The National Institute on Aging (NIA), part of the National Institutes of Health (NIH), has allocated up to $53.4 million over a five-year period to test care interventions in real-world settings. Brown University (Providence, RI) will partner with Hebrew Senior Life (a Harvard Medical School Affiliate in Roslindale, MA), to meet the challenges of complex care management for people with Alzheimer’s disease and related dementias (AD/ADRD) and their families. Specifically known as the Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory, the investigators will team with scientists at other universities with health care and long-term care systems to guide research to develop and test novel ways to care for people with AD/ADRD.

Modeled After NIH’s Health Care Systems Research Collaboratory

The IMPACT Collaboratory is modeled after a similar NIH model known as Health Care Systems Research Collaboratory. This program involves the partnering with health care systems to conduct large-scale clinical trials. Much like the NIH program, the new Collaboratory will promote the development of pragmatic clinical trials conducted in settings such as hospitals, homes, assisted living facilities, adult day centers, and nursing homes, simultaneously training the next generation of pragmatic trialists. IMPACT Collaboratory will also serve as a national resource to support the development of pilot clinical trials to improve care and health outcomes for people with dementia and their caregivers, both in the home and in these other settings reports the National Institutes of Health.

Community Care Environment

Conducting real-world studies directly in dementia care environments offers care improvement opportunities as the organic insights gleaned in these everyday settings should allow broader participation of diverse participants—it will also strengthen the applicability and implementation of research results in real-world settings.

Problems with Disjointed Approaches

Lack of continuity in dementia care is associated with higher rates of hospitalization, emergency department visits, testing and health care spending, as well as premature institutionalization and burdensome transitions in late-life dementia, according to study results. This poor quality of care leads to a worse quality of life for those with dementia and their caregivers. Presently, 5.6 million Americans 65+ live with Alzheimer’s disease—most of them cared for by family members.

IMPACT is Different

Unlike traditional clinical studies (e.g. random controlled, etc.) pragmatic trials test interventions in real-life settings, such as hospitals and medical clinics, where people receiving care are more representative of general patient populations. Pragmatic trials use relatively simple study designs without sacrificing scientific rigor.


Richard J. Hodes, MD, director of NIA

Call to Action: This fascinating opportunity for real-world setting, pragmatic studies affords new opportunity to improve care for Alzheimer’s disease and dementia patients. We offer the Director of NIA’s contact information.

Source: National Institute on Aging

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