# Primary Care Screening and Intervention for Elder Neglect in Patients with Dementia: An Evidence-Based Approach

> **NIH NIH R33** · WEILL MEDICAL COLL OF CORNELL UNIV · 2024 · $1,626,857

## Abstract

PROJECT SUMMARY
The over-arching aims of this research are to: (1) develop a novel primary care screening tool to identify elder
neglect in patients with Alzheimer’s Disease and Related Dementias (AD/ADRD) and a point-of-care
technology-driven intervention for caregivers [R61], and (2) conduct a NIH Model Stage III 3-arm randomized
clinical trial to determine the impact of both screening itself and screening combined with the intervention
compared to usual care [R33]. We are focusing exclusively on developing screening for neglect rather than all
types of mistreatment given that neglect is very common in AD/ADRD patients, neglect is associated with the
highest mortality and morbidity of all mistreatment types, and specific targets exist for interventions. Combining
all types of mistreatment, the approach taken to date in screening tool design, has important disadvantages. It
makes screening time-consuming and challenging. Additionally, different mistreatment types are very different
phenomena, occur in different groups of older adults under different circumstances, have different impacts on
health, and likely require different intervention strategies. Further, our research team has developed and
studied a successful, evidence-based technology intervention for AD/ADRD caregivers. We believe that an
adaptation of this intervention for caregiver neglect, which focuses on education and skill building and access
to resources, may be highly impactful in reducing and preventing neglect. The Specific Aims of the R61 phase
are: (Aim 1a) develop a novel, easy-to-use, brief screening tool to identify elder neglect in primary care and
describe the tool’s test characteristics (KQ3), (Aim 1b) develop an innovative intervention for elder neglect by
modifying a highly successful evidence-based technology-driven caregiving intervention, and (Aim 2) pilot-test
the screening tool and intervention in primary care (NIH Model Stage 1b) to assess feasibility and acceptability.
In the R33 phase, we will conduct a 3-arm randomized controlled trial (NIH Model Stage III) to compare: (1)
screening + intervention, (2) screening only, and (3) usual care without screening. The Specific Aims of the
R33 phase are: (Aim 3) evaluate the impact of screening for elder neglect on reduction in neglect exposure
(KQ1) and other patient and caregiver-important outcomes by comparing to usual care and (Aim 4) evaluate
the impact of screening tool paired with a technology-based caregiver intervention on reduction in exposure to
neglect (KQ5) and other patient and caregiver-important outcomes by comparison to usual care and screening
without intervention. Neglect screening in primary care with a novel screening tool will have a positive impact
on outcomes including decrease in presence of neglect at 6 months and other patient and caregiver-important
outcomes (e.g., neglect severity, neglectful ideation; caregiver burden) and that screening paired with a
technology-based caregiving interventi...

## Key facts

- **NIH application ID:** 11159991
- **Project number:** 4R33AG079012-03
- **Recipient organization:** WEILL MEDICAL COLL OF CORNELL UNIV
- **Principal Investigator:** MARK STEVEN LACHS
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,626,857
- **Award type:** 4N
- **Project period:** 2022-09-30 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11159991

## Citation

> US National Institutes of Health, RePORTER application 11159991, Primary Care Screening and Intervention for Elder Neglect in Patients with Dementia: An Evidence-Based Approach (4R33AG079012-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11159991. Licensed CC0.

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