Strategies to improve research participation by older people with cognitive impairment: a systematic review.

IF 4.6 2区医学 Q1 GERONTOLOGY

Gerontologist Pub Date : 2024-12-18 DOI:10.1093/geront/gnae188

Lucinda Swan, Slavica Kochovska, Nola Ries, Imelda Gilmore, Deborah Parker, Craig Sinclair, Caitlin Sheehan, Aileen Collier, Elizabeth Lobb, Linda Sheahan, Linda Brown, Michael Chapman, Wei Lee, Ingrid Amgarth-Duff, Timothy To, Meera R Agar, Annmarie Hosie

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引用次数: 0

Abstract

Background and objectives: Older people with cognitive impairment are unrepresented in clinical research. Our objective was to review evidence for strategies to support their research inclusion and participation.

Research design and methods: Systematic review of published reports of inclusion and participation strategies for older people with cognitive impairment in clinical research (PROSPERO CRD42020212092). Five databases were searched September 2020, March 2023 and April 2024. Screening, full text review and data extraction were independently performed. Risk of bias was assessed using Scottish Intercollegiate Guidelines Network Methodology Checklists. Outcomes were participant characteristics, recruitment and consent processes, retention, experience, involvement of others, adverse events, and other reported outcomes.

Results: Of 4564 identified sources, 12 studies were included. Nine compared recruitment strategies; three examined consent processes. Of 4,208 participants (mean age 78.3 years), 61% were female. Median (interquartile range) monthly recruitment rate was 10.3 (5.6-14.8). Participants had mild cognitive impairment, dementia and/or delirium and two-thirds of studies involved proxies or study partners. Community outreach or population screening had higher recruitment compared to primary care referral and/or screening. Formal capacity and consent methods achieved lower rates of consent compared to informal. A memory and organisational aid increased participants' ability to provide informed consent compared to standard assessment. Few studies reported participants' or recruiters' subjective experience, and no studies reported participant retention or adverse events.

Discussion and implications: Targeted, tailored and multi-pronged recruitment and consent strategies to support inclusion of older people with cognitive impairment appear promising. Higher quality studies are needed to confirm this finding.

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提高老年认知障碍患者参与研究的策略：系统综述。

背景和目的：老年认知障碍患者在临床研究中没有代表性。我们的目标是为支持他们的研究纳入和参与的策略审查证据。研究设计和方法：系统回顾已发表的关于临床研究中老年人认知障碍纳入和参与策略的报告（PROSPERO CRD42020212092）。5个数据库分别于2020年9月、2023年3月和2024年4月检索。筛选、全文审阅和数据提取独立进行。使用苏格兰校际指南网络方法学检查表评估偏倚风险。结果包括参与者特征、招募和同意过程、保留、经验、他人参与、不良事件和其他报告的结果。结果：在4564个已确定的来源中，纳入了12项研究。9个比较招聘策略；其中三个研究了同意程序。在4208名参与者（平均年龄78.3岁）中，61%为女性。每月招聘率中位数（四分位数间距）为10.3（5.6-14.8）。参与者有轻度认知障碍、痴呆和/或谵妄，三分之二的研究涉及代理或研究伙伴。与初级保健转诊和/或筛查相比，社区外展或人群筛查的招募率更高。与非正式方法相比，正式能力和同意方法获得的同意率较低。与标准评估相比，记忆和组织援助提高了参与者提供知情同意的能力。很少有研究报告了参与者或招聘人员的主观体验，也没有研究报告了参与者的保留或不良事件。讨论和启示：有针对性、量身定制和多管齐下的招募和同意策略，以支持纳入有认知障碍的老年人，似乎很有希望。需要更高质量的研究来证实这一发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gerontologist GERONTOLOGY-

CiteScore

11.00

自引率

8.80%

发文量

171

期刊介绍： The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.