Limitations
dementia
Consistent with the pragmatic design, this study relied on self-reported and proxy-reported information to identify individuals with dementia. Using information that programs typically collect, this pilot is more generalizable than a study that requires a confirmed diagnosis. Future research should validate this self-reported information or assess dementia severity more thoroughly to further nuance recommendations of meal-delivery effectiveness. Another possible limitation is that more participants in the arm assigned to drop-shipped frozen meals lived alone compared with those assigned to daily-delivered meals. We adjusted for living arrangements in the survival model to address this imbalance, but there may still be the possibility of bias, particularly given the challenges that participants expressed for transporting, storing, and reheating frozen meals that were likely exacerbated if living alone.