Objective:

To evaluate the feasibility of implementing the CMS Guiding an Improved Dementia Experience (GUIDE) model in a community neurology practice using digital platforms, standardized scales, and integrated clinical trial recruitment.

Background:

The GUIDE model establishes structured dementia care pathways requiring standardized assessments for both patients and caregivers. Evidence from community neurology settings remains limited. Digital tools may reduce implementation burden, improve caregiver engagement, and facilitate research integration.

Design/Methods:

GUIDE was implemented across a multi-site community neurology practice. The program included: (1) digital cognitive screening via a voice-recognition platform; (2) electronic administration of GUIDE-required scales—functional (FAQ, ADLs/IADLs), behavioral (NPI-Q), depression (GDS), caregiver burden (Zarit), and patient-reported outcomes (PROMIS Global Health); (3) care navigators coordinating APOE testing, MRI scheduling, ARIA monitoring, and linkage to community resources; and (4) embedded recruitment for Alzheimer’s clinical trials through a partnership with a community research network.

Results:

During the first 90 days of GUIDE implementation, 141 participants completed required assessments with >80% electronic form completion, confirming workflow feasibility. Mean dementia staging score was 4.5 ± 1.0 (mild–moderate range), mean GDS 7.2 ± 1.8, PROMIS Global Health 29 ± 5.9, and Zarit caregiver burden 41 ± 15.7, indicating moderate caregiver stress. Higher dementia severity correlated with greater caregiver burden (r = 0.62, p < 0.01) and lower PROMIS Global Health scores (r = –0.58, p < 0.01). Patients reporting better perceived health and quality of life demonstrated lower caregiver stress. Structured scoring data also enabled pre-identification of clinical trial-eligible patients, enhancing recruitment efficiency through the Profound Research partnership. Additional data collection is ongoing to evaluate longitudinal impact.

Conclusions:

Community neurology practices can effectively operationalize GUIDE using digital tools to deliver required assessments, engage caregivers, and support research. Early results demonstrate feasibility and scalability of a digital, community-based dementia care model that bridges clinical care with Alzheimer’s trial participation.