The Profile of the Italian Centers for Cognitive Disorders and Dementia in the Context of New Drugs in Alzheimer's Disease

Abstract

Background: The wait for the upcoming disease-modifying therapies (DMT) for Alzheimer's disease in Europe is raising questions about the preparedness of national healthcare systems to conduct accurate diagnoses and effective prescriptions. In this article, we focus on the current situation in Italy.

Objective: The primary goal is to propose a profile of the Italian Centers for Cognitive Disorders and Dementias (CCDDs) that could be taken into consideration by regional and autonomous provincial authorities when deciding on the prescribing centers for DMT.

Methods: Based on responses to a national survey on CCDDs in Italy, we identified the CCDDs that meet the requirements for effective prescription: 1) Multidisciplinary team; 2) Minimum Core Test for the neuropsychological assessment; 3) PET, CSF, and Brain MRI assessments. Univariate and multivariate comparisons were conducted between CCDDs that met the criteria and the others.

Results: Only 10.4% of CCDDs met the requirements for effective DMT prescription, mainly located in Northern Italy. They are also characterized by longer opening hours, a higher number of professionals, a university location, and a higher frequency of conducting genetic tests, and could potentially result in prescribing centers.

Conclusions: The findings suggest that the Italian national healthcare system may benefit from further enhancements to facilitate the effective prescription of DMTs. This could involve initiatives to reduce fragmentation, ensure adequate resources and equipment, and secure sufficient funding to support this aspect of healthcare delivery.

Keywords: public health; Alzheimer’s disease; Centers for Cognitive Disorders and Dementias; cognitive assessment; disease-modifying therapy; memory clinic.

Fig. 1

Distribution of Italian CCDDs encountering requirements for effective disease-modifying therapies prescription. The figure displays the distribution of the 47 CCDDs that meet the specified requirements for effective prescription of disease-modifying therapies. These requirements include a multidisciplinary team, a minimum core test for neuropsychological assessment, amyloid PET, CSF, and Brain MRI assessment. Legend: – Red: Indicates regions with no CCDDs meeting the elective requirements. – Pink: Represents regions with 1 CCDD meeting the elective requirements (first and second quartile of the distribution, excluding regions without elective CCDDs). – Yellow: Denotes regions with 2 CCDDs meeting the elective requirements (third quartile of the distribution, excluding regions without elective CCDDs). – Green: Signifies regions with more than 2 CCDDs meeting the elective requirements (fourth quartile of the distribution, excluding regions without elective CCDDs).