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.