Evaluating the Use of Anxiety Patient‐Reported Outcome Measures (PROMs) in Dementia Clinical Trials: A Systematic Review.

Background: Anxiety is a common but underdetected or underdiagnosed symptom in dementia, affecting quality of life and care outcomes. Clinical trials are essential for informing effective management, yet the use of patient‐reported outcome measures (PROMs) in dementia trials remains unclear. This re...

Descripción completa

Detalles Bibliográficos
Publicado en:Health Expectations Vol. 29; no. 3; pp. 1 - 18
Autores principales: Domingo, Jason, Alves, Ana, Sanders, Julie
Formato: research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Jun2026
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194811338&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 194811338
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        13696513
        EVY
      jtl: Health Expectations
      issn: 13696513
      maglogo: Y
    pubinfo:
      dt: Jun2026
      vid: 29
      iid: 3
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        194811338
        194811338
        194811338
        10.1111/hex.70736
        194811338
      ppf: 1
      ppct: 17
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: C
          – @attributes:
              type: P
      tig:
        atl: Evaluating the Use of Anxiety Patient‐Reported Outcome Measures (PROMs) in Dementia Clinical Trials: A Systematic Review.
      aug:
        au:
          Domingo, Jason
          Alves, Ana
          Sanders, Julie
        affil: National Institute for Health and Care Research—Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
      sug:
        subj:
          Anxiety Evaluation
          Patient-Reported Outcomes
          Dementia Patients Psychosocial Factors
          Clinical Trials
          Human
          Systematic Review
          Clinical Assessment Tools
          Sociodemographic Factors
          Aged
          Europe
          United States
          United Kingdom
          Medline
          Embase
          Psycinfo
          Cochrane Library
          Descriptive Statistics
          Aged: 65+ years
      ab: Background: Anxiety is a common but underdetected or underdiagnosed symptom in dementia, affecting quality of life and care outcomes. Clinical trials are essential for informing effective management, yet the use of patient‐reported outcome measures (PROMs) in dementia trials remains unclear. This review examined how validated PROMs are used to assess anxiety in dementia trials, including measurement tools, methods, demographic representation and evidence gaps. Methods: A systematic review was conducted following PRISMA and Cochrane Handbook guidance, with protocol registration on PROSPERO (CRD42025649920). Randomised controlled trials published between January 2015 and February 2025 were included if they assessed anxiety in mild to moderate dementia using validated PROMs within pharmacological or non‐pharmacological interventions. Searches were conducted across MEDLINE, Embase, PsycINFO, Cochrane Library and ClinicalTrials.gov, supplemented by citation tracking. Two reviewers independently undertook study selection, data extraction and risk of bias assessment. Due to heterogeneity, findings were narratively synthesised. Results: Of 2328 records screened, 29 trials (n = 5697) met inclusion criteria. While 93.1% used validated anxiety measurement tools, only 44.4% employed PROMs, most frequently the Hospital Anxiety and Depression Scale, mainly in non‐pharmacological trials. Women and individuals of White ethnicity were overrepresented, and no studies examined PROM effectiveness by sex and ethnicity. Most trials showed moderate to high risk of bias, and evidence was confined to high‐income countries. Conclusions: Anxiety outcomes in dementia trials remain largely proxy‐reported. Existing anxiety PROMs are generic and unvalidated for dementia populations. There is a critical need for dementia‐specific, culturally sensitive anxiety PROMs, improved demographic reporting and integration of anxiety assessment within dementia core outcome sets. Patient or Public Contribution: Feedback from research participants in dementia studies, who reported experiencing anxiety, motivated this systematic review. Patient and public involvement was examined across all included studies. The lack of validated dementia‐specific anxiety PROMs identified in this review highlights a broader gap in co‐produced outcome development within dementia research. These findings emphasise the need for meaningful involvement of people living with dementia and care partners in the development, validation and cultural adaptation of anxiety PROMs to ensure that trial outcomes are relevant, acceptable and representative.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N