The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care.
Alzheimers Dement. 2025 Jan; 21(1):e14337.AD

Abstract

US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or a related dementia (ADRD) are two decades old. This evidence-based guideline was developed to empower all clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. An expert workgroup conducted a review of 7374 publications (133 met inclusion criteria) and developed recommendations as steps in an evaluation process. This summary briefly reviews core recommendations and details specialist recommendations of a high-quality, evidence-supported evaluation process aimed at characterizing, diagnosing, and disclosing the patient's cognitive functional status, cognitive-behavioral syndrome, and likely underlying brain disease so that optimal care plans to maximize patient/care partner dyad quality of life can be developed; a companion article summarizes primary care recommendations. If clinicians use the recommendations in this guideline and health-care systems provide adequate resources, outcomes should improve in most patients in most practice settings. HIGHLIGHTS: US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or related dementias (ADRD) are decades old and aimed at specialists. This evidence-based guideline was developed to empower all-including primary care-clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. This summary focuses on recommendations appropriate for specialty practice settings, forming key elements of a high-quality, evidence-supported evaluation process aimed at characterizing, diagnosing, and disclosing the patient's cognitive functional status, cognitive-behavioral syndrome, and likely underlying brain disease so that optimal care plans to maximize patient/care partner dyad quality of life can be developed; a companion article summarizes primary care recommendations. If clinicians use this guideline and health-care systems provide adequate resources, outcomes should improve in most patients in most practice settings.

Links

PMC Free PDF

Authors+Show Affiliations

Dickerson BC

Frontotemporal Disorders Unit, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Atri A

Banner Sun Health Research Institute and Banner Alzheimer's Institute, Sun City, Arizona, USA. Department of Neurology, Center for Brain/Mind Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Clevenger C

Department of Neurology, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.

Karlawish J

Departments of Medicine, Medical Ethics and Health Policy, and Neurology, Perelman School of Medicine, Penn Memory Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Knopman D

Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.

Lin PJ

Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA.

Norman M

Cedars-Sinai Medical Center, Culver City, California, USA.

Onyike C

Division of Geriatric Psychiatry and Neuropsychiatry, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Sano M

James J. Peters VAMC, Bronx, New York, USA. Department of Psychiatry, Alzheimer's Disease Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Scanland S

Dementia Connection, LLC, Clarks Summit, Pennsylvania, USA.

Carrillo M

Medical & Scientific Relations Division, Alzheimer's Association, Chicago, Illinois, USA.

MeSH

HumansAlzheimer DiseaseCounselingDisclosureCognitive DysfunctionUnited States

Pub Type(s)

Journal Article

Practice Guideline

Language

eng

PubMed ID

39713957

Clinical Trial Links

Validation and Reliability of the Turkish Version of the Montreal Cognitive Assessment-Basic (MoCA-B) in Individuals With Low Educational Level

Citation

Dickerson, Bradford C., et al. "The Alzheimer's Association Clinical Practice Guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive Summary of Recommendations for Specialty Care." Alzheimer's & Dementia : the Journal of the Alzheimer's Association, vol. 21, no. 1, 2025, pp. e14337.

Dickerson BC, Atri A, Clevenger C, et al. The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care. Alzheimers Dement. 2025;21(1):e14337.

Dickerson, B. C., Atri, A., Clevenger, C., Karlawish, J., Knopman, D., Lin, P. J., Norman, M., Onyike, C., Sano, M., Scanland, S., & Carrillo, M. (2025). The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care. Alzheimer's & Dementia : the Journal of the Alzheimer's Association, 21(1), e14337. https://doi.org/10.1002/alz.14337

Dickerson BC, et al. The Alzheimer's Association Clinical Practice Guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive Summary of Recommendations for Specialty Care. Alzheimers Dement. 2025;21(1):e14337. PubMed PMID: 39713957.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care. AU - Dickerson,Bradford C, AU - Atri,Alireza, AU - Clevenger,Carolyn, AU - Karlawish,Jason, AU - Knopman,David, AU - Lin,Pei-Jung, AU - Norman,Mary, AU - Onyike,Chiadi, AU - Sano,Mary, AU - Scanland,Susan, AU - Carrillo,Maria, Y1 - 2024/12/23/ PY - 2024/9/19/revised PY - 2024/7/16/received PY - 2024/9/21/accepted PY - 2025/1/28/medline PY - 2024/12/23/pubmed PY - 2024/12/23/entrez PY - 2024/12/23/pmc-release KW - Alzheimer's disease KW - Lewy body dementia KW - cerebrospinal fluid KW - dementia KW - diagnosis KW - frontotemporal dementia KW - magnetic resonance imaging KW - mild cognitive impairment KW - molecular biomarkers KW - positron emission tomography KW - vascular cognitive impairment SP - e14337 EP - e14337 JF - Alzheimer's & dementia : the journal of the Alzheimer's Association JO - Alzheimers Dement VL - 21 IS - 1 N2 - US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or a related dementia (ADRD) are two decades old. This evidence-based guideline was developed to empower all clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. An expert workgroup conducted a review of 7374 publications (133 met inclusion criteria) and developed recommendations as steps in an evaluation process. This summary briefly reviews core recommendations and details specialist recommendations of a high-quality, evidence-supported evaluation process aimed at characterizing, diagnosing, and disclosing the patient's cognitive functional status, cognitive-behavioral syndrome, and likely underlying brain disease so that optimal care plans to maximize patient/care partner dyad quality of life can be developed; a companion article summarizes primary care recommendations. If clinicians use the recommendations in this guideline and health-care systems provide adequate resources, outcomes should improve in most patients in most practice settings. HIGHLIGHTS: US clinical practice guidelines for the diagnostic evaluation of cognitive impairment due to Alzheimer's disease (AD) or related dementias (ADRD) are decades old and aimed at specialists. This evidence-based guideline was developed to empower all-including primary care-clinicians to implement a structured approach for evaluating a patient with symptoms that may represent clinical AD/ADRD. This summary focuses on recommendations appropriate for specialty practice settings, forming key elements of a high-quality, evidence-supported evaluation process aimed at characterizing, diagnosing, and disclosing the patient's cognitive functional status, cognitive-behavioral syndrome, and likely underlying brain disease so that optimal care plans to maximize patient/care partner dyad quality of life can be developed; a companion article summarizes primary care recommendations. If clinicians use this guideline and health-care systems provide adequate resources, outcomes should improve in most patients in most practice settings. SN - 1552-5279 UR - https://www.unboundmedicine.com/medline/citation/39713957/full_citation DB - PRIME DP - Unbound Medicine ER -

Tags

The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care.Alzheimers Dement. 2025 Jan; 21(1):e14337.AD