Real-world diagnosis and management of mild cognitive impairment and Alzheimer's disease dementia in the United Kingdom.

Background: Timely diagnosis of Alzheimer's disease (AD) remains challenging in the United Kingdom and improvements are needed with the introduction of new therapies. Objective: To examine the United Kingdom diagnostic and current treatment journey for people with mild cognitive impairment (MCI) and AD dementia to identify future opportunities for new treatments. Methods: Physician-reported data were drawn from the Adelphi Real World Dementia Disease Specific Programme™, a cross-sectional survey of physicians treating patients with MCI or AD dementia in the United Kingdom between 2022 and 2024. Analyses were descriptive. Results: Physicians (n = 109) reported data for 717 patients with MCI or AD dementia (including 264 with MCI or mild dementia). Overall median (interquartile range) time from symptom onset to first consultation was 26.0 (9.1-52.9) weeks. Time from consultation to diagnosis, for patients not diagnosed at initial consultation, was 15.2 (5.1-21.0) weeks for patients who first consulted and were diagnosed by a general practitioner and 21.9 (12.6-39.0) weeks for those who consulted a general practitioner and were diagnosed by a specialist. Few patients (4.9%) had a biomarker-confirmed diagnosis. Delays due to waiting for specialist referrals and diagnostic tests were reported for 57.6% and 26.9% of patients, respectively. Acetylcholinesterase inhibitors were the most common first-line treatment (82.0%). Conclusions: Our data highlighted delays in AD diagnosis and potential areas for United Kingdom health system improvement. Expediting timely diagnosis through increased public awareness, expanded biomarker use and addressing disparities in services is crucial to maximize access to emerging new therapies.