Table 2.
Inclusion criteria for SMARRT Trial
| Inclusion Criteria | Definition | Data source |
| Older age | 70–89 years | EHR |
| Language | Fluent in English | EHR and telephone screening |
| KPWA enrollment status | ≥12 months (allow 3-month gap) | EHR |
| Low-normal cognitive performance | Brief CASI [28] score 26 to 29 inclusive | Telephone screening |
| Subjective cognitive complaints | Self-report of concern with memory or thinking, as captured by replying yes to the question: “In the past two years, have you experienced a decline in your memory or thinking?” | Telephone screening |
| ≥2 targeted risk factors | ||
| •Poorly controlled hypertension | Systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 twice in the past 6 months | EHR |
| •Poorly controlled diabetes, with evidence of either hyperglycemia or potential hypoglycemia | Hyperglycemia: ≥1 hemoglobin A1c (HbA1c) ≥8.0 in past 12 months | EHR |
| Potential hypoglycemia: Diabetes, taking insulin (at least one fill in past 6 months) and one or more of the following: 1) most recent HbA1c in past 12 months ≤6.0; 2) diagnosis code for hypoglycemia in past 1 year | ||
| •High depressive symptoms | Initial recruitment: Score ≥3 on Patient Health Questionaire-2 (PHQ-2) [50] screen in past 12 months | EHR (recruitment) |
| Final eligibility: Score ≥10 on PHQ-8 [51] | Telephone screening (final eligibility) | |
| •Poor sleep | Initial recruitment: diagnosis code for sleep disorder and/or ≥2 fills for a sleep medication in the past 12 months | EHR (recruitment) |
| Final eligibility: Scoring above the cut-off on the sleep questionnaire (problems with sleep 3+ nights/week and bothered “somewhat” or more) | Telephone screening (final eligibility) | |
| •Risky medications | ≥2 fills for medications in a given class of risky medications in the past 6 months, per modified Beers criteria [48] | EHR |
| •Physical inactivity | <30 minutes moderate intensity most days (<150 minutes/week, Surgeon General guidelines) | Telephone screening |
| •Social isolation | Rarely or never get social and emotional support needed (scoring ≥6 out of 9 possible points) [36] | Telephone screening |
| •Current smoking | Recruitment: EHR evidence of current use of any tobacco | EHR (recruitment) |
| Final eligibility: self-reported current smoking on telephone screen | Telephone screening (final eligibility) |