Objective:

To synthesize European evidence on dementia and neurodegenerative care pathways and develop an evidence-informed conceptual synthesis capturing core functions, domains of care delivery, and cross-cutting implementation principles.

Approach:

• Review Methodology: The review followed PRISMA 2020 guidelines and was registered in PROSPERO. Five databases and gray literature sources were searched for studies published in the last 10 years examining structured care pathways.
• Study Inclusion: Eighty-one studies from 11 European countries and multinational initiatives were included, focusing on care pathways for dementia and neurodegenerative disorders.
• Risk of Bias Assessment: Risk of bias was assessed using design-specific tools, and findings were synthesized narratively due to substantial heterogeneity.

Key Findings:

• Care pathways varied widely in scope, structure, and implementation.
• Most studies focused on early-stage processes like referral, diagnosis, and initial post-diagnostic support.
• Later-stage elements such as long-term management and palliative care were less frequently represented.
• A consistent functional core was identified, including care coordination, multidisciplinary teamwork, case management, caregiver involvement, and structured follow-up.
• Surrounding domains like workforce training, digital technologies, and quality measurement were described with variable formalization.

Interpretation:

Findings reflect patterns reported in the literature rather than a direct representation of routine care across European health systems.

Limitations:

• Substantial heterogeneity in study designs and reporting practices limited comparability across contexts.
• The review may not fully capture the diversity of care pathways across all European health systems.

Conclusion:

The review identifies common organizational functions underlying dementia care pathways and proposes an evidence-informed conceptual framework to support future development of integrated and person-centered care models.