Background: A significant number of living labs (LLs) have been developed across Europe and beyond. A fraction of those LLs have established a new approach to maintaining and studying the health, autonomy, and well-being of older adults with dementia. LLs interact with a broad set of stakeholders, including students, academic institutions, private companies, healthcare organizations, and patient representative bodies -even with other LLs. It is crucial to identify what kinds of co-creations should be done and how they can be facilitated through LLs. Despite a growing body of literature, a clear overview and understanding of the services, research, and clinical activities developed in different LL settings for older adults with dementia are still lacking. Aim: The aim is to scope publications examining all types of LL activities which explore the needs of and suggest solutions for older adults with dementia, whether they live in the community or long-term healthcare facilities. Methods: The bibliographic databases to be searched will include Embase.com, Medline Ovid SP, Pubmed (not medline [sb]) and Web of Science, without language or date restrictions. We will examine the bibliographies of all relevant articles found, conduct a search for unpublished studies, and perform a handsearch in relevant journals associated with LLs involved in healthcare (Electronic Journal for Virtual Organization and Networks, Technology Innovation Management Review, Journal of Engineering and Technology Management). We will consider publications in English, French, and German. Results: Bibliographic database searches will be completed in March 2020, retrieved articles will be screened, and the entire study is expected to be completed by December 2020. Discussion: This comprehensive scoping review will provide a global indication of the types and extent of LL activities aimed at older adults with dementia, whether they live in the community or in long-term care facilities.

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Background Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. Objective This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). Methods This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. Results Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. Conclusions This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. International Registered Report Identifier (IRRID) RR2-10.2147/SHTT.S233130

ImportanceAmyloid positron emission tomography (PET) allows the direct assessment of amyloid deposition, one of the main hallmarks of Alzheimer disease. However, this technique is currently not widely reimbursed because of the lack of appropriately designed studies demonstrating its clinical effect.ObjectiveTo assess the clinical effect of amyloid PET in memory clinic patients.Design, Setting, and ParticipantsThe AMYPAD-DPMS is a prospective randomized clinical trial in 8 European memory clinics. Participants were allocated (using a minimization method) to 3 study groups based on the performance of amyloid PET: arm 1, early in the diagnostic workup (within 1 month); arm 2, late in the diagnostic workup (after a mean [SD] 8 [2] months); or arm 3, if and when the managing physician chose. Participants were patients with subjective cognitive decline plus (SCD+; SCD plus clinical features increasing the likelihood of preclinical Alzheimer disease), mild cognitive impairment (MCI), or dementia; they were assessed at baseline and after 3 months. Recruitment took place between April 16, 2018, and October 30, 2020. Data analysis was performed from July 2022 to January 2023.InterventionAmyloid PET.Main Outcome and MeasureThe main outcome was the difference between arm 1 and arm 2 in the proportion of participants receiving an etiological diagnosis with a very high confidence (ie, ≥90% on a 50%-100% visual numeric scale) after 3 months.ResultsA total of 844 participants were screened, and 840 were enrolled (291 in arm 1, 271 in arm 2, 278 in arm 3). Baseline and 3-month visit data were available for 272 participants in arm 1 and 260 in arm 2 (median [IQR] age: 71 [65-77] and 71 [65-77] years; 150/272 male [55%] and 135/260 male [52%]; 122/272 female [45%] and 125/260 female [48%]; median [IQR] education: 12 [10-15] and 13 [10-16] years, respectively). After 3 months, 109 of 272 participants (40%) in arm 1 had a diagnosis with very high confidence vs 30 of 260 (11%) in arm 2 (P < .001). This was consistent across cognitive stages (SCD+: 25/84 [30%] vs 5/78 [6%]; P < .001; MCI: 45/108 [42%] vs 9/102 [9%]; P < .001; dementia: 39/80 [49%] vs 16/80 [20%]; P < .001).Conclusion and RelevanceIn this study, early amyloid PET allowed memory clinic patients to receive an etiological diagnosis with very high confidence after only 3 months compared with patients who had not undergone amyloid PET. These findings support the implementation of amyloid PET early in the diagnostic workup of memory clinic patients.Trial RegistrationEudraCT Number: 2017-002527-21

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