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NCT03786471: D-CARE

D-CARE - The Dementia Care Study: A Pragmatic Clinical Trial of Health System-Based Versus Community-Based Dementia Care

Completed NA Results posted Last updated 30 January 2025
What this trial tests

NA trial testing Health System-based Dementia Care in Dementia in 2,176 participants. Completed in 21 August 2023.

Timeline
28 June 2019
Primary endpoint
21 August 2023
21 August 2023

Quick facts

Lead sponsorUniversity of California, Los Angeles
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingdouble
Primary purposesupportive care
Enrollment2,176
Start date28 June 2019
Primary completion21 August 2023
Estimated completion21 August 2023
Sites4 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of California, Los Angeles

Who can join

Eligibility, any sex, with Dementia. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Severity of Dementia-related Behavioral Symptoms Primary · Baseline

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care10.32± 0.22
Community-Based Dementia Care9.93± 0.21
Usual Care10.42± 0.56
Severity of Dementia-related Behavioral Symptoms Primary · 3-month

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care9.10± 0.24
Community-Based Dementia Care8.98± 0.22
Usual Care9.67± 0.65
Severity of Dementia-related Behavioral Symptoms Primary · 6-month

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care9.41± .25
Community-Based Dementia Care8.78± .23
Usual Care9.93± .68
Severity of Dementia-related Behavioral Symptoms Primary · 12-month

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care9.58± .27
Community-Based Dementia Care9.14± .25
Usual Care9.95± .74
Severity of Dementia-related Behavioral Symptoms Primary · 18-month

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care9.80± 0.29
Community-Based Dementia Care9.51± 0.27
Usual Care9.60± 0.79
Severity of Dementia-related Behavioral Symptoms (Common Baseline) Primary · Baseline

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Common Baseline10.079.71 – 10.43
Severity of Dementia-related Behavioral Symptoms Primary · Average of 3M, 6M, 12M, and 18M least square means.

The severity of symptoms of psychopathology in persons with dementia as measured by the Neuro-Psychiatric Inventory Questionnaire - Severity (NPI-Q Severity). The NPI-Q Severity is a validated survey that assesses the caregiver's perception of the severity of 12 dementia-related psychiatric and behavioral symptoms. NPI-Q Severity score ranges from 0-36 with higher scores indicating more severe symptoms. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data

GroupValue95% CI
Health Systems-Based Dementia Care9.799.37 – 10.22
Community-Based Dementia Care9.509.08 – 9.91
Usual Care10.129.15 – 11.08
Caregiver Distress/Strain Primary · Baseline

The level of caregiver distress/strain as measured by the Modified Caregiver Strain Index (MCSI). The MCSI is a 13-item validated tool used to assess severity of caregiver strain. The index targets financial, physical, psychological, and social aspects of strain and is scored from 0 to 26 with higher scores indicating greater levels of strain. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data to a common "treatment 0." This entry presents the means of

GroupValue95% CI
Health Systems-Based Dementia Care11.03± 0.20
Community-Based Dementia Care10.65± 0.19
Usual Care11.13± 0.55
Caregiver Distress/Strain Primary · 3-month

The level of caregiver distress/strain as measured by the Modified Caregiver Strain Index (MCSI). The MCSI is a 13-item validated tool used to assess severity of caregiver strain. The index targets financial, physical, psychological, and social aspects of strain and is scored from 0 to 26 with higher scores indicating greater levels of strain. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data to a common "treatment 0." This entry presents the means of

GroupValue95% CI
Health Systems-Based Dementia Care10.52± 0.22
Community-Based Dementia Care10.01± 0.20
Usual Care10.00± 0.53
Caregiver Distress/Strain Primary · 6-month

The level of caregiver distress/strain as measured by the Modified Caregiver Strain Index (MCSI). The MCSI is a 13-item validated tool used to assess severity of caregiver strain. The index targets financial, physical, psychological, and social aspects of strain and is scored from 0 to 26 with higher scores indicating greater levels of strain. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data to a common "treatment 0." This entry presents the means of

GroupValue95% CI
Health Systems-Based Dementia Care10.61± 0.23
Community-Based Dementia Care10.26± 0.22
Usual Care10.53± 0.65
Caregiver Distress/Strain Primary · 12-month

The level of caregiver distress/strain as measured by the Modified Caregiver Strain Index (MCSI). The MCSI is a 13-item validated tool used to assess severity of caregiver strain. The index targets financial, physical, psychological, and social aspects of strain and is scored from 0 to 26 with higher scores indicating greater levels of strain. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data to a common "treatment 0." This entry presents the means of

GroupValue95% CI
Health Systems-Based Dementia Care11.00± 0.24
Community-Based Dementia Care10.50± 0.24
Usual Care10.41± 0.69
Caregiver Distress/Strain Primary · 18-month

The level of caregiver distress/strain as measured by the Modified Caregiver Strain Index (MCSI). The MCSI is a 13-item validated tool used to assess severity of caregiver strain. The index targets financial, physical, psychological, and social aspects of strain and is scored from 0 to 26 with higher scores indicating greater levels of strain. The analyses are comparisons between each arm's average of its 3-month, 6-month, 12-month, and 18-month least squares means using a constrained longitudinal model that assigns all baseline data to a common "treatment 0." This entry presents the means of

GroupValue95% CI
Health Systems-Based Dementia Care11.26± 0.26
Community-Based Dementia Care10.64± 0.24
Usual Care10.32± 0.72

Adverse events — posted to ClinicalTrials.gov

Time frame: Enrollment through death, withdrawal, or 18 months of follow-up. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Health Systems-Based Dementia Care
Serious: 528/1016 (52%)
Deaths: 254/1016
Community-Based Dementia Care
Serious: 533/1016 (52%)
Deaths: 223/1016
Usual Care
Serious: 70/144 (49%)
Deaths: 37/144

Serious adverse events (32 terms)

ReactionSystemHealth Systems-Based Demen…Community-Based Dementia C…Usual Care
Falls or fracturesMusculoskeletal and connective tissue disorders
InfectionInfections and infestations
NeurologicNervous system disorders
CardiopulmonaryCardiac disorders
GastroenterologicGastrointestinal disorders
CardiopulmonaryRespiratory, thoracic and mediastinal disorders
Unknown/OtherGeneral disorders
COVID-19Infections and infestations
Renal or electrolytesRenal and urinary disorders
Neuropsychiatric complications of dementiaPsychiatric disorders
Surgical procedure other than fracture repairSurgical and medical procedures
MuskuloskeletalMusculoskeletal and connective tissue disorders
Unknown/OtherInfections and infestations
Endocrine or MetabolicEndocrine disorders
Unknown/OtherMusculoskeletal and connective tissue disorders
OncologicNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Unknown/OtherCardiac disorders
HematologicHepatobiliary disorders
Unknown/OtherNervous system disorders
Unknown/OtherRespiratory, thoracic and mediastinal disorders
Unknown/OtherSurgical and medical procedures
AllergicImmune system disorders
Unknown/OtherInjury, poisoning and procedural complications
CardiopulmonaryCardiac disorders
CardiopulmonaryInfections and infestations

Most-reported serious reactions: Falls or fractures, Infection, Neurologic, Cardiopulmonary, Gastroenterologic, Cardiopulmonary, Unknown/Other, COVID-19.

Data from ClinicalTrials.gov NCT03786471 adverse events section.

Sponsor's own description

D-CARE: The Dementia Care Study This pragmatic randomized clinical trial of 2150 persons with dementia and their caregivers, at four diverse clinical trial sites in the United States, compares the effectiveness and cost-effectiveness of 18 months of health systems-based dementia care provided by a Dementia Care Specialist (nurse practitioner or physician assistant) who works within the heath system versus community-based dementia care provided by a Care Consultant (social worker, nurse, or therapist) who works at a Community-Based Organization (CBO). The trial will also compare the effectiveness and cost-effectiveness of both models versus usual care.

Publications & conference data

7 peer-reviewed publications reference this trial (live from Europe PMC):

  1. D-CARE: The Dementia Care Study: Design of a Pragmatic Trial of the Effectiveness and Cost Effectiveness of Health System-Based Versus Community-Based Dementia Care Versus Usual Dementia Care.
    Reuben DB, Gill TM, Stevens A, Williamson J, et al · · 2020 · cited 22× · PMID 32949145 · DOI 10.1111/jgs.16862
  2. Health System, Community-Based, or Usual Dementia Care for Persons With Dementia and Caregivers: The D-CARE Randomized Clinical Trial.
    Reuben DB, Gill TM, Stevens A, Williamson J, et al · · 2025 · cited 13× · PMID 39878968 · DOI 10.1001/jama.2024.25056
  3. Utility of a short, telephone-administered version of the Montreal Cognitive Assessment.
    Jennings LA, Araujo KLB, Meng C, Peduzzi P, et al · · 2021 · cited 8× · PMID 34106473 · DOI 10.1111/jgs.17318
  4. The dementia care study (D-CARE): Recruitment strategies and demographic characteristics of participants in a pragmatic randomized trial of dementia care.
    Yang M, Samper-Ternent R, Volpi E, Green AN, et al · · 2024 · cited 6× · PMID 38358084 · DOI 10.1002/alz.13698
  5. Considerations When Designing and Implementing Pragmatic Clinical Trials That Include Older Hispanics.
    Samper-Ternent R, Silveira SL, Stevens A, Volpi E, et al · · 2023 · cited 4× · PMID 38845738 · DOI 10.18865/ed.33.2-3.076
  6. Self-efficacy change among diverse family caregivers in dementia care.
    Oyeyemi DM, Greene EJ, Xu Y, Lee DR, et al · · 2026 · PMID 41243731 · DOI 10.1093/geronb/gbaf233
  7. Patient and Caregiver Outcomes of Health System, Community-Based, and Usual Dementia Care: A Prespecified Analysis of the Dementia Care Study (D-CARE) Randomized Clinical Trial.
    Reuben DB, Stevens AB, Gill TM, Williamson J, et al · · 2025 · PMID 40892399 · DOI 10.1001/jamainternmed.2025.4247

Verify or expand the search:

Other recruiting trials for Dementia

Currently open trials in the same condition.

Other University of California, Los Angeles trials

Trials by the same sponsor.

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Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03786471.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing