. https://doi.org/10.1111/ene.13728
1. Jack CR, Bennett DA, Blennow K, et al. NIA-AA Research Framework: toward a biological definition of Alzheimer's disease. Alzheimers Dement. 2018;14:535-562. https://doi.org/10.1016/j.jalz.2018.02.018

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

Affiliations

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

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical