FACILITATING DEMENTIA SCREENING, EDUCATION AND REFERRAL

DESCRIPTION (provided by applicant): This application proposes to develop two interactive voice response (IVR) products: Alzheimer's Early Recognition Telephone System (ALERTS) and Telephonic Remote Evaluation of Neuropsychological Deficits (TREND). Research results from a previous Phase I grant provide the conceptual and scientific foundations for these products. Two independent research projects are proposed. In collaboration with the Wisconsin Alzheimer's Institute, ALERTS content will be developed and statewide system implementation will be promoted and evaluated by a regionally disperse network of diagnostic clinics and local chapters of the Alzheimer's Association. Modules to be included in ALERTS will be: (1) educational information about dementia; (2) current treatments; (3) informant-based or individual direct screening; (4) caregiver support; and (5) local resource referral. If successful in promoting early detection and initiation of dementia treatment, ALERTS design will permit nationwide expansion and multilingual delivery. Continued support and system expansion would be beneficial to public health agencies, private patient advocacy groups, and the pharmaceutical industry. In collaboration with the NIA-funded Alzheimer's Disease Center at Stanford University, a 24-week longitudinal study of TREND will be conducted with 105 subjects (N=35 from elderly controls, mild cognitive impairment, mild dementia). TREND data will be compared to clinical assessments using both the cognitive and non-cognitive items of the Alzheimer's disease Assessment Scale (ADAS) to assess the reliability and validity of IVR automated monitoring of longitudinal changes in cognitive functioning. If successful, pharmaceutical companies could be provided the ability to collect reliable and valid data remotely with electronic storage of data for immediate availability during and after randomized clinical trials. TREND availability would permit frequent patient evaluation with fewer logistic difficulties than is currently possible. Such capabilities would promote more rapid submission of effective compounds to the Food and Drug Administration and reduce drug development cycles. Methodological proof-of-concept regarding IVR assessment of cognitive deficits would open new avenues for research into treatments of many disorders and diseases, such as schizophrenia, depression, Parkinson's disease, epilepsy, alcohol and other drug dependence, and stroke.