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Editorial| Volume 19, ISSUE 7, P560-562, July 2018

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Identifying and Supporting Nonpharmacological Dementia Interventions Ready for Pragmatic Trials: Results From an Expert Workshop

      In October 2017, the National Institute on Aging (NIA) convened the National Research Summit on Care, Services and Supports for Persons with Dementia and their Caregivers. The summit was a national 2-day research conference to discuss accelerating improvements in care for people with Alzheimer's disease and related dementias (ADRD) and their caregivers.
      Office of the Assistant Secretary for Planning and Evaluation
      National Research Summit on Care, Services and Supports for Persons With Dementia and Their Caregivers: Goal [Online].
      Improving ADRD care is a national priority.
      National Institute on Aging
      Alzheimer's Disease and Related Dementias research implementation milestone database [Online].
      Over 5 million Americans currently live with ADRD; the lifetime cost of caring for a person with ADRD is $321,780,
      • Jutkowitz E.
      • Kane R.L.
      • Gaugler J.E.
      • et al.
      Societal and family lifetime cost of dementia: Implications for policy.
      and on a population level annual costs exceed $226 billion.
      Alzheimer’s Association
      2015 Alzheimer's disease facts and figures.
      Numerous nonpharmacologic interventions have demonstrated efficacy in improving outcomes in persons with ADRD and their caregivers in multiple care settings. However, many of these interventions have not been widely adopted, and observational studies continue to find that care for people with ADRD and their families remains suboptimal.
      • Ahronheim J.C.
      • Morrison R.S.
      • Baskin S.A.
      • et al.
      Treatment of the dying in the acute care hospital. Advanced dementia and metastatic cancer.
      • Mitchell S.L.
      • Kiely D.K.
      • Hamel M.B.
      Dying with advanced dementia in the nursing home.
      • Mitchell S.L.
      • Teno J.M.
      • Kiely D.K.
      • et al.
      The clinical course of advanced dementia.
      • Mitchell S.L.
      • Black B.S.
      • Ersek M.
      • et al.
      Advanced dementia: State of the art and priorities for the next decade.
      • Teno J.M.
      • Gozalo P.
      • Khandelwal N.
      • et al.
      Association of increasing use of mechanical ventilation among nursing home residents with advanced dementia and intensive care unit beds.
      • Mitchell S.L.
      • Mor V.
      • Gozalo P.L.
      • et al.
      Tube feeding in US nursing home residents with advanced dementia, 2000-2014.
      Pragmatic trials have the potential to accelerate the translation of evidence-based, nonpharmacologic, ADRD interventions into clinical practice. The National Institutes of Health (NIH) has invested in a pragmatic trial infrastructure via the NIH Common Fund Collaboratory, but the Collaboratory has not focused on trials of ADRD interventions implemented in the various care settings in which people with ADRD are served.
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      References

        • Office of the Assistant Secretary for Planning and Evaluation
        National Research Summit on Care, Services and Supports for Persons With Dementia and Their Caregivers: Goal [Online].
        (Available at:)
        • National Institute on Aging
        Alzheimer's Disease and Related Dementias research implementation milestone database [Online].
        (Available at:)
        https://www.nia.nih.gov/research/milestones
        Date accessed: February 5, 2018
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        • Kane R.L.
        • Gaugler J.E.
        • et al.
        Societal and family lifetime cost of dementia: Implications for policy.
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        • Baskin S.A.
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        Treatment of the dying in the acute care hospital. Advanced dementia and metastatic cancer.
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        Dying with advanced dementia in the nursing home.
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        • Teno J.M.
        • Kiely D.K.
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        The clinical course of advanced dementia.
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        • Black B.S.
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        Advanced dementia: State of the art and priorities for the next decade.
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        • Gozalo P.
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        • Mor V.
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        Tube feeding in US nursing home residents with advanced dementia, 2000-2014.
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      1. State of the science for pragmatic trials of non-drug interventions to improve outcomes among persons with dementia and their caregivers [Online].
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        • National Institutes of Health (NIH) Common Fund
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        (Available at:)
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        Date accessed: February 5, 2018