OBJECTIVES: Mild cognitive impairment (MCI) is associated with an increased risk of further cognitive decline, partly depending on demographics and biomarker status. The aim of the present study was to survey the clinical practices of physicians in terms of biomarker counseling, management, and follow-up in European expert centers diagnosing patients with MCI. METHODS: An online email survey was distributed to physicians affiliated with European Alzheimer's disease Consortium centers (Northern Europe: 10 centers; Eastern and Central Europe: 9 centers; and Southern Europe: 15 centers) with questions on attitudes toward biomarkers and biomarker counseling in MCI and dementia. This included postbiomarker counseling and the process of diagnostic disclosure of MCI, as well as treatment and follow-up in MCI. RESULTS: The response rate for the survey was 80.9% (34 of 42 centers) across 20 countries. A large majority of physicians had access to biomarkers and found them useful. Pre- and postbiomarker counseling varied across centers, as did practices for referral to support groups and advice on preventive strategies. Less than half reported discussing driving and advance care planning with patients with MCI. CONCLUSIONS: The variability in clinical practices across centers calls for better biomarker counseling and better training to improve communication skills. Future initiatives should address the importance of communicating preventive strategies and advance planning.

1st Department of Neurology Aiginitio University Hospital National and Kapodistrian University of Athens Athens Greece

Ageing Epidemiology Research Unit School of Public Health Imperial College London London UK

Alzheimer Research Center and Department of Neurology Salpêtrière University Hospital AP HP Sorbonne University Paris France

Center for Cognitive Impairments University Medical Center Ljubljana Ljubljana Slovenia

Center of Cognitive Neurology Lariboisière Hospital Paris University of Paris Paris France

Clinic for Cognitive Disorders Theme Aging Karolinska University Hospital Huddinge Stockholm Sweden

Department of Clinical Neuroscience Vaud University Hospital Leenaards Memory Centre Lausanne Switzerland

Department of Geriatric Psychiatry Central Institute for Mental Health University of Heidelberg Mannheim Germany

Department of Geriatrics Radboudumc Alzheimer Center Radboud University Medical Center Nijmegen The Netherlands

Department of Neurodegenerative Disorders Mossakowski Medical Research Centre PAN Warsaw Poland

Department of Neurology and Center for Neurosciences UZ Brussel and Vrije Universiteit Brussel Brussels Belgium

Department of Neurology and Neuropsychology CHU Timone APHM and Aix Marseille University Inserm Institut de Neurosciences des Systèmes Marseille France

Department of Neurology Clinica Universidad de Navarra University of Navarra Madrid Spain

Department of Neurology Cliniques Universitaires Saint Luc Université Catholique de Louvain Institute of Neuroscience Brussels Belgium

Department of Neurology Columbia University Medical Center New York USA

Department of Neurology Danish Dementia Research Centre Rigshospitalet University of Copenhagen Copenhagen Denmark

Department of Neurology Dokuz Eylül University Medical School Izmir Turkey

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

Department of Neurology Memory Resources and Research Center Gui de Chauliac Hospital Montpellier University Hospital University of Montpellier Montpellier France

Department of Neurology UH Alexandrovska Sofia Bulgaria

Department of Neurology University of Eastern Finland Kuopio University Hospital Kuopio Finland

Department of Neuroscience University of Genoa Genoa Italy

Department of Neurosciences and Geriatrics University of Helsinki Helsinki University Hospital Helsinki Finland

Department of Neurosciences Dokuz Eylül University Medical School Izmir Turkey

Department of Psychiatry and Psychotherapy Klinikum rechts der Isar School of Medicine Technical University of Munich Munich Germany

Department of Psychiatry and Psychotherapy University Hospital Ludwig Maximilians University Munich Munich Germany

Excellence Memory Clinic and Longevity Medicine Ana Aslan International Foundation Bucharest Romania

Faculdade de Medicina da Universidade de Lisboa Lisbon Portugal

Faculty of Medicine Neurology Clinic Clinical Center of Serbia University of Belgrade Belgrade Serbia

Faculty of Medicine University of Coimbra Coimbra Portugal

Geriatrics Gerontology and Old Age Psychiatry Clinical Department Carol Davila University of Medicine and Pharmacy Bucharest Romania

German Center for Neurodegenerative Disorders Munich Munich Germany

IRCCS Ospedale Policlinico San Martino Genova Italy

Lille 2 University of Health and Law Pôle de Neurologie Lille France

Memory Center ICRC International Clinical Research Center St Anne's University Hospital Brno Czech Republic

Memory Clinic Clinical Research Center Toulouse University Hospital Toulouse France

Memory Clinic St James's Hospital Dublin Ireland

Munich Cluster for Systems Neurology Munich Germany

Networking Research Center on Neurodegenerative Diseases Instituto de Salud Carlos 3 Madrid Spain

Neurology Department Centro Hospitalar e Universitário de Coimbra Coimbra Portugal

Neurology Department Hospital de la Santa Creu i Sant Pau Barcelona Spain

Neuroprogressive Disorders and Dementia Network Ninewells Hospital Dundee Scotland

Reference Center of Biological Markers of Dementia Institute Born Bunge and University of Antwerp Antwerp Belgium

Research Center and Memory Clinic Fundació ACE Institut Català de Neurociències Aplicades Universitat Internacional de Catalunya Barcelona Spain

School of Medicine and Surgery and Milan Center for Neuroscience University of Milano Bicocca Milan Italy

Servicio de geriatria Hospital Universitario Ramon y Cajal Madrid Spain

References provided by Crossref.org

European Academy of Neurology/European Alzheimer's Disease Consortium position statement on diagnostic disclosure, biomarker counseling, and management of patients with mild cognitive impairment