The DARE study (Dementia-Friendly Apothecaries as a Resource for Mental Health in the Elderly) is a multicenter, prospective cohort study aiming to identify individuals with cognitive impairments early in pharmacies and enhance their access to support services. Partner pharmacies are equipped with memory test stations, and pharmaceutical staff are trained to guide participants. The digital memory test evaluates cognitive, psychosocial, and health factors, displaying results in a traffic light graphic. Participants with concerning results are referred to specialists or support services.

The study's primary goals are to establish pharmacies as dementia screening hubs, improve care for affected individuals, promote interdisciplinary collaboration, and lay the groundwork for legal and billing frameworks. An optional subproject validates the screening through neurological evaluations.

The DARE study (Dementia-Friendly Apothecaries as a Resource for Mental Health in the Elderly) is a multicenter, prospective cohort initiative designed to identify individuals with early cognitive impairments through pharmacies, making healthcare and support more accessible. It targets people with initial cognitive symptoms or mild dementia and aims to promote early intervention and improve quality of life.

Key Features:

• Screening Process: Partner pharmacies (10 across urban and rural settings) are equipped with memory test stations, including tablets for digital cognitive assessments and structured questionnaires. These cover cognitive decline, cardiovascular risk, and depression.
• Traffic Light System: Results are displayed via a color-coded system (green, yellow, red), guiding next steps for participants, such as seeking medical consultation or accessing support services.
• Pharmacy Staff Training: Staff receive training to communicate effectively with cognitively impaired individuals and manage the digital tools.
• Demographic Data Collection: Information such as age, education, and marital status is gathered to understand participant profiles and tailor interventions.

Objectives:

1. Establish pharmacies as accessible hubs for dementia screening and support.
2. Evaluate the effectiveness of the screening process and its impact on participants' healthcare behavior.
3. Validate digital screening tools in non-clinical environments and explore their sensitivity and specificity.

Optional Subproject: A subset of participants undergoes additional clinical validation at the Alzheimer Therapy and Research Center, including neurological exams, imaging, and biomarker analysis.

The study emphasizes privacy through double pseudonymization, secure data handling, and adherence to ethical standards. It seeks to demonstrate the socioeconomic value of pharmacy-based dementia screening and create a framework for broader implementation.

Inclusion Criteria

1. Age: Participants must be 60 years or older at the time of consent.
2. Language Proficiency: Sufficient knowledge of the German language to understand instructions and participate in the study.
3. Cognitive Status: Presence of self-reported, relative-reported, or pharmacist-identified cognitive impairments (e.g., memory problems or mild cognitive changes).
4. Consent: Ability to provide informed consent voluntarily.

Exclusion Criteria

1. Severe Sensory Impairments: Participants unable to see or hear well enough to complete the digital assessments or questionnaires.
2. Previous Dementia Diagnosis: Individuals with a prior formal diagnosis of dementia, whether with or without underlying pathology.
3. Severe Cognitive or Physical Impairments: Any condition that would prevent meaningful participation in the digital tests or structured screening process.

These criteria aim to ensure that the study includes participants at risk of early cognitive decline while excluding those for whom the interventions or assessments would not be feasible or relevant.

Study Population:

The study population consists of individuals aged 60 and older, recruited from urban and rural pharmacies. Participants include those with self-reported, relative-reported, or pharmacist-identified cognitive impairments ranging from initial symptoms to mild dementia. The cohort emphasizes diversity, capturing various demographic factors such as migration background, education level, marital status, and living situations, with a focus on underrepresented and underserved groups, including isolated individuals and those in rural areas.