In-home dementia assessments feasible
In-home assessments for dementia are feasible, resulting in acceptable dropout rates and accuracy in determining cognitive status, a recent study has found.
Researchers randomly assigned 640 participants to receive either mail-in questionnaires with life telephone interviews (MIP; n=207; mean age, 81.18±4.31 years; 67 percent female), automated telephone correspondence with interactive voice response system (IVR; n=196; mean age, 80.96±4.46 years; 66 percent female) or computer- and internet-based assessment (KIO; n=178; mean age, 80.72±4.48 years; 68 percent female).
Rates of completion after 48 months were comparable across arms: 52 percent in MIP, 49 percent in IMR and 43 percent in KIP (p=0.201). Higher education, better Mini-Mental State Examination findings at baseline and being free of mild cognitive impairment at baseline were significant predictors of completion.
In terms of staff resources needed, those assigned to the KIO group required a greater mean staff time per participant (1,426±48.6 vs 299±22.0 minutes in IVR and 529±23.0 minutes in MIP). A similar result was obtained regarding the total number of staff contacts per participant: 106.5±2.2 times in KIO, 33.3±0.9 times in MIP and 32.7±0.89 times in IVR.
At the end of the study period, the home-based assessments showed that participants who converted tended to show declines in cognition over time. This effect was absent in those who were cognitively stable, suggesting that a practice effect may be present.
Moreover, across all three arms, participants who declined before a defined trigger value were more likely to convert, though significance was achieved only in the MIP group. “Although not optimal in predicting cognitive conversion, data provided in this study may help create more efficient trigger measures that enable better trial design and shorten study duration to clinically meaningful endpoints,” said researchers.