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Current evidence from clinical trials testing anti-beta amyloid (A\u03b2) monoclonal antibodies (mAbs) in patients with early AD, though, suggests a likely marketing authorization in the next years. Since the implementation of disease-modifying therapies for AD in the clinical practice will evidently require a huge change of dementia care in all countries, a group of prominent AD clinical experts in Italy met to discuss patients\u2019 selection and management strategies. The current diagnostic\u2013therapeutic standard of care in Italy was taken as the starting point. The prescription of new therapies cannot ignore the definition of a biological diagnosis through the assessment of both amyloid- and tau-related biomarkers. The high risk\/benefit ratio of anti-A\u03b2 immunotherapies, moreover, needs a highly specialized diagnostic work-up and a thorough exclusion criteria assessment, which should be provided by a neurology specialist. The Expert Panel also suggests a reorganization of the Centers for dementia and cognitive decline in Italy into 3 levels of increasing complexity: community center, first- and second-level center. Tasks and requirements for each level were defined. Finally, specific characteristics of a center deputed to prescribe anti-A\u03b2 mAbs were discussed.<\/jats:p>","DOI":"10.1007\/s00415-023-11642-0","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T13:03:07Z","timestamp":1678366987000},"page":"3159-3170","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Redefinition of dementia care in Italy in the era of amyloid-lowering agents for the treatment of Alzheimer\u2019s disease: an expert opinion and practical guideline"],"prefix":"10.1007","volume":"270","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5485-0479","authenticated-orcid":false,"given":"Massimo","family":"Filippi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6544-410X","authenticated-orcid":false,"given":"Giordano","family":"Cecchetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2894-0825","authenticated-orcid":false,"given":"Annachiara","family":"Cagnin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3994-4044","authenticated-orcid":false,"given":"Camillo","family":"Marra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-0897","authenticated-orcid":false,"given":"Flavio","family":"Nobili","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-3967","authenticated-orcid":false,"given":"Lucilla","family":"Parnetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-4979","authenticated-orcid":false,"given":"Federica","family":"Agosta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"11642_CR1","volume":"8","author":"J Cummings","year":"2022","unstructured":"Cummings J, Lee G, Nahed P et al (2022) Alzheimer\u2019s disease drug development pipeline: 2022. 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Filippi is Editor-in-Chief of the Journal of Neurology and Associate Editor of Human Brain Mapping, Neurological Sciences, and Radiology; received compensation for consulting services and\/or speaking activities from Almiral, Alexion, Bayer, Biogen, Celgene, Eli Lilly, Genzyme, Merck-Serono, Novartis, Roche, Sanofi, Takeda, and Teva Pharmaceutical Industries, and receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, Teva Pharmaceutical Industries, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA). G. Cecchetti has received speaker honoraria from Neopharmed Gentili. C. Marra is Associate Editor of Journal of Alzheimer\u2019s disease, received compensation for consulting services and\/or speaking activities from Biogen, Roche, Novo-Nordisk, Angelini, PIAM, and receives research support from Biogen Idec, Novo Nordisk, EISAI, and AIFA. A. Cagnin received compensation for consulting services and\/or speaking activities from Biogen, Roche, Angelini, and PIAM and receives research support from Italian Ministry of Health. F. Nobili has received honoraria for advisory board participation by Roche and Biogen, for consultation from BIAL, and speaker honoraria from G.E. healthcare. L. Parnetti is the Vice President of the Society for CSF Analysis and Clinical Neurochemistry; Director of the Fresco Perugia Excellence Centre for Parkinson\u2019s Disease; and receives research support from the European Joint Programme on Neurodegenerative Diseases (JPND, European Union\u2019s Horizon 2020 research and innovation programme), Marie-Curie Actions, Horizon 2020, Airalzh-Grants-for-Young-Researchers\u2014AGYR2020 (AirAlzh), Fresco Parkinson Institute, the US Parkinson\u2019s Foundation, and the Italian Ministry of Health\u2013PNRR. F. Agosta is Associate Editor of NeuroImage: Clinical, has received speaker honoraria from Roche, Biogen Idec, Zambon and Italfarmaco, and receives or has received research supports from the Italian Ministry of Health, AriSLA (Fondazione Italiana di Ricerca per la SLA), and the European Research Council and Foundation Research on Alzheimer Disease.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"An ethical standard statement is not required. This study did not involve human participants, their data or biological material. This is an axpert opinion and practical guideline.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standard"}}]}}