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Improving generalizability and study design of Alzheimer's disease cohort studies in the United States by including under-represented populations
Mindt MR, Okonkwo O, Weiner MW, Veitch DP, Aisen P, Ashford M, Coker G, Donohue MC et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2022-11-13
Topic: Amyloid, tau and blood-test diagnosis
The poor generalizability of clinical research data due to the enrollment of highly educated, non-Latinx White participants hampers the development of therapies for Alzheimer's disease (AD). Black and Latinx older adults have a greater risk for dementia, yet it is unclear how health-care disparities and sociocultural factors influence potential AD therapies and prognosis. Low enrollment of under-represented populations may be attributable to several factors including greater exclusion due to higher rates of comorbidities, lower access to AD clinics, and the legacy of unethical treatment in medical research. This perspective outlines solutions tested in the Brain Health Registry (BHR) and the Alzheimer's Disease Neuroimaging Initiative (ADNI), including culturally-informed digital research methods, community-engaged research strategies, leadership from under-represented communities, and the reduction of exclusion criteria based on comorbidities. Our successes demonstrate that it is possible to increase the inclusion and engagement of under-represented populations into US-based clinical studies, thereby increasing the generalizability of their results.
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APA 7th
Mindt, M. R., Okonkwo, O., Weiner, M. W., Veitch, D. P., Aisen, P., Ashford, M., et al. (2023). Improving generalizability and study design of Alzheimer's disease cohort studies in the United States by including under-represented populations. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.12823
Vancouver
Mindt MR, Okonkwo O, Weiner MW, Veitch DP, Aisen P, Ashford M, et al. Improving generalizability and study design of Alzheimer's disease cohort studies in the United States by including under-represented populations. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2023. doi:10.1002/alz.12823. PMID: 36372959.
BibTeX
@article{mindt2023-36372959,
author = {Mindt, M. R. and Okonkwo, O. and Weiner, M. W. and Veitch, D. P. and Aisen, P. and Ashford, M. and Coker, G. and Donohue, M. C. and others},
title = {{Improving generalizability and study design of Alzheimer's disease cohort studies in the United States by including under-represented populations}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2023},
doi = {10.1002/alz.12823},
pmid = {36372959},
url = {https://doi.org/10.1002/alz.12823}
}
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Key findings
- Our successes demonstrate that it is possible to increase the inclusion and engagement of under-represented populations into US-based clinical studies, thereby increasing the generalizability of their results.
Why it matters
This perspective describes ways to include more Black and Latinx older adults in Alzheimer's cohort studies so results apply more broadly. It addresses research participation, not treating, curing, or preventing the disease.
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Study details
- Evidence strengthLow
How this study scored 47/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 4 / 7 | Cited 46 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 9.2 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 3 / 6 | Cited 7.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 40 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Rachel L. Nosheny: h-index 41 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 11 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36372959) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 47 / 100 | — |
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