# Helping Patients, Families, and Clinicians Make Shared Decisions about Therapies for Dementia

> **NIH NIH R21** · UNIVERSITY OF COLORADO DENVER · 2024 · $234,000

## Abstract

PROJECT SUMMARY
On July 6th, 2023, the FDA approved Lecanemab-IRMB, the first drug with evidence of slowing the rate of
cognitive decline through a reduction in amyloid plaques, the protein that accumulates in the brains of people
with Alzheimer’s disease. Like all major medical treatments, there are trade-offs and alternatives that should be
considered. First, the improvements in clinical symptoms are minimal. For example, Lecanemab-IRMB only
demonstrated a 0.45 improvement on an 18 point scale at 18 months despite drastic improvements on imaging
evidence of Amyloid. Clinically, this therapy is going to be challenging to discuss with patients. If this is like
other high-cost therapies with a common indication, patients and families will likely see direct-to-consumer
information and will approach clinicians hoping to receive this therapy. Situations such as this are ripe for
standardized information such as a patient decision aid (DA) to help clinicians communicate effectively and
accurately about the benefits and burdens and help patients and families make a well-informed decision.
Shared decision making supported by patient DAs is an evidence-based strategy to improve decision making.
A DA regarding dementia care could facilitate higher quality discussions to assure that patients wanting this
therapy are fully informed regarding the potential benefits and harms. Using an iterative, user-centered
approach with multilevel partner input, we will conduct a needs assessment among patients and clinicians
while simultaneously developing and piloting a DA to support SDM for pharmacologic drugs for dementia.
The project aims include:
Aim 1 (year 1): Among a sample of eligible patients, caregivers, and clinicians, we will:
 Aim 1a: Conduct a qualitative decision needs assessment of pharmacologic therapies for dementia.
 Aim 1b: Simultaneously develop a DA based on international standards and user-centered design.
Aim 2 (year 2): Using a pilot trial of 20 patients and their clinicians considering pharmacologic therapy
for dementia, we will:
 Aim 2a: Determine the feasibility and acceptability of a dementia DA among a diverse population of older
 adults and their clinicians using a mixed-methods approach.
 Aim 2b: Determine the preliminary efficacy of the dementia DA on knowledge, decision conflict, satisfaction
 with decision, shared decision making, and care concordant with patient preferences.
We aim to make sure that patients’ and families’ expectations are aligned with the expected benefits and that
they are fully aware of the potential costs and harms of the new therapies for Dementia

## Key facts

- **NIH application ID:** 10949237
- **Project number:** 1R21AG088955-01
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Daniel D Matlock
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $234,000
- **Award type:** 1
- **Project period:** 2024-09-15 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10949237

## Citation

> US National Institutes of Health, RePORTER application 10949237, Helping Patients, Families, and Clinicians Make Shared Decisions about Therapies for Dementia (1R21AG088955-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10949237. Licensed CC0.

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