Improving Early Dementia Detection Among Diverse Older Adults With Cognitive Concerns With the 5-Cog Paradigm: Protocol for a Hybrid Effectiveness-Implementation Clinical Trial
JMIR Research Protocols,
Journal Year:
2025,
Volume and Issue:
14, P. e60471 - e60471
Published: April 3, 2025
Background
The
5-Cog
paradigm
is
a
5-minute
brief
cognitive
assessment
coupled
with
clinical
decision
support
tool
designed
to
improve
clinicians’
early
detection
of
impairment,
including
dementia,
in
their
diverse
older
primary
care
patients.
battery
uses
picture-
and
symbol-based
assessments
questionnaire.
It
low
cost,
simple,
minimizes
literacy
bias,
culturally
fair.
component
the
helps
nudge
appropriate
provider
response
an
abnormal
battery.
Objective
objective
our
study
evaluate
effectiveness,
implementation,
cost
paradigm.
Methods
We
will
enroll
6600
patients
concerns
from
22
clinics
Bronx,
New
York,
multiple
locations
Indiana
for
this
hybrid
type
1
effectiveness-implementation
trial.
analyze
effectiveness
increase
rate
new
diagnoses
mild
impairment
syndrome
or
dementia
using
pragmatic,
cluster
randomized
trial
design.
secondary
outcome
ordering
tests,
treatments,
referrals
indications
within
90
days
after
visit.
5-Cog’s
be
deployed
as
electronic
medical
record
feature.
implementation
process,
context,
outcomes
through
Consolidated
Framework
Implementation
Research
mixed
methods
design
(surveys
interviews).
also
examine
cost-effectiveness
societal
payer
(Medicare)
perspectives
by
estimating
per
additional
diagnosis.
Results
funded
National
Institute
Neurological
Disorders
Stroke
Institutes
Health
(2U01NS105565).
protocol
was
approved
Albert
Einstein
College
Medicine
Institutional
Review
Board
September
2022.
A
validation
completed
select
cut
scores
Among
76
enrolled,
resulting
were
follows:
32
(42%);
28
(37%);
subjective
without
12
(16%);
no
diagnosis
assigned
2
(3%).
mean
Picture-Based
Memory
Impairment
Screen
5.8
(SD
2.7),
Symbol
Match
27.2
18.2),
Subjective
Motoric
Cognitive
Risk
2.4
1.7).
positive
result
on
components
≤6
(range
0-8),
≤25
0-65),
>5
0-7).
As
December
2024,
total
had
onboarding
processes,
2369
been
enrolled.
Conclusions
findings
facilitate
rapid
adaptation
dissemination
effective
practical
across
settings.
Trial
Registration
ClinicalTrials.gov
NCT05515224;
https://www.clinicaltrials.gov/study/NCT05515224
International
Registered
Report
Identifier
(IRRID)
DERR1-10.2196/60471
Language: Английский
Long‐term effects of collaborative dementia care on quality of life and caregiver well‐being
Alzheimer s & Dementia,
Journal Year:
2024,
Volume and Issue:
21(1)
Published: Nov. 19, 2024
Collaborative
dementia
care
models
with
navigation,
including
the
Care
Ecosystem,
improve
outcomes
for
persons
living
(PLWDs)
and
their
caregivers.
The
effects
of
continuous
over
long
periods
have
not
been
studied.
In
this
randomized
clinical
trial
456
PLWD-caregiver
dyads
high
caregiver
burden,
we
evaluated
cumulative
5-year
treatment
effect
on
PLWD
quality
life,
health
utilization,
depression,
self-efficacy,
burden.
Five-year
participation
was
associated
higher
lower
self-efficacy
(all
p's
<
0.05)
a
trend
burden
(p
=
0.07).
Treatment
were
most
robust
during
first
2
years.
emergency
department
visits
hospitalizations
significant.
benefits
collaborative
life
well-being
are
sustained
5
years,
may
experience
greatest
benefit
navigation
years
using
trial.
better
person
caregiver.
in
Language: Английский