Alzheimer Europe is delighted to have contributed to a new position paper position paper on diagnostic disclosure, biomarker counselling, and management of patients with mild cognitive impairment. The paper, published by the European Academy of Neurology/European Alzheimer’s Disease Consortium, in open access in the European Journal of Neurology, looks at the importance of counselling through the diagnostic process and adequate post-diagnostic support for people receiving a diagnosis of mild cognitive impairment (MCI).
A panel of dementia specialists was appointed to write this paper, including Jean Georges, Executive Director of Alzheimer Europe.
Some of the recommendations made in the paper are:
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Prior to diagnostic evaluation, the wishes of the patient should be sought.
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Diagnostic disclosure should be carried out by a dementia specialist taking the ethical principles of “the right to know” versus “the wish not to know” into account.
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Disclosure should be accompanied by written information and a follow-up plan.
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It should be made clear that MCI is not dementia.
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Pre-biomarker counselling should always be carried out if biomarker sampling is considered and post-biomarker counselling if sampling is carried out.
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A dementia specialist knowledgeable about biomarkers should inform about pros and cons, including alternatives, to enable an autonomous and informed decision.
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Post-biomarker counselling will depend in part on the results of biomarkers.
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Follow-up should be considered for all people diagnosed with MCI and include advice on brain health and possibly treatment for specific underlying causes.
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Advice on advance directives may be relevant.
The paper concludes that further studies are needed to enable more evidence-based and standardised recommendations in the future.
