Emergency Departments LEading the transformation of Alzheimer’s and Dementia Care, or ED-LEAD for short, is a large-scale pragmatic randomized control clinical trial focused on improving emergency care and follow-up for persons living with dementia and their care partners through evidence-based clinical programs. Beginning in 2023, researchers, emergency medicine providers, paramedics, and nurses at 79 emergency departments across 15 health systems in the United States began collaborating on this five-year initiative.

Over 6 million Americans have Alzheimer’s Disease or an Alzheimer’s Disease Related Dementia (AD/ADRD), a number projected to reach 13 million by 2050. Nearly half of the population with AD/ADRD visit the emergency department each year, are often seriously ill, and experience excessive healthcare costs. Despite the frequent use of emergency care, current systems are not equipped to meet the unique and complex needs of persons living with dementia and their care partners. ED-LEAD seeks to fill this critical gap through a series of structured, evidence-based interventions.

ED-LEAD is evaluating three programs designed to improve care in the emergency department and for the weeks to months after ED discharge for persons living with dementia and their care partners:

• Emergency Care Redesign (ECR)
• Community Paramedic–Led Transitions Intervention (CPTI)
• Nurse-Led Telephonic Care (NLTC)

All three ED-LEAD programs aim to reduce avoidable emergency department visits and hospitalizations, improve satisfaction and care quality, and improve health care access by addressing social determinants of health. We will measure the success of our program across the following areas:

• Fewer ED revisits and hospitalizations
• Increased days at home after ED-discharge

The study uses data from the Centers for Medicare and Medicaid Services (CMS) to measure outcomes and monitor the programs.