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

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 liveassessors has implications for internet-based recruitment and assessment efforts currently proposed for diverse populations. Published by Elsevier Inc. on behalf of the Alzheimer's Association.