<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03773757</url>
  </required_header>
  <id_info>
    <org_study_id>1707549593</org_study_id>
    <secondary_id>1R01AG057733-01A1</secondary_id>
    <nct_id>NCT03773757</nct_id>
  </id_info>
  <brief_title>Indiana Palliative Excellence in Alzheimer's Care Efforts</brief_title>
  <acronym>IN-PEACE</acronym>
  <official_title>Indiana Palliative Excellence in Alzheimer's Care Efforts- Randomized Control Trial</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Indiana University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Regenstrief Institute, Inc.</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>National Institute on Aging (NIA)</agency>
      <agency_class>NIH</agency_class>
    </collaborator>
  </sponsors>
  <source>Indiana University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The overarching goal of this research is to improve the care of community dwelling patients&#xD;
      with dementia and their family caregivers through an innovative model of supportive care that&#xD;
      combines an existing, evidence-based intervention for dementia care with an innovative&#xD;
      intervention for palliative care in dementia. The intervention projects this care into the&#xD;
      homes of patients and caregivers, empowering caregivers, and integrating with ongoing care.&#xD;
      IN-PEACE will enroll 200 patient-caregiver dyads, randomizing 100 dyads each to the&#xD;
      intervention and usual care arms and follow for 24 months with quarterly outcome assessments.&#xD;
      The core of the multi-component intervention is regular, proactive telephone contact by a&#xD;
      dementia care coordinator (DCC; social worker or RN) to anticipate and identify patients'&#xD;
      symptoms and caregivers needs and address by utilizing specific, evidence-based protocols.&#xD;
      Protocols cover basic dementia care, caregiver distress, neuropsychiatric symptoms, pain,&#xD;
      navigating the hospital, feeding difficulties, and transition to hospice. The intervention&#xD;
      also involves advance care planning and support with caregivers tailored to decisions faced&#xD;
      in dementia care, highlighting where palliative care options can replace the default that&#xD;
      often results in burdensome treatments.&#xD;
&#xD;
      The primary aim of IN-PEACE is to test the effect of the intervention on patients'&#xD;
      neuropsychiatric symptoms. Other aims include testing the effect of IN-PEACE on patients'&#xD;
      overall symptom outcomes, caregiver mood and distress, and the provision of burdensome&#xD;
      treatments to patients (hospitalizations and emergency room visits).&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Dementia is an increasingly prevalent, costly and burdensome condition. The dramatic aging of&#xD;
      the US population is creating a dementia &quot;epidemic&quot; that our health care system is poorly&#xD;
      prepared to handle. More than 5 million people are affected by Alzheimer's disease (AD) and&#xD;
      related dementias in 2016, with that number estimated to nearly triple to 13.8 million by&#xD;
      2050. The direct health care costs alone for dementia care are projected to increase from&#xD;
      $236 billion in 2016 to more than $1 trillion in 2050. In addition to cognitive and&#xD;
      functional deterioration, patients with dementia experience behavioral and psychological&#xD;
      complications such as agitation and depression. Family caregivers of patients with dementia&#xD;
      experience higher levels of anxiety, depression, chronic fatigue, and an increased mortality&#xD;
      risk.&#xD;
&#xD;
      Dementia and palliative care are national research priorities. Both dementia and palliative&#xD;
      care have been identified as priority conditions for research and quality improvement by&#xD;
      numerous organizations such as the Institute of Medicine, National Quality Forum, the Centers&#xD;
      for Medicare and Medicaid Services, and Agency for Healthcare Research and Quality and&#xD;
      National Institute on Aging. In addition, a workgroup developing milestones for care and&#xD;
      support under the U.S. National Alzheimer's Plan has explicitly stated that palliative care&#xD;
      needs to be incorporated throughout the course of caring for patients and families affected&#xD;
      by dementia.&#xD;
&#xD;
      2.0 Rationale and Specific Aims&#xD;
&#xD;
      Aim 1: To test the effect of the IN-PEACE intervention on patients' neuropsychiatric symptoms&#xD;
      (e.g., agitation/aggression, anxiety, repetitive behaviors). Mixed effects models will be&#xD;
      used to compare repeated NPI-Q scores obtained at 3, 6, 9, 12, 15, 18, 21, and 24 months.&#xD;
      Repeatedly measured NPI-Q scores will be the dependent variable in the model.&#xD;
&#xD;
      Aim 2: To test the effect of the IN-PEACE intervention on patients' overall symptom outcomes.&#xD;
      Analyses in this aim will use repeatedly measured SM-EOLD scores over 24 months of follow-up&#xD;
      as the dependent variable in the mixed effects model, similarly to the approach described for&#xD;
      Aim 1.&#xD;
&#xD;
      Aim 3: To test the effect of the IN-PEACE intervention on caregivers' distress and mood. Aim&#xD;
      3 analyses will use repeatedly measured caregiver NPI-Q distress scores and caregiver PHQ-9&#xD;
      over 24 months of follow-up as the dependent variables in separate mixed effects models,&#xD;
      similar to the approach for Aim 1.&#xD;
&#xD;
      Aim 4: Evaluate the effect of the IN-PEACE intervention on ER/hospital use.&#xD;
      ER/hospitalization events will be obtained from accessing electronic medical records&#xD;
      maintained by the Indiana Health Information Exchange (IHIE) and the Indiana Network for&#xD;
      Patient Care (INPC). Poisson regression models will be used to compare rates of any&#xD;
      ER/hospitalization event between the two groups while adjusting for dementia severity and&#xD;
      significant baseline variables that differ between the two groups.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">December 1, 2018</start_date>
  <completion_date type="Actual">January 7, 2023</completion_date>
  <primary_completion_date type="Actual">January 7, 2023</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Supportive Care</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Neuropsychiatric Inventory Questionnaire (NPI-Q)</measure>
    <time_frame>0-24 months</time_frame>
    <description>To test the effect of the IN-PEACE intervention on patients' neuropsychiatric symptoms (e.g., agitation/aggression, anxiety, repetitive behaviors). Repeatedly measured NPI-Q scores will be the dependent variable in the model. Neuropsychiatric Inventory-Questionnaire is a questionnaire completed by caregivers about patients designed to measure both neuropsychiatric symptoms and caregiver stress. There were 12 symptoms included in NPI-Q. Each domain includes an initial response of &quot;yes&quot; or &quot;no&quot;. If &quot;yes&quot;, then the caregiver rates the severity of the symptom on a 3-point scale and caregiver distress in a 5-point scale. The NPI-Q provides a total severity score ranged 0-36 with higher scores indicating more severe symptoms.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Symptom Outcomes</measure>
    <time_frame>0-24 months</time_frame>
    <description>To test the effect of the IN-PEACE intervention on patients' overall symptom outcomes. Analyses in this aim will use repeatedly measured Symptom Management - End of Life for Dementia (SM-EOLD) scores as the dependent variable in the mixed effects model. Symptom Management in End of Life Dementia (SM-EOLD) is a 9-item scale that measures comfort in patients with advanced dementia. The symptoms assessed are pain, fear, depression, anxiety, dyspnea, agitation, skin breakdown, resistance to care, and calm (reverse scored). For each symptom, the frequency over the preceding 90 days is reported by a caregiver on a scale of 0 to 5 (daily, several days a week, once a week, 2 or 3 days a month, once a month, never). The SM-EOLD score is constructed by summing the value of each item, and ranges from 0-45 with higher scores indicating better symptom control.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Caregiver Mood, Distress</measure>
    <time_frame>0-24 months</time_frame>
    <description>To test the effect of the IN-PEACE intervention on caregivers' distress and mood. Analyses will use repeatedly measured caregiver Neuropsychiatric Inventory Questionnaire (NPI-Q) distress scores and caregiver Patient Health Questionnaire (PHQ-8) over 24 months of follow-up as the dependent variables in separate mixed effects models. See above for NPI-Q. The NPI-Q distress score is constructed by summing the values of the distress score of each symptom and ranges from 0-60 with higher score indicating more distress.&#xD;
PHQ-8 is a 8-item depression scale with a total score ranging from 0 to 24 with higher score indicating more depressive symptoms.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">402</enrollment>
  <condition>Dementia</condition>
  <arm_group>
    <arm_group_label>IN-PEACE Dementia Care Coordination</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>In-PEACE intervention arm will have monthly contact with a dementia care coordinator (DCC) to to identify symptoms the person with memory problems is having, including: pain, sadness, or other symptoms. The Dementia Care Coordinator will consult with the project clinical team to develop a plan of care utilizing standardized protocols to reduce the burdens of disease associated symptoms and behaviors.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Usual Care</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>The usual care arm will have access to education and informational materials from the local chapter of the Alzheimer's Association and other community resources and will be reminded of these resources throughout the study.</description>
  </arm_group>
  <intervention>
    <intervention_type>Behavioral</intervention_type>
    <intervention_name>IN-PEACE Dementia Care Coordination</intervention_name>
    <description>Patient/Caregivers assigned to the intervention arm will have monthly phone calls with a Nurse or Social Worker, in the capacity of a Dementia care coordinator (DCC) to identify symptoms and behavior problems the person with memory problems is having, including: pain, sadness, or other symptoms. The Dementia Care Coordinator will consult with the project clinical team to develop a plan of care utilizing standardized protocols to reduce the burdens of disease associated symptoms and behaviors. In addition, education and support materials will be provided to the caregiver in the role caring and management of a patient with dementia.</description>
    <arm_group_label>IN-PEACE Dementia Care Coordination</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria: Community-dwelling and living in the Indianapolis metropolitan area;&#xD;
        Patient with an established diagnosis of dementia of any etiology; Dementia in the moderate&#xD;
        (FAST stage 5) to severe stage (FAST 6-7); and English-speaking Primary caregiver informant&#xD;
        enrolled in study.&#xD;
&#xD;
        Exclusion Criteria: Patient with dementia residing in a nursing facility or receiving&#xD;
        hospice care; Patient or Caregiver with long-standing history of severe mental illness or&#xD;
        Psychiatric disorder preexisting the dementia diagnosis. Initially, non-English speaking&#xD;
        patients were excluded. On April 14, 2020, IRB Amendment eliminated this exclusion so&#xD;
        non-English speaking patients could be enrolled as long as their Caregiver was&#xD;
        English-speaking and able to complete assessments.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>65 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Greg A Sachs, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Indiana University</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Sandra Eskenazi Center for Brain Care Innovation</name>
      <address>
        <city>Indianapolis</city>
        <state>Indiana</state>
        <zip>46202</zip>
        <country>United States</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <results_reference>
    <citation>Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL, DeKosky ST. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000 Spring;12(2):233-9. doi: 10.1176/jnp.12.2.233.</citation>
    <PMID>11001602</PMID>
  </results_reference>
  <results_reference>
    <citation>Volicer L, Hurley AC, Blasi ZV. Scales for evaluation of End-of-Life Care in Dementia. Alzheimer Dis Assoc Disord. 2001 Oct-Dec;15(4):194-200. doi: 10.1097/00002093-200110000-00005.</citation>
    <PMID>11723370</PMID>
  </results_reference>
  <results_reference>
    <citation>Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201. doi: 10.1097/00005650-200412000-00006.</citation>
    <PMID>15550799</PMID>
  </results_reference>
  <verification_date>February 2023</verification_date>
  <study_first_submitted>November 21, 2018</study_first_submitted>
  <study_first_submitted_qc>December 11, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 12, 2018</study_first_posted>
  <last_update_submitted>February 21, 2023</last_update_submitted>
  <last_update_submitted_qc>February 21, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">February 23, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Indiana University</investigator_affiliation>
    <investigator_full_name>Greg Sachs</investigator_full_name>
    <investigator_title>Professor of Medicine, Division Chief General Internal Medicine and Geriatrics</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Dementia</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Informed Consent Form</document_type>
      <document_has_protocol>No</document_has_protocol>
      <document_has_icf>Yes</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>March 29, 2018</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/57/NCT03773757/ICF_000.pdf</document_url>
    </provided_document>
  </provided_document_section>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03773757
org study id: 1707549593
secondary id: 1R01AG057733-01A1
nct id: NCT03773757
lead sponsor: 
collaborator: 
collaborator: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
The overarching goal of this research is to improve the care of community dwelling patients
      with dementia and their family caregivers through an innovative model of supportive care that
      combines an existing, evidence-based intervention for dementia care with an innovative
      intervention for palliative care in dementia. The intervention projects this care into the
      homes of patients and caregivers, empowering caregivers, and integrating with ongoing care.
      IN-PEACE will enroll 200 patient-caregiver dyads, randomizing 100 dyads each to the
      intervention and usual care arms and follow for 24 months with quarterly outcome assessments.
      The core of the multi-component intervention is regular, proactive telephone contact by a
      dementia care coordinator (DCC; social worker or RN) to anticipate and identify patients'
      symptoms and caregivers needs and address by utilizing specific, evidence-based protocols.
      Protocols cover basic dementia care, caregiver distress, neuropsychiatric symptoms, pain,
      navigating the hospital, feeding difficulties, and transition to hospice. The intervention
      also involves advance care planning and support with caregivers tailored to decisions faced
      in dementia care, highlighting where palliative care options can replace the default that
      often results in burdensome treatments.

      The primary aim of IN-PEACE is to test the effect of the intervention on patients'
      neuropsychiatric symptoms. Other aims include testing the effect of IN-PEACE on patients'
      overall symptom outcomes, caregiver mood and distress, and the provision of burdensome
      treatments to patients (hospitalizations and emergency room visits).
Dementia is an increasingly prevalent, costly and burdensome condition. The dramatic aging of
      the US population is creating a dementia "epidemic" that our health care system is poorly
      prepared to handle. More than 5 million people are affected by Alzheimer's disease (AD) and
      related dementias in 2016, with that number estimated to nearly triple to 13.8 million by
      2050. The direct health care costs alone for dementia care are projected to increase from
      $236 billion in 2016 to more than $1 trillion in 2050. In addition to cognitive and
      functional deterioration, patients with dementia experience behavioral and psychological
      complications such as agitation and depression. Family caregivers of patients with dementia
      experience higher levels of anxiety, depression, chronic fatigue, and an increased mortality
      risk.

      Dementia and palliative care are national research priorities. Both dementia and palliative
      care have been identified as priority conditions for research and quality improvement by
      numerous organizations such as the Institute of Medicine, National Quality Forum, the Centers
      for Medicare and Medicaid Services, and Agency for Healthcare Research and Quality and
      National Institute on Aging. In addition, a workgroup developing milestones for care and
      support under the U.S. National Alzheimer's Plan has explicitly stated that palliative care
      needs to be incorporated throughout the course of caring for patients and families affected
      by dementia.

      2.0 Rationale and Specific Aims

      Aim 1: To test the effect of the IN-PEACE intervention on patients' neuropsychiatric symptoms
      (e.g., agitation/aggression, anxiety, repetitive behaviors). Mixed effects models will be
      used to compare repeated NPI-Q scores obtained at 3, 6, 9, 12, 15, 18, 21, and 24 months.
      Repeatedly measured NPI-Q scores will be the dependent variable in the model.

      Aim 2: To test the effect of the IN-PEACE intervention on patients' overall symptom outcomes.
      Analyses in this aim will use repeatedly measured SM-EOLD scores over 24 months of follow-up
      as the dependent variable in the mixed effects model, similarly to the approach described for
      Aim 1.

      Aim 3: To test the effect of the IN-PEACE intervention on caregivers' distress and mood. Aim
      3 analyses will use repeatedly measured caregiver NPI-Q distress scores and caregiver PHQ-9
      over 24 months of follow-up as the dependent variables in separate mixed effects models,
      similar to the approach for Aim 1.

      Aim 4: Evaluate the effect of the IN-PEACE intervention on ER/hospital use.
      ER/hospitalization events will be obtained from accessing electronic medical records
      maintained by the Indiana Health Information Exchange (IHIE) and the Indiana Network for
      Patient Care (INPC). Poisson regression models will be used to compare rates of any
      ER/hospitalization event between the two groups while adjusting for dementia severity and
      significant baseline variables that differ between the two groups.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Supportive Care
masking: Single (Outcomes Assessor)
measure: Neuropsychiatric Inventory Questionnaire (NPI-Q)
time frame: 0-24 months
description: To test the effect of the IN-PEACE intervention on patients' neuropsychiatric symptoms (e.g., agitation/aggression, anxiety, repetitive behaviors). Repeatedly measured NPI-Q scores will be the dependent variable in the model. Neuropsychiatric Inventory-Questionnaire is a questionnaire completed by caregivers about patients designed to measure both neuropsychiatric symptoms and caregiver stress. There were 12 symptoms included in NPI-Q. Each domain includes an initial response of "yes" or "no". If "yes", then the caregiver rates the severity of the symptom on a 3-point scale and caregiver distress in a 5-point scale. The NPI-Q provides a total severity score ranged 0-36 with higher scores indicating more severe symptoms.
measure: Symptom Outcomes
time frame: 0-24 months
description: To test the effect of the IN-PEACE intervention on patients' overall symptom outcomes. Analyses in this aim will use repeatedly measured Symptom Management - End of Life for Dementia (SM-EOLD) scores as the dependent variable in the mixed effects model. Symptom Management in End of Life Dementia (SM-EOLD) is a 9-item scale that measures comfort in patients with advanced dementia. The symptoms assessed are pain, fear, depression, anxiety, dyspnea, agitation, skin breakdown, resistance to care, and calm (reverse scored). For each symptom, the frequency over the preceding 90 days is reported by a caregiver on a scale of 0 to 5 (daily, several days a week, once a week, 2 or 3 days a month, once a month, never). The SM-EOLD score is constructed by summing the value of each item, and ranges from 0-45 with higher scores indicating better symptom control.
measure: Caregiver Mood, Distress
time frame: 0-24 months
description: To test the effect of the IN-PEACE intervention on caregivers' distress and mood. Analyses will use repeatedly measured caregiver Neuropsychiatric Inventory Questionnaire (NPI-Q) distress scores and caregiver Patient Health Questionnaire (PHQ-8) over 24 months of follow-up as the dependent variables in separate mixed effects models. See above for NPI-Q. The NPI-Q distress score is constructed by summing the values of the distress score of each symptom and ranges from 0-60 with higher score indicating more distress.
PHQ-8 is a 8-item depression scale with a total score ranging from 0 to 24 with higher score indicating more depressive symptoms.
arm group label: IN-PEACE Dementia Care Coordination
arm group type: Experimental
description: In-PEACE intervention arm will have monthly contact with a dementia care coordinator (DCC) to to identify symptoms the person with memory problems is having, including: pain, sadness, or other symptoms. The Dementia Care Coordinator will consult with the project clinical team to develop a plan of care utilizing standardized protocols to reduce the burdens of disease associated symptoms and behaviors.
arm group label: Usual Care
arm group type: No Intervention
description: The usual care arm will have access to education and informational materials from the local chapter of the Alzheimer's Association and other community resources and will be reminded of these resources throughout the study.
intervention type: Behavioral
intervention name: IN-PEACE Dementia Care Coordination
description: Patient/Caregivers assigned to the intervention arm will have monthly phone calls with a Nurse or Social Worker, in the capacity of a Dementia care coordinator (DCC) to identify symptoms and behavior problems the person with memory problems is having, including: pain, sadness, or other symptoms. The Dementia Care Coordinator will consult with the project clinical team to develop a plan of care utilizing standardized protocols to reduce the burdens of disease associated symptoms and behaviors. In addition, education and support materials will be provided to the caregiver in the role caring and management of a patient with dementia.
arm group label: IN-PEACE Dementia Care Coordination
criteria: 
gender: All
minimum age: 65 Years
maximum age: N/A
healthy volunteers: No
last name: Greg A Sachs, MD
role: Principal Investigator
affiliation: Indiana University
facility: 
country: United States
citation: Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL, DeKosky ST. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000 Spring;12(2):233-9. doi: 10.1176/jnp.12.2.233.
PMID: 11001602
citation: Volicer L, Hurley AC, Blasi ZV. Scales for evaluation of End-of-Life Care in Dementia. Alzheimer Dis Assoc Disord. 2001 Oct-Dec;15(4):194-200. doi: 10.1097/00002093-200110000-00005.
PMID: 11723370
citation: Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004 Dec;42(12):1194-201. doi: 10.1097/00005650-200412000-00006.
PMID: 15550799
responsible party type: Principal Investigator
investigator affiliation: Indiana University
investigator full name: Greg Sachs
investigator title: Professor of Medicine, Division Chief General Internal Medicine and Geriatrics
mesh term: Dementia
sharing ipd: No
provided document: 