Community Memory Screening as a Strategy for Recruiting Older Adults into Alzheimer’s Disease Research

Abstract

<jats:title>Abstract</jats:title> <jats:p>Background Growing awareness of Alzheimer’s disease (AD) has prompted a demand for quick and effective ways to screen for memory loss and cognitive decline in large numbers of individuals in the community. Periodic Memory Screening Day events provide free, brief cognitive screening aimed at those 65 years and older, and can serve as an opportunity to gauge participants’ attitudes towards AD research and recruit them into ongoing research projects. Methods Over 6 single-day events in 2 years, more than 574 individuals were individually screened using the MoCA and a story recall task (immediate and delayed), given feedback about their performance, and introduced to AD research and opportunities to participate. Results Screening classified 297 individuals (52.0%) as having “ No Decline ”, 192 (33.6%) as “ Possible decline ” and 82 (14.4%) as “ Likely decline ”. Those with “ Likely decline ” were older and less educated, had more memory concerns, were more likely to be men, and were less likely to have a positive family history of dementia than those with “ No Decline ”. Subsequent validation of screening procedures against a full clinical evaluation showed 72% classification accuracy with a skew towards over-calling Possible and Likely decline and thereby guiding questionable individuals to a more thorough evaluation. Of those screened, 378 (66%) agreed to additional research and consented to being listed in a research registry; and a majority (70-85%) of those consenting reported they were amenable to various AD research procedures including lumbar puncture, MRI and autopsy. Overall, 19.1% of those screened met inclusion criteria for ongoing studies and were successfully recruited into AD research. Conclusions Conducting a few concentrated community memory screening events each year may help meet the public’s demand for brief assessment of memory concerns and can be a relatively effective and efficient recruitment strategy for AD research.</jats:p>

Recommendations to address key recruitment challenges of Alzheimer's disease clinical trials

“…To facilitate early screening and trial recruitment, innovative prescreening strategies could be deployed to identify potential prodromal AD and mild AD dementia patients in the community 37 . Individuals whose screening indicates they may have a degree of cognitive impairment could be referred for further clinical evaluation, connected to support services, and offered opportunities to enroll in clinical trials.…”

“…To facilitate early screening and trial recruitment, innovative prescreening strategies could be deployed to identify potential prodromal AD and mild AD dementia patients in the community. 37 [40][41][42][43] The APT Webstudy, in particular, uses demographic information plus longitudinal cognitive and subjective concern data to predict brain amyloid elevation and select individuals for referral to sites for trial screening.…”