A randomized clinical trial to evaluate home-based assessment of people over 75 years old

Alzheimers Dement. 2019 May;15(5):615-624. doi: 10.1016/j.jalz.2019.01.007. Epub 2019 Mar 11.


Introduction: There is an unmet need for effective methods for conducting dementia prevention trials.

Methods: Home-based assessment study compared feasibility and efficiency, ability to capture change over time using in-home instruments, and ability to predict cognitive conversion using predefined triggers in a randomized clinical trial in (1) mail-in questionnaire/live telephone interviews, (2) automated telephone/interactive voice recognition, and (3) internet-based computer Kiosk technologies. Primary endpoint was defined as cognitive conversion.

Results: Analysis followed a modified intent-to-treat principle. Dropout rates were low and similar across technologies but participants in Kiosk were more likely to dropout earlier. Staff resources needed were higher in Kiosk. In-home instruments distinguished conversion and stable groups. Cognitively stable group showed improvement in cognitive measures. Triggering was associated with higher likelihood of conversion but statistically significant only in mail-in questionnaire/live telephone interviews.

Discussion: Relatively low efficiency of internet-based assessment compared with testing by live-assessors has implications for internet-based recruitment and assessment efforts currently proposed for diverse populations.

Keywords: Alzheimer's disease; Dementia prevention; Home-based assessment; Randomized clinical trial.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dementia / prevention & control*
  • Feasibility Studies
  • Female
  • Geriatric Assessment*
  • Healthy Volunteers / statistics & numerical data*
  • Home Care Services
  • Humans
  • Male
  • Neuropsychological Tests / statistics & numerical data
  • Surveys and Questionnaires*
  • Telephone