​​​​Welcome to the IMPACT Knowledge Repository, a searchable collection of resources related to pragmatic clinical trials for people living with dementia and their caregivers. For additional content and information visit the IMPACT Collaboratory.


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Grand Rounds 52: Improving Advance Care Planning for Seriously Ill Primary Care Patients: UC Health Care Planning Study (Video)1/16/2025Grand Rounds/Webinars
(Video) In this Grand Rounds, Rebecca Sudore, MD, and Anne Walling, MD, PhD, discuss the evolving Advance Care Planning (ACP) definition and research along with lessons learned from their ACP PCORI pragmatic randomized control trial.
Grand Rounds 52: Improving Advance Care Planning for Seriously Ill Primary Care Patients: UC Health Care Planning Study (Slides)1/16/2025Grand Rounds/Webinars
(Slides) In this Grand Rounds, Rebecca Sudore, MD, and Anne Walling, MD, PhD, discuss the evolving Advance Care Planning (ACP) definition and research along with lessons learned from their ACP PCORI pragmatic randomized control trial.
Randomized in error in pragmatic clinical trials1/1/2025Publications/Articles
(Article) Differential exclusion in pragmatic clinical trials after randomization can lead to selection bias.  Under the potential outcomes framework, investigators evaluated the feasibility of using a Bayesian model to identify the randomized-in-error status and estimate the average treatment effect among participants not randomized in error.
Comprehensive Dementia Care Models: State of the Science and Future Directions1/1/2025Publications/Articles
(Article) The current Annual State of the Science Review provides an overview of the current state of comprehensive dementia care models in the United States and relevant policies. Challenges and opportunities for nursing education, research, and implementation across the translational research continuum are also outlined.
Grand Rounds 51: COVID Vaccination among Medicare Beneficiaries: Findings from an IMPACT Supplement (Slides)12/19/2024Grand Rounds/Webinars
(Slides) In this Grand Rounds, Kaley Hayes, PharmD, PhD & Daniel Harris, PhD, MPH discuss the COVid VAXines Effects on the Aged (COVVAXAGE) database, which was the first project with NIA LINKAGE program (external data linkage to CMS data in NIA-funded projects); they walk through associated papers and lessons learned working with industry partners CVS and Walgreens.
Grand Rounds 51: COVID Vaccination among Medicare Beneficiaries: Findings from an IMPACT Supplement (Video)12/19/2024Grand Rounds/Webinars
(Video) In this Grand Rounds, Kaley Hayes, PharmD, PhD & Daniel Harris, PhD, MPH discuss the COVid VAXines Effects on the Aged (COVVAXAGE) database, which was the first project with NIA LINKAGE program (external data linkage to CMS data in NIA-funded projects); they walk through associated papers and lessons learned working with industry partners CVS and Walgreens.
"What Matters" in the Emergency Department: A Prospective Analysis of Older Adults' Concerns and Desired Outcomes12/1/2024Publications/Articles
(Article) Researchers performed a secondary analysis of a multicenter prospective observational study as part of the 4Ms framework identifying "What Matters" to older adults seeking emergency department care and to identify patient characteristics associated with meeting desired outcomes.
Developing a prediction model for cognitive impairment in older adults following critical illness11/29/2024Publications/Articles
(Article) Researchers developed and tested a machine learning model for identifying new cognitive impairment or dementia in older adults after critical illness using electronic health record (EHR) data. Findings indicate taht machine learning using EHR data can predict new CI or dementia at 1-year post ICU discharge with acceptable accuracy, but further studies are needed.
Technology that CARES: Enhancing dementia care through everyday technologies11/7/2024Publications/Articles
(Article) Investigators provide a common language and conceptual structure to understand digital technology use in ADRD care. They describe the pathways by which researchers might develop and deploy technology, including via Cognitive offloading, Automation, Remote monitoring, Emotional/social support, and Symptom treatment (CARES) and highlight emerging issues in technology-based care research.
Variation in the time to complete the primary COVID-19 vaccine series by race, ethnicity, and geography among older US adults11/7/2024Publications/Articles
(Article) The researchers conducted an observational study using the COVVAXAGE database. Medicare beneficiaries who received the COVID-19 vaccine primary series (two doses) between 01/01/2021 and 12/31/2021 were included. Racial differences in the time between doses was assessed across levels of urbanicity using g-formula.  Most beneficiaries received their second COVID-19 vaccine on time. Racial disparities were observed and shown to vary in size by geographic area.
A mixed-methods examination of the acceptability of, CareMOBI, a dementia-focused mhealth app, among primary care providers11/5/2024Publications/Articles
(Article) The aim of this study was to examine the acceptability of CareMOBI in the primary care setting and identify factors contributing to the likelihood of adoption among primary care providers. CareMOBI (mhealth for Organization to Bolster Interconnectedness) is a user-centered mobile application that supports secure communication between adult day health centers, primary care providers, and family caregivers.
Reactions of clinical neuropsychologists to the Alzheimer's Association workgroup's draft diagnostic and staging criteria for Alzheimer's disease10/29/2024Publications/Articles
(Article) Researchers surveyed clinical neuropsychologists with expertise in dementia about the criteria for diagnosing and staging of Alzheimer's disease recently published by an Alzheimer's Association workgroup.
Grand Rounds 50: Using Pilot Studies to Inform ePCTs in Hispanic/Latino People Living with Dementia and their Care Partners (Slides)10/17/2024Grand Rounds/Webinars
(Slides)  In this Grand Rounds, Maggie Ramirez, PhD, MS, MS, and Rafael Samper-Ternent, MD, PhD, describe "Using Pilot Studies to Inform ePCTs in Hispanic/Latino People Living with Dementia and their Care Partners"
Grand Rounds 50: Using Pilot Studies to Inform ePCTs in Hispanic/Latino People Living with Dementia and their Care Partners (Video)10/17/2024Grand Rounds/Webinars
(Video)  In this Grand Rounds, Maggie Ramirez, PhD, MS, MS, and Rafael Samper-Ternent, MD, PhD, describe "Using Pilot Studies to Inform ePCTs in Hispanic/Latino People Living with Dementia and their Care Partners"
Emergency Department Visits Among Patients with Dementia Before and After Diagnosis10/14/2024Publications/Articles
(Article) This cohort study assesses changes in emergency department (ED) use among Medicare beneficiaries aged 65 years and older before and after receiving a diagnosis of dementia. Researcher used data from the Medicare Current Beneficiary Survey from 2015 to 2021 to identify sample of 1779 Medicare beneficiaries with incident dementia and 3558 matched comparators without dementia.
Technology-based instrumental activities of daily living in persons with Alzheimer's disease and related disorders10/10/2024Publications/Articles
(Article) The current study examined the applicability and diagnostic accuracy of technology-based Instrumental activities of daily living (iADLs) in those evaluated for Alzheimer's disease and related dementias (ADRD).
A review of current practice in the design and analysis of extremely small stepped-wedge cluster randomized trials10/8/2024Publications/Articles
(Article) Authors conducted a review of published small stepped-wedge cluster randomized trials to understand how and why they are used, and to characterize approaches used in their design and analysis.
Feasibility of Implementing Dementia Collaborative Coaching into Routine Care in Nursing Homes10/6/2024Publications/Articles
(Article) This study evaluated the feasibility of implementing Dementia Collaborative Coaching (DCC) into the routine workflow of speech-language pathologists (SLPs) working in nursing homes (NHs). DCC is an intervention delivered by SLPs to train nursing assistants (CNAs) in communication strategies to support people living with dementia (PLWD).
Exploring Family Caregivers' Likelihood of Adopting a Novel App That Connects Care Teams of Persons Living With Dementia: A Mixed-Methods Study10/5/2024Publications/Articles
(Article) The research involved a concurrent mixed-methods triangulation design to assess the acceptability and likely use of CareMOBI, a mHealth app prototype that aims to support improved care coordination and communication between care team members, among family caregivers of PLWD adopting app.
Alzheimer's disease biomarkers and the tyranny of treatment10/3/2024Publications/Articles
(Article) Authors reflect on the advanced in Alzheimer's disease treatment and the implications these advances have on both therapeutic and diagnostic options for people living with the disease.
Embedding Authorship Identity into a Portal-Based Agenda Setting Intervention to Support Older Adults and Care Partners10/1/2024Publications/Articles
(Article) This cross-sectional chart review study evaluated an adaptation to OurNotes, a portal-based pre-visit agenda setting questinnaire.  The adaptation included a self-identification question to help clinicians interpret information by nonpatients of patients in a geriatric practice.
Socioeconomic and medical determinants of state-level subjective cognitive decline in the United States10/1/2024Publications/Articles
(Article) This study highlights critical links between subjective cognitive decline SCD and socioeconomic and medical determinants in adults aged ≥ 45 in the United States, including the prevalence of poverty, diabetes, and hypertension
Grand Rounds 49: Evidence for Reducing Infections, Hospitalizations, and Antibiotic Resistant Pathogens in Nursing Homes through Universal Nasal Decolonization & Bathing with Chlorhexidine (Slides)9/19/2024Grand Rounds/Webinars
(Slides) In this Grand Rounds, Susan Huang, MD, MPH, presents on "Evidence for Reducing Infections, Hospitalizations, and Antibiotic Resistant Pathogens in Nursing Homes through Universal Nasal Decolonization & Bathing with Chlorhexidine."
Grand Rounds 49: Evidence for Reducing Infections, Hospitalizations, and Antibiotic Resistant Pathogens in Nursing Homes through Universal Nasal Decolonization & Bathing with Chlorhexidine (Video)9/19/2024Grand Rounds/Webinars
(Video) In this Grand Rounds, Susan Huang, MD, MPH, presents on "Evidence for Reducing Infections, Hospitalizations, and Antibiotic Resistant Pathogens in Nursing Homes through Universal Nasal Decolonization & Bathing with Chlorhexidine."
Executive Functions are Independently Associated with Cognitive Dispersion in HIV Disease9/17/2024Publications/Articles
A Pragmatic Approach to Identifying Goal-Concordant Care for Nursing Home Residents with Alzheimer’s Disease or Related Dementias9/16/2024Publications/Articles
(Research Letter) Researcher team sought to develop an innovative pragmatic approach to identifying goal-concordant care among nursing home (NH) residents with ADRD using existing NH EHR data from one large NH chain as a first step towards operationalizing an outcome that can be used in pragmatic trials.
Health equity in COVID-19 testing among patients of a large national pharmacy chain9/11/2024Publications/Articles
Discontinuing the Term “Stakeholder” From the NIA IMPACT Collaboratory Engaging Partners Team: An Example of the Process of Language Change in an Organization9/4/2024Publications/Articles
(Article) Authors describe the process of changing language of the National Institute on Aging Imbedded Pragmatic Alzheimer's disease and related dementia Clinical Trials Collaboratory (IMPACT Collaboratory) “Stakeholder Engagement Team” to “Engaging Partners Team” in response to feedback and reflection on the term “stakeholder” and its problematic connotations.
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