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Abstract <p>This national expert-based Delphi-consensus aims at formulating recommendations on the management of dementia care in Italy. This effort seems important and timely given in light of a new scenario arising from a new biological definition of Alzheimer’s disease (AD) and the availability of disease-modifying treatments (DMTs).</p> Methods <p>the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A&#xa0;(full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement &lt; 5%) were included in the final document. Round answers’ consistency was graded using the Cohen’s k and within-class correlation coefficient.</p> Results <p>Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements.</p> Conclusion <p>The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient’s journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.</p>

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Towards a new Value-based scenario for the management of dementia in Italy: a SINdem delphi consensus study

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  • 发表日期：

    2025年4月16日

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  • Camillo Marra,
  • Flavia Beccia,
  • Paolo Caffarra,
  • Federica L’Abbate,
  • Federica Agosta,
  • Alberto Benussi,
  • Laura Bonanni,
  • Amalia C. Bruni,
  • Giuseppe Bruno,
  • Stefano F. Cappa,
  • Chiara Cerami,
  • Francesco Di Lorenzo,
  • Carlo Ferrarese,
  • Daniela Galimberti,
  • Biancamaria Guarnieri,
  • Claudio Mariani,
  • Benedetta Nacmias,
  • Leonardo Pantoni,
  • Tommaso Piccoli,
  • Daniela Perani,
  • Innocenzo Rainero,
  • Fabrizio Tagliavini,
  • Annalena Venneri,
  • Stefania Boccia,
  • Annachiara Cagnin,
  • Giovanna Elisa Calabrò,
  • Marco Bozzali,
  • Rossano Angeloni,
  • Gennarina Arabia,
  • Andrea Arighi,
  • Sergio Bagnato,
  • Claudio Babiloni,
  • Roberta Baschi,
  • Giuseppe Bellelli,
  • Valentina Bessi,
  • Edoardo Domenico Giorgio Canu,
  • Sabina Capellari,
  • Moira Ceci,
  • Rosanna Colao,
  • Laura De Togni,
  • Gennaro Della Rocca,
  • Lucia Di Giorgi,
  • Sabrina Esposito,
  • Katia Fabi,
  • Elisabetta Farina,
  • Massimo Filippi,
  • Chiara Fiori,
  • Gianluca Floris,
  • Gianluigi Forloni,
  • Franco Giubilei,
  • Daniela Gragnaniello,
  • Maria Guarino,
  • Alessandro Iavarone,
  • Daniele Imperiale,
  • Valeria Isella,
  • Antonina Luca,
  • Donata Luiselli,
  • Simona Luzzi,
  • Susanna Malagù,
  • Michela Marcon,
  • Alessandro Marti,
  • Alessandro Martorana,
  • Maria Giuseppina Mascia,
  • Patrizia Mecocci,
  • Daniele Mei,
  • Paola Merlo,
  • Fabio Moda,
  • Roberto Monastero,
  • Giuseppe Mura,
  • Anna Maria Musso,
  • Anna Vittoria Marta Orsini,
  • Piero Parchi,
  • Matteo Pardini,
  • Lucilla Parnetti,
  • Andrea Plutino,
  • Gianfranco Puccio,
  • Sabina Roncacci,
  • Mara Rosso,
  • Elisa Rubino,
  • Stefano Sensi,
  • Grazia Sibilia,
  • Marco Spallazzi,
  • Patrizia Sucapane,
  • Pietro Tiraboschi,
  • Gloria Tognoni,
  • Gabriele Tripi,
  • Alessandro Vacca,
  • Marco Vista,
  • Gianluigi Zanusso,
  • Marta Zuffi

摘要

Abstract

This national expert-based Delphi-consensus aims at formulating recommendations on the management of dementia care in Italy. This effort seems important and timely given in light of a new scenario arising from a new biological definition of Alzheimer’s disease (AD) and the availability of disease-modifying treatments (DMTs).

Methods

the Steering Committee of the Italian Neurological Society for dementia (SINdem) created appropriate statements. Invited SINdem experts were requested to vote on the statements according to a modified three-round Delphi method. Only those statements reaching Grade A (full agreement ≥ 75%) or B (overall agreement ≥ 80% and full disagreement < 5%) were included in the final document. Round answers’ consistency was graded using the Cohen’s k and within-class correlation coefficient.

Results

Forty-six experts voted on 20 statements, which focused on the following aspects: i) organization of care services from early diagnosis to the management of advanced clinical stages; ii) access to biomarkers for a biological diagnosis of AD; iii) requirements necessary for the administration of DMTs; iv) main actors and pathways for the management of patients suffering from cognitive disorders. At the end of the process, 4 statements (20%) received a Grade A consensus, while 16 (80%) reached a Grade B consensus. Although the responses reflect heterogeneity among Italian regions, there was a fair degree of consistency for all statements.

Conclusion

The high strength of this expert-based Delphi-consensus may offer guidance for improving the patient’s journey of individuals with cognitive decline from a biological diagnosis to DMTs administration and may possibly offer hints to the Health Systems on dementia.