Strategies to Improve Research Participation By Older People With Cognitive Impairment: A Systematic Review.
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 part...
| Publicado en: | Gerontologist Vol. 65; no. 6; pp. 1 - 17 |
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| Autores principales: | , , , , , , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jun2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=185837782&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 185837782 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00169013 GET jtl: Gerontologist issn: 00169013 maglogo: N pubinfo: dt: Jun2025 vid: 65 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 185837782 10.1093/geront/gnae188 ppf: 1 ppct: 16 formats: tig: atl: Strategies to Improve Research Participation By Older People With Cognitive Impairment: A Systematic Review. aug: au: Swan, Lucinda Kochovska, Slavica Ries, Nola Gilmore, Imelda Parker, Deborah Sinclair, Craig Sheehan, Caitlin Collier, Aileen Lobb, Elizabeth Sheahan, Linda Brown, Linda Chapman, Michael Lee, Wei Amgarth-Duff, Ingrid To, Timothy Agar, Meera R Hosie, Annmarie affil: Faculty of Medicine, Nursing, Midwifery and Health Sciences, University of Notre Dame Australia, Darlinghurst, New South Wales, Australia St Vincent's Health Network Sydney, Darlinghurst, New South Wales, Australia IMPACCT (Improving Palliative, Aged and Chronic Care through Research and Translation), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia Faculty of Law, University of Technology Sydney, Ultimo, New South Wales, Australia School of Psychology, University of New South Wales, Kensington, New South Wales, Australia Palliative Care Department, Calvary Health Care Kogarah, Kogarah, New South Wales, Australia Research Centre for Palliative Care Death and Dying, Flinders University, Adelaide, South Australia, Australia Northern Adelaide Local Health Network, Adelaide, South Australia, Australia Clinical Ethics Service, South Eastern Sydney Local Health District, Randwick, New South Wales, Australia Sydney Health Ethics, University of Sydney, Camperdown, New South Wales, Australia Department of Palliative Care, Canberra Health Services, Canberra Hospital, Garran, Australian Capital Territory, Australia School of Medicine, Australian National University, Australian Capital Territory, Australia HammondCare North, Greenwich, NSW 2065, Australia Wesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute Australia, Nedlands, WA, Australia Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia su: Human research subjects Primary health care Evaluation of medical care Informed consent (Medical law) Medical screening Patient participation Patient selection Cognition disorders in old age Systematic reviews Medical referrals sug: subj: Human research subjects Primary health care Evaluation of medical care Informed consent (Medical law) Medical screening Patient participation All Other Miscellaneous Ambulatory Health Care Services Patient selection Cognition disorders in old age Systematic reviews Medical referrals keyword: Analysis—Systematic review Cognition Decision making Dementia Ethics (research individual choices) policy practice Analysis—Systematic review Cognition Decision making Dementia Ethics (research individual choices) policy practice ab: 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). 5 databases were searched in September 2020, March 2023, and April 2024. Screening, full-text review, and data extraction were independently performed. The 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 4,564 identified sources, 12 studies were included. 9 compared recruitment strategies; 3 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 the studies involved proxies or study partners. Community outreach or population screening had higher recruitment compared with primary care referral and/or screening. Formal capacity and consent methods achieved lower rates of consent compared with informal. A memory and organizational aid increased participants' ability to provide informed consent compared with 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 the inclusion of older people with cognitive impairment appear promising. Higher-quality studies are needed to confirm this finding. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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