Diagnosis and management of subjects with mild cognitive impairment in clinical practice: an Italian delphi consensus study

Background: The prevalence of Mild Cognitive Impairment (MCI) is increasing worldwide, while the scarce evidence regarding clinical practice requires real-life research and consensus. This study examined real-life practices regarding the diagnosis and management of subjects with MCI in Italy. Methods: Data were collected from a modified Delphi study conducted in April-December 2023. The study involved 12 advisors and 16 specialists working in Italian Memory Clinics. The 50 statements proposed by the 12 advisors were rated on a 1–6 Likert scale in a two-round survey. Consensus was a priori defined when the rates of each statement in each round reached a mean value ≥ 5. The ratings of each statement were collected using an Excel spreadsheet. The data were analysed using Microsoft Excel and expressed as mean, median, and standard deviation (SD). Results: The response rate was 100% for both voting rounds. In the first round, 40 statements reached a consensus, while 8 did in the second. The SD of the eight final statements in the first round of voting ranged from 0.91 to 1.74, and that of the second round from 0.57 to 1.71. Conclusions: This consensus study emphasized the need to standardize investigations, set cut-off thresholds, and establish quantitative reporting standards. Building on this, the study recommended combining biomarker studies to stratify risks and predict decline. Furthermore, it advised integrating genetic data into risk algorithms and increasing testing and clinical criteria. Additionally, the consensus valued promoting specialized and integrative training, while fostering structured relationships with general practitioners.