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. 2025 Jan;21(1):e14200.
doi: 10.1002/alz.14200. Epub 2024 Dec 30.

Applying recommendations for diagnostic disclosure of mild cognitive impairment and dementia: Practical guidance for clinicians

Kyra O'Brien  1 , Emily A Largent  2 , Jason Karlawish  1   2   3
Affiliations

Applying recommendations for diagnostic disclosure of mild cognitive impairment and dementia: Practical guidance for clinicians

Kyra O'Brien et al. Alzheimers Dement. 2025 Jan.

Abstract

A comprehensive evaluation for cognitive impairment should culminate with the communication of the diagnosis to patients and their care partners. This diagnostic disclosure sets the stage for subsequent care. Diagnostic disclosure for individuals with cognitive impairment due to Alzheimer's disease (AD) or AD-related dementias (ADRD) is particularly nuanced and requires a conscientious approach. Clinicians must assess patients' understanding and appreciation of symptoms, goals for the evaluation, and desire for information. Because AD/ADRD can impact patients' perceptions of their symptoms, it is recommended to include an informant or care partner for this assessment and for future care. Here, we provide guidance for addressing the complexities of AD/ADRD diagnostic disclosure to build clinicians' confidence in communicating diagnostic findings and a plan of care. HIGHLIGHTS: Diagnostic disclosure is a key part of the evaluation of cognitive impairment. The disclosure process begins at the moment a cognitive evaluation is initiated. Care partners must be included in the cognitive evaluation and diagnostic disclosure. Clinicians should use patient-centered communication for evaluation and disclosure.

Keywords: Alzheimer's disease and related dementias; dementia; diagnostic disclosure; mild cognitive impairment.

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Conflict of interest statement

K. O'Brien and E. Largent have no conflicts of interest to disclose. J. Karlawish is a site investigator for Eli Lilly, Biogen, and Eisai. Author disclosures are available in the Supporting information.

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