SwissDEM - Dementia burden, trends, and risk factors in three Swiss cantons

Ref. 21304

  

Methods

Method description

SwissDEM used a one-phase, population-based, cross-sectional design, based on the 10/66 Dementia Research Group protocol. Data were collected through structured face-to-face and telephone interviews with participants (aged 65+) and, for each participant, a designated informant (a family member or close acquaintance). Participants were identified through age- and sex-stratified random sampling from official population registries (Swiss Federal Office of Statistics). Selected individuals received an informative letter followed two weeks later by an invitation letter; they could register to participate via online form (REDCap), paper-based form, phone, or email. In Zurich, recruitment leveraged an existing cohort infrastructure (Corona Immunitas). All questionnaires and assessments were administered electronically via REDCap, a data collection platform hosted on USI servers (Lugano), accessible on tablets, smartphones, and laptops. Trained interviewers (non-clinicians) conducted the interviews, which lasted approximately 45 minutes with the participant and 15–30 minutes with the informant, either at the participant's home, a nursing home, or another location of the participant's choosing. The interview had a modular structure covering informed consent, psychological dimensions, economic impact and risk/protective factors, cognitive assessment of the participant, and, for informants, proxy-rated cognition, neuropsychiatric symptoms, dementia severity, caregiver burden, social cognition, and care arrangements. Interviewers received standardized, manualized training and were periodically supervised for data quality. The electronic system included built-in validation checks and alerts for implausible or incomplete entries, with automated data transfer and encrypted storage. Written informed consent was obtained from all participants (or their legal representative in case of impairment) prior to any study procedure.

Method (instruments)

Other method instrument

Standardised face-to-face interviews with validated psychological instruments (REDCap)

Population, unit of observation

The unit of observation is the individual participant, each paired with an informant (a family member or close acquaintance) who provided proxy-reported information relevant to cognitive status, functional decline, and care arrangements. This specific dataset includes only community-dwelling participants from Ticino and Zurich.

Participant selection or sampling method (census, random sampling, other sampling method (specify))

Two recruitment strategies were used. (1) In the Canton of Ticino, a randomised sample of people aged ≥65 years was recruited through the Federal Statistical Office (FSO): eligible participants randomly selected from local registries received an informative letter, and, two weeks later, an official invitation letter. (2) In the Canton of Zurich, the then ongoing Corona Immunitas study (Zurich Coronavirus Cohort Study, 2020) was leveraged, with participants randomly selected from the population registry of the Federal Statistical Office. Eligible Corona Immunitas participants aged 65 years and older were invited to take part in the cognitive assessment through an invitation letter or email.

Other significant comments

The broader SwissDEM programme also included a pilot/validation study of the Italian 10/66 short diagnostic schedule (Ibnidris et al., 2021, BMJ Open), conducted in Ticino and Piedmont in 2019. This validation phase involved 160 participant-informant dyads and informed the subsequent qualitative studies on informed consent comprehension (Falvo et al., 2021) and on the return of individual-specific results (Fadda et al., 2021). Nursing home data in Ticino were collected separately, within COV-RISK (led by IRB, with CTU-EOC and IPH-USI), covering cognitive health (SARCA-TI, funded by ADiCASI) and mental health/pandemic impact (Corona Immunitas Ticino – Nursing Homes, funded by SSPH+). These data are not included in this dataset. Recruitment for the main study was preceded by the 100%SwissDEM awareness campaign (May 2020), featuring 100 video testimonials from older Ticino residents ahead of interviews starting September 2020.