Research Applicants
Dr Christopher Butler (Joint Lead Applicant)
Professor Jaime Miranda (previous Joint Lead Applicant)
Dr Maria Sofia Cuba-Fuentes (current Joint Lead Applicant)
Dr Filipa Landeiro (Co-Applicant, Work Package Lead)
Professor José Oliden (Co-Applicant)
Mr Carlos Vera Tudela Melgarejo (Co-Applicant)
Mrs Maria Kathia Cárdenas (Work Package Lead)
Dr Antonio Bernabe-Ortiz (Work Package Lead)
Dr Maria Lazo-Porras (Work Package Lead)
Dr Jemma Hawkins (Work Package Lead)
Professor Graham Moore (Work Package Lead)
Mr Francisco Diez-Canseco
Professor Rafael Calvo
Dr Nilton Custodio
Dr Maria Amalia Pesantes
Dr William Whiteley
Professor German Málaga
Other research team members
Cecilia Anza
Marco Da Re
Fernanda Espinoza
Miriam Lúcar
Rosa Montesinos
Micaela Pesantes
Francisco Tateishi Serruto
Lee White
Background
Health systems in low- and middle-income countries are ill-equipped to cope with rapidly aging populations and associated chronic disease. Dementia is a particular problem in Peru and challenges the health system on many fronts. People with dementia often have other health problems as well (co-morbidities) which go untreated, cause suffering and cost money. There is almost no social care infrastructure and care is provided almost entirely by over-stretched family members. The COVID-19 pandemic has particularly affected the elderly and cognitively impaired in Peru, which has the highest death rate per capita from COVID in the world. Our goal is to strengthen the health system in Peru to meet the challenges highlighted by dementia by using technology and trained community health workers to bring expert diagnosis, treatment and support right to where it is needed to the homes of patients and carers.
Aims and Objectives
Project IMPACT will use dementia as a tracer condition to strengthen health systems in Latin America through sustainable, integrated, person-centred, community-delivered, technology-enabled innovation. Our specific objectives are to:
i) evaluate health systems readiness to provide support for PWD;
ii) develop and implement an mHealth application for diagnosis of dementia by community health workers (CHWs) in Peru;
iii) determine the feasibility of an mHealth-delivered, CHW-supported intervention to improve health-related quality of life for PWD and their carers;
iv) assess the socioeconomic burden of dementia in Peru.
Study Design
Our strongly interdisciplinary team includes researchers, policymakers and community representatives working together across 5 interrelated work packages.
Work Package 1: (Health System Readiness) will assess the needs of PWD and their carers and the readiness of the Peruvian health system to meet those needs. The tools developed will also be applied in 3 other Latin American countries.
Work Package 2: (Diagnosis) will co-produce an mHealth app for CHWs to find cases of dementia and record co-morbidities. We will evaluate the acceptability and accuracy of this app in 1600 PWD and controls from four distinct regions of Peru: the capital city (Lima), a coastal semi-urban region, the Andes mountains and the Amazon jungle. We will test integration of the app into primary health care.
Work Package 3: (Intervention) will adapt an existing mHealth intervention, developed in the US, to the Peruvian context. The intervention will include co-morbidity management help, motivation for physical exercise and group-based activities and carer support. Its implementation will be assessed in a feasibility study.
Work Package 4: (Health Economics) will estimate the economic burden and impact on quality of life of dementia and co-morbidities using questionnaires administered to the PWD and controls identified in WP2.
Work Package 5: will oversee all project management activities and engage stakeholders and the wider community to increase awareness and tackle sigma.
Further information and publications
Project website: https://www.impact-dementia.org/
Peru initiates the IMPACT project https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(23)00239-9/fulltext – The Lancet Neurology
Start date
1st November 2022
End date
31st October 2026
Funders
Amount
£ 3,868,869.73