{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T05:23:46Z","timestamp":1794374626329,"version":"4.9.0"},"reference-count":60,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Adelphi Real World"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The identification and early diagnosis of mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia are critical for timely intervention, yet implementation of biomarker-based diagnostics in the Italian healthcare system remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize the real-world diagnostic journey, barriers, and management pathways of MCI and mild AD dementia patients in Italy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were drawn from the Adelphi Real World Dementia Disease Specific Programme\u2122, a cross-sectional survey of Italian primary care physicians and specialists. Physicians reported on diagnostic assessments, biomarker testing, and treatment initiation for consulting patients with MCI\/mild AD dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physicians provided data on 325 patients (mean age: 74.1 years; 48.3% female). Patients aged \u226575 had lower Mini-Mental State Examination scores at survey (p\u2009=\u20090.0028) and diagnosis (p\u2009=\u20090.0223) than patients aged &lt;75 years. Short-term memory loss (87.6%) was the most common symptom. Delays in diagnosis were most commonly attributed to limited specialist access (55.8%), prolonged interval between consultations (27.0%), and restricted diagnostic resources (20.4%). Magnetic resonance imaging was the primary imaging modality (65.7%), while biomarker testing such as cerebrospinal fluid and amyloid positron emission tomography were performed in 15.9% and 16.3% of cases, likely hindered by patient's reluctance and cost, respectively, as indicated by specialist-perceived challenges in using biomarkers for early symptomatic AD diagnosis. Patients whose treatment was initiated by specialists were commonly prescribed acetylcholinesterase inhibitors (72.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Delays in MCI and mild AD dementia diagnosis persist alongside systemic barriers and limited biomarker use. Improving referral pathways and biomarker access is essential for timely diagnosis and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261490595","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:09:23Z","timestamp":1790604563000},"page":"938-952","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and management of mild cognitive impairment and mild Alzheimer's disease dementia: Findings from an Italian real-world survey"],"prefix":"10.1177","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8408-6216","authenticated-orcid":false,"given":"Stefania","family":"Ippati","sequence":"first","affiliation":[{"name":"Eli Lilly Italy S.p.A., Sesto Fiorentino, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Torelli","sequence":"additional","affiliation":[{"name":"Eli Lilly Italy S.p.A., Sesto Fiorentino, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Zamboni","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neuroscience, University of Modena and Reggio Emilia, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Iavarone","sequence":"additional","affiliation":[{"name":"Neurology Unit, Ospedale CTO, AORN \u201cOspedali Dei Colli\u201d Naples, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Martorana","sequence":"additional","affiliation":[{"name":"University of Rome Tor Vergata"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Botello","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cotton","sequence":"additional","affiliation":[{"name":"Adelphi Real World"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Walker","sequence":"additional","affiliation":[{"name":"Adelphi Real World"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Phillips","sequence":"additional","affiliation":[{"name":"Adelphi Real World"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Avitabile","sequence":"additional","affiliation":[{"name":"Eli Lilly Italy S.p.A., Sesto Fiorentino, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13809"},{"key":"e_1_3_3_3_2","article-title":"The economic and societal burden of Alzheimer disease: managed care considerations","volume":"28","author":"Skaria AP.","year":"2022","unstructured":"Skaria AP. The economic and societal burden of Alzheimer disease: managed care considerations. Am J Manag Care 2022; 28: S188\u2013S196.","journal-title":"Am J Manag Care"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.937486"},{"key":"e_1_3_3_5_2","article-title":"Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019","volume":"7","author":"GBD 2019 Dementia Forecasting Collaborators","year":"2022","unstructured":"GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7: e105\u2013e125.","journal-title":"Lancet Public Health"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nrl.2016.02.016"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.748888"},{"key":"e_1_3_3_8_2","unstructured":"Prevalence of dementia in Europe 2025 https:\/\/www.alzheimer-europe.org\/resources\/publications\/prevalence-dementia-europe-2025?language_content_entity=en (2025 accessed 24 March 2026)."},{"key":"e_1_3_3_9_2","unstructured":"https:\/\/www.epicentro.iss.it\/en\/alzheimer\/ (accessed 17 December 2024)."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-022-00338-8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2015.12.002"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2021.23"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.03.005"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13239"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2212948"},{"key":"e_1_3_3_16_2","unstructured":"Singh R Sadiq NM. Cholinesterase inhibitors. In: StatPearls. StatPearls Publishing http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK544336\/ (2024 accessed 13 December 2024)."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2019.00043"},{"key":"e_1_3_3_18_2","unstructured":"https:\/\/www.alzint.org\/news-events\/news\/over-41-million-cases-of-dementia-go-undiagnosed-across-the-globe-world-alzheimer-report-reveals\/ (accessed 13 December 2024)."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00066-1"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23116079"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41999-023-00847-1"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13764"},{"key":"e_1_3_3_23_2","article-title":"Geographic variation in shortfalls of dementia specialists in the United States","volume":"2","author":"Liu JL","year":"2024","unstructured":"Liu JL, Baker L, Chen AY-A, et al. Geographic variation in shortfalls of dementia specialists in the United States. Health Aff Sch 2024; 2: qxae088.","journal-title":"Health Aff Sch"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-240594"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007990802457040"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2023.2279679"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010352"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S120101"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/13872877251322978"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-019-01250-2"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-021-05845-4"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12929-019-0609-7"},{"key":"e_1_3_3_34_2","unstructured":"EPHMRA Code of conduct https:\/\/www.ephmra.org\/sites\/default\/files\/2022-08\/EPHMRA%202022%20Code%20of%20Conduct.pdf (2022 accessed 13 December 2024)."},{"key":"e_1_3_3_35_2","first-page":"191","article-title":"Health insurance portability and accountability act of 1996","volume":"104","author":"Act A.","year":"1996","unstructured":"Act A. Health insurance portability and accountability act of 1996. Public law 1996; 104: 191.","journal-title":"Public law"},{"key":"e_1_3_3_36_2","unstructured":"Act H. Health Information Technology for Economic and Clinical Health. 2010."},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2023.1324522"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24135"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbas.2023.100093"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-022-01193-z"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12071768"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2022.919859"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2023.1325231"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2015.01.002"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2022.41"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.3390\/geriatrics8010012"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24108976"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13195-023-01314-6"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-024-02988-7"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-221160"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-023-00504-6"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-019-01212-0"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drudis.2024.103911"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2024.148812"},{"key":"e_1_3_3_55_2","unstructured":"Health at a Glance 2021: OECD Indicators OECD Publishing Paris https:\/\/www.oecd.org\/en\/publications\/health-at-a-glance-2021_ae3016b9-en.html%20 (2021 22 accessed January 2025)."},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.2217\/fnl-2023-0024"},{"key":"e_1_3_3_57_2","unstructured":"World Alzheimer Report 2021 https:\/\/www.alzint.org\/resource\/world-alzheimer-report-2021\/ (2021 accessed 22 January 2025)."},{"key":"e_1_3_3_58_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10072-022-06056-1"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.2174\/1567205015666180119092427"},{"key":"e_1_3_3_60_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-024-01911-3"},{"key":"e_1_3_3_61_2","first-page":"192","article-title":"The Italian fund for Alzheimer\u2019s and other dementias: strategies and objectives to face the dementia challenge","volume":"58","author":"Ancidoni A","year":"2022","unstructured":"Ancidoni A, Sciancalepore F, Bacigalupo I, et al. The Italian fund for Alzheimer\u2019s and other dementias: strategies and objectives to face the dementia challenge. Ann Ist Super Sanita 2022; 58: 192\u2013196.","journal-title":"Ann Ist Super Sanita"}],"container-title":["Journal of Alzheimer\u2019s Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261490595","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/13872877261490595","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/13872877261490595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T04:42:52Z","timestamp":1794372172000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/13872877261490595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":60,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/13872877261490595"],"URL":"https:\/\/doi.org\/10.1177\/13872877261490595","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]}}}