Background: Currently, approximately 7.2 million people in the US live with ADRD, with 65% being community-dwelling and 26% of those living alone. People living alone in the early stages of ADRD (PLA) are less likely to receive a correct dementia diagnosis and to recognize their own limitations, since they can still do many daily activities and make valid decisions.  Few evidence-based interventions have been identified to help PLA and positively impact key outcomes.  The EPIC LA Pilot was designed to help PLA manage ongoing memory changes, associated stressors, and related distress, and prepare for the future. Findings and lessons informed enhancements to an updated program, EPIC LA+, designed to address the lack of effective technology-enabled interventions to improve psychological well-being and other QoL indicators for PLA.

Methods: The RCT is conducted via Zoom and consists of 6 weekly group sessions, each lasting 2.5 hours, and 1 individualized 90-minute session. EPIC LA+ creates a supportive environment that provides education on memory changes associated with ADRD; teaches mood management, communication, and stress reduction skills; helps clarify care values and preferences for future care tasks; and develops an individualized care plan for the future.  EPIC LA+ includes a real-time virtual whiteboard (Miro) to promote online ideation, visualization, and collaboration, and a microwebsite with resources. Participants complete individual assessments with trained staff using measures with established reliability and validity.

Results: To date, EPIC LA+ has received more than 250 referrals, resulting in 68 screenings and 27 enrollments, forming five groups. These participants include 22 women and 5 men ranging from 60 to 88 years old (mean=72.2; SD=7.2) and reside in WA, CA, ID, AZ, CO, TX, MO, IL, WI, OH, IN, FL, VA, NC, NJ, NY, or ME. The majority described themselves as non-Hispanic White (96.3%); retired (77.8%); still driving (92.6%); and without an identified care partner (81.5%); and have noticed changes in memory (51.8% scored 3 or 4 on the AD8).

Conclusions: Findings from the EPIC LA pilot were very promising, indicating that participants benefited in multiple ways, including feeling better prepared for the future, and helped guide the EPIC LA+ trial.  The new RCT has a 96.2% retention rate, has enrolled participants across multiple states, and, after the intervention, some have stated they would recommend it to others in a similar situation, promising indicators of future success.