May 12, 2026
NIA IMPACT member Lisa Kern, MD, MPH, responded to comments from other researchers on her study comparing approaches to assigning care coordinators to people living with dementia.
In the letter, Kern clarifies how she defines “fragmented care,” emphasizing patterns of visits across multiple providers rather than assuming coordination within a single health system. They explain that their threshold for high fragmentation is based on prior evidence linking it to increased hospitalization risk, and they present data showing that patients classified as highly fragmented have distinctly more complex care patterns.
Kern also underscored the importance of caregiver engagement and notes opportunities for future studies, such as using patient portals to better involve caregivers. More broadly, she highlights the need for additional pragmatic trials to guide how limited care coordination resources are allocated.
Read the response here.