Feasibility of implementing a standard cognitive assessment in Italian academic and non‐academic memory clinics

Abstract

AbstractBackgroundA previous survey conducted among the European Alzheimer´s Disease Consortium (EADC) of academic memory clinics showed mild propensity (65%) towards implementing the clinician’s Uniform Dataset (cUDS), a standard cognitive assessment consistent with the US Uniform Dataset‐3rd, to diagnose mild cognitive impairment (MCI). Currently, in Italy translation and adaptations of the cUDS is in progress. Here, we evaluate the cUDS implementation feasibility in Italian academic and non‐academic settings.MethodThe 382 clinicians affiliated to the Italian Society of Neurology on Dementia (SINDem) were invited to complete the EADC online survey translated into Italian, investigating centers current practices, acceptability and feasibility of cUDS implementation. We used a mixed‐methods design to perform descriptive statistics, logistic regressions and qualitative analysis of clinicians' comments to investigate hurdles, facilitators and mechanisms impacting implementation.ResultSixty‐two clinicians participated from 14 of the 20 Italian regions. Response rates were unevenly distributed: 56% from Northern, 16% Central and 27% Southern regions (χ2(1) = 39, p = .0005). Centers were equally distributed among academic (48%) and non‐academic (52%) institutions(χ2(1) = 30, p = .899), had a variable yearly patient flow (M = 454;SD = 686) and mainly offered neurological (90%) and psychological (87%) services. 88% reported to use formal definitions for the diagnosis of MCI. 10% of academic and 30% of non‐academic clinicians reported full reimbursement of assessment. Fifty‐nine responders (95%) expressed willingness to implement cUDS. The most frequent facilitators were the availability of neuropsychologists(26%) and of tests' material(23%). 42% of non‐academic clinicians envisioned no specific barrier; 12% envisioned lack of neuropsychologists training, 12% cultural issues and 12% unavailability of local norms. 24% of academic clinicians identified time‐economic factors as barriers.ConclusionOur data showed very high acceptability for cUDS. Lower need of cross‐compatibility with previous standard might explain the higher acceptability in SINDem compared to EADC. Indeed, EADC clinicians are more reluctant due to the lack of compatibility and digital tools supporting harmonization with local datasets. Similar to EADC, SINDem academic clinicians reported the need for tests' material, but neuropsychologists’ training‐availability and finances were considered more important in Italy. Despite the small sample size, these results inform the design of future implementation in SINDem memory clinics.