ArticleJournal of the American Geriatrics Society2020
D-CARE: The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System-Based Versus Community-Based Dementia Care Versus Usual Dementia Care.
Article in Journal of the American Geriatrics Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for primary care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Guideline
- The Alzheimer's Association clinical practice guideline for the Diagnostic Evaluation, Testing, Counseling, and Disclosure of Suspected Alzheimer's Disease and Related Disorders (DETeCD-ADRD): Executive summary of recommendations for specialty care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Guideline
- Correlates and predictors of self-efficacy among dementia caregivers: D-CARE findings.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Trial
- Patient and Caregiver Outcomes of Health System, Community-Based, and Usual Dementia Care: A Prespecified Analysis of the Dementia Care Study (D-CARE) Randomized Clinical Trial.JAMA internal medicine · 2025Trial
- Clinical Outcomes and Cost-Effectiveness of Collaborative Dementia Care: A Secondary Analysis of a Cluster Randomized Clinical Trial.JAMA network open · 2024Trial
- The dementia care study (D-CARE): Recruitment strategies and demographic characteristics of participants in a pragmatic randomized trial of dementia care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Trial
- Dissemination of a successful dementia care program: Lessons to facilitate spread of innovations.Journal of the American Geriatrics Society · 2022Trial
- Utility of a short, telephone-administered version of the Montreal Cognitive Assessment.Journal of the American Geriatrics Society · 2021Trial
- Partnering with Latino communities for dementia research: a mixed-methods study of engagement.Research involvement and engagement · 2026Article
- The Evolution in Dementia Caregiving Research: NIA's Catalyst Role.The Gerontologist · 2024Article
- Promoting serious illness conversations in primary care through telehealth among persons living with cognitive impairment.Journal of the American Geriatrics Society · 2024Article
- The Complex Relationship Between Social and Functional Needs in Frail Older Adults.North Carolina medical journal · 2024Article
- Palliative Care Coordination Interventions for Caregivers of Community-Dwelling Individuals with Dementia: An Integrative Review.Nursing reports (Pavia, Italy) · 2024Review
- The Pepper Older Americans Independence Centers: An NIA-sponsored program for improving physical function among older persons.Journal of the American Geriatrics Society · 2024Article
- Dissemination of a successful dementia care program: Lessons from early adopters.Journal of the American Geriatrics Society · 2022Article
- Participation of persons with dementia and their caregivers in research.Journal of the American Geriatrics Society · 2021Review
- Alzheimer disease.Nature reviews. Disease primers · 2021Review
- Aducanumab: Appropriate Use Recommendations.The journal of prevention of Alzheimer's disease · 2021Article
Corrections and comments
- Erratum issuedErratum.2022
Authors and funding
35 authors.
Funding
Abstract
BACKGROUND/
objectivesAlthough several approaches have been developed to provide comprehensive care for persons living with dementia (PWD) and their family or friend caregivers, the relative effectiveness and cost effectiveness of community-based dementia care (CBDC) versus health system-based dementia care (CBDC) and the effectiveness of both approaches compared with usual care (UC) are unknown.
designPragmatic randomized three-arm superiority trial. The unit of randomization is the PWD/caregiver dyad.
settingFour clinical trial sites (CTSs) based in academic and clinical health systems.
participantsA total of 2,150 English- or Spanish-speaking PWD who are not receiving hospice or residing in a nursing home and their caregivers.
interventionsEighteen months of (1) HSDC provided by a nurse practitioner or physician's assistant dementia care specialist who works within the health system, or (2) CBDC provided by a social worker or nurse care consultant who works at a community-based organization, or (3) UC with as needed referral to the Alzheimer's Association Helpline. MEASUREMENTS: Primary outcomes: PWD behavioral symptoms and caregiver distress as measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q) Severity and Modified Caregiver Strain Index scales. SECONDARY OUTCOMES: NPI-Q Distress, caregiver unmet needs and confidence, and caregiver depressive symptoms. Tertiary outcomes: PWD long-term nursing home placement rates, caregiver-reported PWD functional status, cognition, goal attainment, "time spent at home," Dementia Burden Scale-Caregiver, a composite measure of clinical benefit, Quality of Life of persons with dementia, Positive Aspects of Caregiving, and cost effectiveness using intervention costs and Medicare claims.
resultsThe results will be reported in the spring of 2024.
conclusionD-CARE will address whether emphasis on clinical support and tighter integration with other medical services has greater benefit than emphasis on social support that is tied more closely to community resources. It will also assess the effectiveness of both interventions compared with UC and will evaluate the cost effectiveness of each intervention.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.