Supplementary Material for: The care pathway for patients with mild cognitive impairment in Korea: a survey of dementia specialists

Introduction: Mild cognitive impairment (MCI) represents a loss of memory or other cognitive function whilst maintaining the ability to independently perform most activities of daily living. This study assessed how Korean specialists in dementia care diagnosed and treated patients with MCI symptoms.
Methods: A questionnaire on the current management of MCI was developed by 6 experts in MCI care. Specialists in MCI care (n = 24: 14 neurologists/10 psychiatrists) verbally answered questions relating to their experience/views in caring for MCI patients.
Results: Respondents diagnosed MCI using the Seoul Neuropsychological Screening Battery (79%) and the Consortium to Establish a Registry for Alzheimer's Disease – Korea (21%) neuropsychological battery tests. All or nearly all respondents also assessed patients with Mini Mental State Examination, Geriatric Depression Scale, Clinical Dementia Rating, Activities of Daily Living (ADL), and Instrumental ADL tests. All respondents used MRI or CT for differential diagnosis of diseases causing MCI, about one-third used amyloid PET. Most respondents (96%) treated patients with MCI due to Alzheimer’s disease (AD) with medication, commonly choline alfoscerate (71%) and donepezil (53%), mainly as combination therapy. Unmet needs included patient/caregiver education (63%) and time constraints for consulting patients (54%). Most respondents considered that increased amyloid-β testing for patients with MCI due to AD or subjective cognitive decline is likely.
Conclusions: This survey described the current management of MCI due to AD, identified unmet needs and considered possible future developments in the changing landscape of early AD treatment. Early detection and diagnosis, and continued development of emerging preventative or therapeutic interventions, are critical for MCI outcomes.

引言：轻度认知障碍（Mild cognitive impairment, MCI）指患者出现记忆或其他认知功能减退，但仍可独立完成大部分日常生活活动。本研究评估了韩国痴呆护理专科医师对轻度认知障碍症状患者的诊断与治疗方案。
方法：本研究由6名轻度认知障碍护理专家制定了一份关于轻度认知障碍当前管理方案的调查问卷。共有24名轻度认知障碍护理专科医师（其中14名神经科医师、10名精神科医师）以口头作答的方式，回答了与他们照护轻度认知障碍患者的经验及观点相关的问题。
结果：受访医师采用首尔神经心理筛查量表（Seoul Neuropsychological Screening Battery, 79%）以及阿尔茨海默病注册联盟-韩国版（Consortium to Establish a Registry for Alzheimer's Disease – Korea）神经心理筛查量表（21%）对轻度认知障碍进行诊断。几乎所有受访医师均会采用简易精神状态检查（Mini Mental State Examination）、老年抑郁量表（Geriatric Depression Scale）、临床痴呆评定量表（Clinical Dementia Rating）、日常生活活动能力（Activities of Daily Living, ADL）以及工具性日常生活活动能力（Instrumental ADL）对患者进行评估。所有受访医师均采用磁共振成像（MRI）或计算机断层扫描（CT）对引发轻度认知障碍的疾病进行鉴别诊断，约三分之一的医师会使用淀粉样蛋白正电子发射断层扫描（amyloid PET）。大部分受访医师（96%）会对阿尔茨海默病（Alzheimer’s disease, AD）相关轻度认知障碍患者采用药物治疗，其中最常用的为胞磷胆碱（choline alfoscerate, 71%）与多奈哌齐（donepezil, 53%），且多采用联合用药方案。未被满足的医疗需求包括患者/照料者教育（63%）以及接诊患者的时间不足（54%）。多数受访医师认为，针对阿尔茨海默病相关轻度认知障碍或主观认知下降患者，增加β淀粉样蛋白（amyloid-β）检测的做法有望推广。
结论：本调研阐明了当前阿尔茨海默病相关轻度认知障碍的管理方案，明确了未被满足的医疗需求，并探讨了早期阿尔茨海默病治疗格局变化下可能的未来发展方向。早期检测与诊断，以及持续开发新兴的预防性或治疗性干预手段，对改善轻度认知障碍患者的预后至关重要。