Indiana University Dementia Screening Trial: The IU CHOICE Study

Indiana University Indianapolis, Indianapolis IN

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): The United States Preventive Services Task Force (USPSTF) found no clinical trial that evaluated the efficacy of dementia screening in primary care. Pressures to institute screening of unproved benefit could divert much needed resources from health care systems and have an overall negative impact on care for patients with dementia and other illnesses, ultimately reducing current opportunities for dementia recognition. Using the framework of the chronic care model and evidence-based, comprehensive biopsychosocial dementia care protocols, our investigators developed and conducted a randomized controlled trial of a Collaborative Dementia Care Management program and found that such a program improves the behavioral and psychological symptoms related to dementia care and reduced the burden of dementia relative to usual care. Study Design: A two-phase randomized controlled dementia screening trial among 4,000 Americans aged 75 and older attending urban primary care clinics in Indianapolis, Indiana. Intervention: A dementia screening procedure followed by a Collaborative Dementia Care program. Controls: The study will have two control groups: No Screening and Screening Only groups. Primary Outcome of Potential Benefits: Behavioral and psychological symptoms related to dementia as measured by the Neuropsychiatric Inventory (NPI) at 18 months of randomization. Primary Outcome for Potential Harms: Mood and anxiety symptoms as measured by the PHQ-9 and GAD-7 at 18 months of randomization. Impact: The results of this study will help guide the United States Preventive Services Task Force in the decision to recommend for or against routine screening for dementia in primary care. In addition, the data generated by our proposed study could be used to model the impact of future pharmacological therapeutics targeting dementia but requiring early recognition of the syndrome as can occur if screening is done routinely among elders.