Diagnostic journey, biomarker testing, treatment, and care partner burden in patients with mild cognitive impairment and Alzheimer's disease dementia in China: A real-world survey

Background The prevalence of Alzheimer's disease (AD) is rising in China. Although disease-modifying treatments are available, their efficacy is mostly seen in the early stage. Timely and accurate diagnosis is crucial for AD management. Objective This study aimed to describe the diagnostic trajectory, current treatments, and care burden for mild cognitive impairment (MCI)/AD in China. Methods Data were derived from the Adelphi Real World Dementia Disease Specific Programme™, a cross-sectional survey of neurologists, patients with MCI/AD dementia and their care partners, conducted in China from February–May 2024. Patient characteristics, diagnoses, treatments, and care were reported by neurologists and supplemented by self-reports from patients and care partners. Results Overall, 93 neurologists reported on 774 patients. Of patients with a Mini-Mental State Examination (MMSE) score at the time of survey (n = 699), mean (standard deviation) age was 69.3 (8.2) years, 49.6% (n = 347) female and most had MCI/mild AD (MMSE 20–28) at survey (52.5%, n = 367). Over one-third of patients presented with moderate to severe disease at initial consultation (34.7%, n = 203) and at diagnosis (36.2%, n = 265). Biomarker testing was infrequently used in diagnosis, with cerebrospinal fluid being the most used (11.2%, n = 81) and physician-reported challenges including cost, patient reluctance, and availability. Most patients received only non-professional care primarily from a partner/spouse and/or children, who spent up to 47.0 (45.8) hours per week caring. Conclusions Challenges in early and biomarker-based diagnosis were identified and care partners continued to experience a substantial burden. Continued efforts are needed to ensure the healthcare system's preparedness for the AD epidemic.