Sophia Wang

OBJECTIVE: The objective of this study was to explore Black older adults’ and their study partners’ (dyads) perceptions of a community informed brain health education program, with the intention of culturally adapting the program for the community. METHODS: Semi-structured interviews were conducted with dyads (Black older adults (≥50 years) and their study partners) and staff members (n = 12). Participants reviewed selected educational materials and provided feedback on cultural relevance, clarity, and acceptability. Interviews were transcribed and analyzed using thematic analysis. RESULTS: Nine themes emerged, emphasizing trust, visuals that reflect the community, and supportive interpersonal dynamics as key facilitators of engagement. CONCLUSION: Community informed, visually engaging educational materials may enhance brain health awareness and research participation among Black older adults. INNOVATION: This study incorporated insights from three distinct groups (staff, older adults, and their study partners) in order to culturally adapt materials and facilitation to an education program designed to get individuals more involved with cognitive screening.

INTRODUCTION: This study examined veteran‐specific factors affecting interest in Alzheimer's disease and related dementias (ADRD) biomarker research participation. METHODS: In this study, 505 community‐dwelling older adults (age ≥55) who had never participated in AD research, including 179 veterans, completed a survey about their perceptions of AD biomarker research. RESULTS: Most veterans expressed interest in doing biomarker research (74.0%). They were more likely than non‐veterans to be very concerned about their memory and thinking (31.8% vs 20.6%, p = 0.041) and view research participation as an activity that everyone should do (64.8% vs 52.9%, p = 0.045). However, they were more likely to perceive positron emission tomography scans as unsafe (27.1% vs 14.0%, p = 0.027). DISCUSSION: Veterans have distinct facilitators and barriers to AD research participation. Future studies to develop veteran‐centered recruitment strategies should consider differences in motivators, knowledge levels, and hesitancy for specific research procedures.

Introduction: Healthcare professionals (HCPs) are a critical referral source for Alzheimer's disease and related disorders (ADRD) biomarker research. There is a need to better understand their attitudes about ADRD biomarker research to develop scalable HCP‐centered referral strategies. Methods: We approached 20 HCPs using purposive and snowball sampling, conducted 14 semi‐structured interviews to assess HCP attitudes toward ADRD biomarker research, and analyzed the data using thematic analysis to understand their perceptions about ADRD biomarker research and barriers to referring their patients to research. Results: Key themes which emerged from HCP interviews included: HCPs perceived that both they and their patients experience various barriers to research participation. Despite these challenges, HCPs perceive value in research outcomes, are interested in making patient referrals, and seek collaboration with researchers. Discussion: Future directions to develop HCP‐centered referral strategies include creating HCP‐centered educational and recruitment materials about the value of ADRD biomarker research and recruitment workflows tailored to their practice settings.

IMPORTANCE: Delirium is a neuropsychiatric syndrome characterized by fluctuating disturbances in attention and awareness, associated with worse clinical outcomes and higher mortality. Previous research studies have noted an association between geographic disadvantage and delirium, but it is unknown if this association extends to critically ill adults. OBJECTIVES: This study aimed to explore the relationship between geographic disadvantage and ICU delirium characteristics. DESIGN, SETTING, AND PARTICIPANTS: We performed a secondary analysis of data collected from an National Institutes of Health-funded clinical trial, the Pharmacologic Management of Delirium study. Adults 18 years old or older admitted to the ICU who experienced delirium based on the Confusion Assessment Method for the ICU (CAM-ICU) were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The study population included 326 participants: 54.5% were female and 48% Black, with a mean age of 60.3 years, mean Acute Physiology and Chronic Health Evaluation II score of 20, and in-hospital mortality rate of 12.3%. The area deprivation index (ADI), a composite measure of geographic disadvantage derived from census data that yields a national percentile score ranging from 1 to 100 (with higher scores representing greater disadvantage), was obtained for each participant’s address. Main outcome variables included delirium duration, which was assessed by the number of delirium- and coma-free days (DCFDs), and delirium severity, which was assessed by mean CAM-ICU-7 scores. Analysis of covariance models were used to examine differences in DCFDs and mean CAM-ICU-7 scores between ADI quintiles while controlling for demographic and clinical variables. Other clinical outcomes of interest included discharge home rates and in-hospital mortality. The sample was heavily skewed toward higher national ADI percentile scores (indicating greater disadvantage); only 11.7% of patients had an ADI score lower than 50. Our regression analyses did not reveal any associations between ADI quintile and DCFDs or mean CAM-ICU-7 scores, or between ADI quintile and discharge home rates or in-hospital mortality. However, the Black race was associated with longer delirium duration and greater delirium severity in the first week of ICU hospitalization. CONCLUSIONS: Our study did not find an association between geographic disadvantage and delirium duration or severity in the ICU. However, an association with race was observed, highlighting the need for further research into how socioeconomic determinants of health relate to delirium.

Introduction: The study examined the relationship between trust of researchers in research‐naïve participants, including those at higher risk, and interest in Alzheimer's disease and related dementias (ADRD) biomarker research participation.Methods: A cohort of 399 community‐dwelling older adults completed a survey about their trust of researchers and interest in participating in ADRD biomarker research.Results: After controlling for sociodemographics and knowledge of ADRD, higher trust of researchers was associated with lower levels of hesitancy to participate in ADRD biomarker and neuroimaging studies (p < 0.001). Higher trust of researchers was associated with agreement with research‐related motivation statements and interest in return of results from neuroimaging and memory tests (p < 0.05).Discussion: Our findings show that trust of researchers is highly correlated with research participation, independent of knowledge of ADRD and sociodemographics, and should be a focus to accelerate ADRD biomarker research participation, such as groups at higher risk.

More than 2 million older Americans from underrepresented racial and ethnic minority groups (URGs) have early‐stage Alzheimer's disease and related dementias (ADRD). There are very few scalable recruitment strategies, particularly for Black older adults, to accelerate participation in ADRD research. The Indiana Alzheimer's Disease Research Center (IADRC) and its Community Advisory Board developed and implemented the innovative RAAISE‐D Framework. This Framework informed the creation of community‐first recruitment strategies designed to accelerate participation of Black older adults in ADRD research. Preliminary outcomes from its implementation included the doubling of Black adult enrollment (46, 13.4% to 101, 26.9%) from April 2020 to April 2024. Black adults were more likely to have normal cognition, be female, and ≤ 12 years of education than non‐Hispanic White adults. The RAAISE‐D Framework identified key concepts for URG focused recruitment strategies which successfully accelerated enrollment of Black adults in ADRD research and could be generalized to other URGs. Highlights: RAAISE‐D Framework provides adaptable URG recruitment strategies. IADRC CAB‐researcher partnership was the foundation of community‐first methodology. RAAISE‐D Framework doubled the Black enrollment in the IADRC in 4 years.

Introduction: Community advisory boards (CABs) and researcher partnerships present a promising opportunity to accelerate enrollment of underrepresented groups (URGs). We outline the framework for how the CAB and researchers at the Indiana Alzheimer's Disease Research Center (IADRC) partnered to accelerate URG participation in AD neuroimaging research. Methods: CAB and the IADRC researchers partnered to increase the CAB's impact on URG study enrollment through community and research interactions. Community interactions included the CAB collaboratively building a network of URG focused community organizations and collaborating with those URG‐focused organizations to host IADRC outreach and recruitment events. Research interactions included direct impact (CAB members referring themselves or close contacts as participants) and strategic impact, mainly by the CAB working with researchers to develop and refine URG focused outreach and recruitment strategies for IADRC and affiliated studies to increase URG representation. We created a database infrastructure to measure how these interactions impacted URG study enrollment. Results: Out of the 354 URG research referrals made to the IADRC between October 2019 and December 2022, 267 referrals were directly referred by the CAB ( N = 36) or from community events in which CAB members organized and/or volunteered at ( N = 231). Out of these 267 referrals, 34 were enrolled in IADRC and 2 were enrolled in Indiana University Longitudinal Early Onset AD Study (IU LEADS). Of note, both studies require the prospective participants to be willing to do MRI and PET scans. As of December 2022, 30 out of the 34 enrolled participants have received a consensus diagnosis; the majority were cognitively normal (64.7%), with the remainder having mild cognitive impairment (17.6%) or early‐stage AD (2.9%). Discussion: The IADRC CAB‐researcher partnership had a measurable impact on the enrollment of African American/Black adults in AD neuroimaging studies. Future studies will need to test whether this conceptual model works for other sites and for other URGs.