Supplementary Material for: Tailored dementia care across seven Swiss memory clinics: the CareMENS model improves patients’ mood and quality of life

Background: Dementia is a growing global health concern, requiring a comprehensive approach to care. The CareMENS model is a non-pharmacological intervention designed to ensure continuity of care for individuals at the early stages of cognitive decline (CDR ≤ 1) or those with subjective cognitive complaints. It combines tailored neuropsychological, speech and language, and physical therapies with community-based leisure activities to sustain cognitive and physical function, promote social engagement and enhance overall patient well-being. A Care manager - a new role introduced within Swiss memory clinics implementing the model - provides personalized and ongoing support.
Methods: This observational study was conducted across seven memory clinics in Western Switzerland between September 2020 and January 2024. It evaluated the acceptability and impact of the CareMENS model of care through the following outcomes: anxiety and depression symptoms (HADS), functional autonomy (DAD-6), global cognition (MoCA) and quality of life (WHOQOL). Pre-post analyses were performed in 184 patients (medianage: 74 years old; 53.3% women) assessed at baseline (T0) and, on average, 324.2 days later (T1). Changes over time were evaluated using a linear mixed-effects model. A retrospective standard care group (N=165) of patients aged ≥50 years (median age: 74 years old; 53.9% women) and with a dementia severity score (CDR) ≤ 1 was included for comparison of HADS, DAD-6 and MoCA outcomes.
Results: The CareMENS model was successfully implemented into routine clinical practices of the participating memory clinics. Compared to standard care, the CareMENS intervention was associated with greater improvements in HADS-depression overall scores (-0.853, 95%CI = -1.441 to -0.265; p = 0.005) and in HADS-anxiety scores among patients with high baseline anxiety (-1.134, 95%CI = -2.134 to -0.133; p = 0.027). No significant between-groups differences were found in MoCA (0.361, 95%CI = -0.32 to 1.04; p = 0.299) and DAD-6 scores (0.892, 95%CI=-3.5 to 5.28; p = 0.69). Following the intervention, we observed positive within-group changes in the WHOQOL mean total score (+2.67, 95%CI = 1.31 to 4.02; p<0.001) and particularly in the social participation subdomain (+6.1, 95%CI = 3.82 to 8.32; p<0.001).
Conclusion: These findings indicate that the CareMENS model of care can be effectively implemented into clinical settings. It showed a significant reduction in mood symptoms and suggested positive benefits for quality of life. Integrating Care management models into memory clinics may enhance patient outcomes and represents a promising direction for the evolution of current memory clinic practice.