INTRODUCTION: The diagnosis of mild cognitive impairment (MCI) refers to cognitive impairment not meeting dementia criteria. A survey among members of the American Association of Neurology (AAN) showed that MCI was considered a useful diagnosis. Recently, research criteria have been proposed for the diagnosis of Alzheimer's disease (AD) in MCI based on AD biomarkers (prodromal AD/MCI due to AD). The aim of this study was to investigate the attitudes of clinicians in Europe on the clinical utility of MCI and prodromal AD/MCI due to AD criteria. We also investigated whether the prodromal AD/MCI due to AD criteria impacted management of MCI patients. METHODS: An online survey was performed in 2015 among 102 members of the European Academy of Neurology (EAN) and the European Alzheimer's Disease Consortium (EADC). Questions were asked on how often criteria were used, how they were operationalized, how they changed patient management, and what were considered advantages and limitations of MCI and prodromal AD/MCI due to AD. The questionnaire consisted of 47 questions scored on a Likert scale. RESULTS: Almost all respondents (92%) used the MCI diagnosis in clinical practice. Over 80% of the EAN/EADC respondents found a MCI diagnosis useful because it helped to label the cognitive problem, involve patients in planning for the future, and start risk reduction activities. These findings were similar to those reported in the AAN survey. Research criteria for prodromal AD/MCI due to AD were used by 68% of the EAN/EADC respondents. The most common reasons to use the criteria were increased certainty of diagnosis (86%), increased possibilities to provide counseling (51%), facilitation of follow-up planning (48%), start of medical intervention (49%), and response to patients' wish for a diagnosis (41%). Over 70% of the physicians considered that a diagnosis of prodromal AD/MCI due to AD had an added value over the MCI diagnosis. CONCLUSIONS: The diagnostic criteria of MCI and prodromal AD/MCI due to AD are commonly used among EAN/EADC members. The prodromal AD/MCI due to AD were considered clinically useful and impacted patient management and communication.

Alzheimer Centre Department of Neurology VU University Medical Centre De Boelelaan 1118 1081 HZ Amsterdam The Netherlands

Alzheimer Centre School for Mental Health and Neuroscience Maastricht University Maastricht The Netherlands

Alzheimer's Disease and Other Cognitive Disorders Unit Neurology Service Hospital Clínic Barcelona Spain

BarcelonaBeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain

Clinical Neurology Unit Department of Neuroscience University of Genoa Genoa Italy

Clinical Neuroscience Department of Neurology Clinical Neuroscience Unit and German Center for Neurodegenerative Disease Bonn Germany

Department of Neurology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital Prague Czech Republic

Department of Neurology and Laboratory of Neurosciences Faculty of Medicine University of Lisbon Lisbon Portugal

Department of Psychiatry University of Zurich Zürich Switzerland

Learning and Research Faculty of Health Sciences University of Bristol Bristol UK

Mayo Clinic Alzheimer's Disease Research Center and the Mayo Clinic Study of Aging Rochester MN USA

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