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

Abstract

IntroductionThere is an unmet need for effective methods for conducting dementia prevention trials.MethodsHome‐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.ResultsAnalysis 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.DiscussionRelatively 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.

Protocol for the Brain Health Support Program Study of the Canadian Therapeutic Platform Trial for Multidomain Interventions to Prevent Dementia (CAN-THUMBS UP): A Prospective 12-Month Intervention Study

“…This fully remote online research protocol provides an accessible approach to research, with all study activities being completed in the participants’ home environment. Previous studies have demonstrated that in-home assessments are feasible and can be implemented with acceptable study dropout rates ( 26 ). In the BHSP Study, data is collected by utilizing adapted remote assessments with accessible technology (e.g., videoconferencing, electronic informed consent, cognitive testing via computer and mobile phone, wearable devices to track physical activity and sleep, self-administered saliva sample collection).…”

A survey of smartphone and interactive video technology use by participants in Alzheimer's disease research: Implications for remote cognitive assessment

“…Remote cognitive assessments, if well validated, will also have similar benefits for clinical assessments, potentially improving access and diminishing health disparities. Previous work has supported the feasibility and utility of home‐based cognitive assessments, 12 and recently published guidance details considerations and best practices for conducting remote cognitive and behavioral assessment 13 . Considerations for remote assessment include potential impacts of vision or hearing impairments, size and resolution of display screens, and reliability/stability of internet connectivity.…”

Early Detection of Mild Cognitive Impairment (Mci) in an at-Home Setting

“…In recent years, interest in methods to evaluate cognitive performance outside a clinical setting has steadily increased, with countless cognitive performance assessments in development across academia and industry. At-home cognitive assessments, including phone-based and online batteries, have shown promise in identifying individuals who are most likely to have MCI identified through outpatient neuropsychometric testing (12). A variety of assessments are currently available to consumers for at-home use, though levels of clinical validation and interactivity vary (Table 1).…”