Action at a Distance: Geriatric Research during a Pandemic

Abstract

BACKGROUND “Action at a distance” may be the new norm for clinical researchers in the context of the COVID‐19 pandemic that may require social distancing for the next 18 months. We must minimize face‐to‐face contact with vulnerable populations. But we must also persist, adapt, and help our older patients and study participants during the pandemic. METHODS Clinical researchers have an obligation to help, and we can. Recommendations for clinical researchers working with older adults during the COVID‐19 pandemic are discussed. RESULTS Implement technology now: Minimize face‐to‐face contact with participants by utilizing digital tools, such as shifting to electronic informed consent and digital HIPAA‐compliant tools such as e‐mailed surveys or telehealth assessments. Assess the psychological and social impact of COVID‐19: How are participants coping? What health or social behaviors have changed? How are they keeping up with current events? What are they doing to stay connected to their families, friends, and communities? Are their healthcare needs being met? Current studies should be adapted immediately to these ends. Mobilize research platforms for patient needs: Leverage our relationships with participants and rapidly deploy novel clinical engagement techniques such as digital tools to intervene remotely and reduce the negative effects of social isolation on our participants. Equip research staff with tangible resources, and provide timely population‐specific health information to support patients and healthcare providers. CONCLUSIONS We have an opportunity to make an impact on our older adult patients now as this pandemic continues to unfold. Above all, clinical researchers need to continue working, to help as many people as possible through the crisis. J Am Geriatr Soc 68:922–925, 2020

Anticipating and Mitigating the Impact of the COVID-19 Pandemic on Alzheimer's Disease and Related Dementias

“…This pandemic also threatens the -patients of tomorrow.‖ Researchers have already sounded the alarm on how the COVID-19 pandemic may affect clinical research in unprecedented ways. 33,34 The consequences may be even more dire for ADRD research. Over the past two decades, ADRD has become one of the most active areas of both basic and clinical research, attracting major industry, government, and philanthropic funding in the Western world.…”

“…35 Abrupt interruption of all these research studies would not only jeopardize a crucial investment society has already made, but it could also have long lasting consequences for the field of ADRD research. At the same time, the COVID-19 pandemic could be a welcome catalyst to accelerate the adoption of innovative design and methods in clinical research, 33 fundamentally changing the way participants in trials for ADRD are recruited and assessed. The rest of this section discusses whether and how ADRD clinical research can continue during the pandemic.…”

“…As per the declaration of Helsinki, -concern for the interests of the subject must always prevail over the interest of science and society.‖ 36 Therefore, all research activities such as observational studies in which participants are exposed a potentially lethal infection (e.g., through face-to-face contact with research staff) without the possibility of any direct benefit should be suspended unless they can be continued entirely remotely. 33 When participation in a study entails provision of essential medical care (e.g., an intervention that is only available through a research trial), continuation of the study should be considered with the maximum possible mitigation of the risk of infection. 34 The US Food and Drug Administration (FDA) has issued some guidance regarding continuation of research participation for intervention studies and how to mitigate the risks to participants and to the integrity of the research studies during the pandemic.…”

Factors impacting social distancing measures for preventing coronavirus disease 2019 [COVID-19]: A systematic review

“…The likelihood is that COVID-19 will become endemic, which suggests long-term behavioural adjustments as reported in our study [45]. Similarly, we argued that social distancing is not part of the culture in either developed or developing countries, for different reasons [60]. In developing countries, it is more related to population density, crowding, workplace conditions etc., such as overcrowding in public transport.…”

A Systematic Review Assessing the Under-Representation of Elderly Adults in COVID-19 Trials

“…36 Rahmel at al showed that patients surviving sepsis had a better 5-year survival when bene ting from a rehabilitation program. 37 In an RCT of 72 COVID-19 patients (median age 69), Liu et al reported that a six-week respiratory rehabilitation program could improve pulmonary function and quality of life. 38 Finally, ethical standards should facilitate inclusion of elderly adults with more adapted informed consent, including the possibility to obtain consent by proxy if the patient has diminished capacity.…”