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Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists

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Abstract

Background

Alzheimer’s disease (AD) is a progressive, neurodegenerative disease presenting along a continuum ranging from asymptomatic disease to mild cognitive impairment (MCI), followed by dementia characterized as mild, moderate, or severe.

Objectives

To better understand the medical journey of patients with all-cause MCI or mild AD dementia from the perspective of patients, care partners, and physicians.

Design

Cross-sectional study.

Setting

Online surveys in the United States between February 4, 2021, and March 1, 2021.

Participants

103 patients with all-cause MCI or mild AD dementia and 150 care partners participated in this survey. 301 physicians (75 of whom were neurologists) completed a survey.

Measurements

The surveys included questions regarding attitudes, experiences, and behaviors related to diagnosis and management of MCI and mild AD dementia. For the patient and care partner surveys, questions regarding healthcare received for MCI and mild AD dementia were only asked of care partners.

Results

Most patients (73%) had a similar medical journey. The majority (64%) initially consulted a primary care physician on average 15 months after symptom onset, with symptoms primarily consisting of forgetfulness and short-term memory loss. About half (51%) of patients in the typical medical journey were diagnosed by a neurologist. Upon diagnosis, most neurologists reported having discussions with patients and care partners about the potential causes of MCI or mild AD dementia (83%); of these physicians, 83% explained the effect other conditions have on the risk of the diagnoses and symptom progression. Neurologists (52%) consider themselves the coordinator of care for patients with MCI or mild AD dementia. Amongst patients and care partners, about one-third (35%) perceive the neurologists to be the coordinating physician.

Conclusions

Neurologists commonly diagnose MCI and mild AD dementia but are typically not the first point of contact in the medical journey, and patients do not consult with a physician for over a year after symptom onset. Neurologists play a key role in the medical journey for patients and care partners, and could help ensure earlier diagnosis and treatment, and improve clinical outcomes by coordinating MCI and mild AD dementia care and collaborating with primary care physicians.

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Acknowledgements

The authors thank Rebecca Hahn, MPH and Elizabeth Tanner, PhD of KJT Group, Inc., Rochester, NY for providing medical writing support, which was funded by Novo Nordisk, Inc., Plainsboro, NJ in accordance with Good Publication Practice (GPP3) guidelines.

Funding

Funding: Novo Nordisk Inc. funded the study and writing support, and had a role in the study design, data collection, analysis, interpretation of data, and review/approval of the manuscript.

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Authors and Affiliations

  1. Banner Alzheimer’s Institute, University of Arizona College of Medicine, 901 E. Willetta St, Phoenix, AZ, 85006, USA

    Jeremy J. Pruzin & G. Gopalakrishna

  2. Primary Care Education Consortium, Winnsboro, SC, USA

    S. Brunton

  3. Novo Nordisk, Inc., Plainsboro, NJ, USA

    S. Alford, C. Hamersky & A. Sabharwal

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  1. Jeremy J. Pruzin
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  2. S. Brunton
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  3. S. Alford
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  6. G. Gopalakrishna
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Corresponding author

Correspondence to Jeremy J. Pruzin.

Ethics declarations

Disclosures: Susan Alford, Carol Hamersky, and Anup Sabharwal are employees of and own stock in Novo Nordisk. Jeremy Pruzin has received grants from the Arizona Alzheimer’s Disease Research Center for a research project involving cardiovascular disease, APOE, and blood biomarkers in autosomal dominant AD; he is the recipient of an Alzheimer’s Association Clinician Scientist Fellowship award examining physical activity, cardiovascular risk and their influence on Alzheimer’s disease. Stephen Brunton has received consulting fees from Acadia and Novo Nordisk; he is also on the speakers’ bureau for Novo Nordisk. Ganesh Gopalakrishna declares no conflicts of interest.

Ethical standards: Western Institutional Review Board prospectively reviewed the study and considered it exempt because it is an online survey with adequate protections in place to protect the privacy of subjects and to maintain the confidentiality of data. The study and data accumulation were in conformity with all country, federal, or state laws, informed consent was obtained from participants, and the study was in adherence to the tenets of the Declaration of Helsinki.

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Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists

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Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists

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Pruzin, J.J., Brunton, S., Alford, S. et al. Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists. J Prev Alzheimers Dis 10, 162–170 (2023). https://doi.org/10.14283/jpad.2023.21

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