Promoting Engagement and Clinical Trial Readiness for Alzheimer's Disease and Related Dementias Among Underserved Sexual and Gender Minorities

University Of Nevada Las Vegas, Las Vegas NV

Investigators

Abstract

SUMMARY Sexual and gender minorities (SGM), defined here as individuals who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and/or another identity, continue to be underrepresented in Alzheimer’s disease and related dementia (AD/ADRD) clinical trials. Over 350,000 SGM older adults in the U.S. are currently living with AD/ADRD, and expected to increase to over a million by 2050. Several studies have found higher rates of subjective and objective cognitive impairment/decline and diagnosis of AD/ADRD among SGM communities compared with non-SGM communities. SGM subgroups, such as Black/African American, Hispanic/Latino/a/e/x, gender minorities, and lower socioeconomic backgrounds, have been found to experience increased rates of AD/ADRD and risk factors. Ensuring inclusion and participation in AD/ADRD clinical trials is crucial for advancing equitable clinical care and research for diverse aging populations. We will use community-engaged mixed methods research to identify specific barriers and facilitators affecting trial participation and co-develop a tailored AD/ADRD clinical trial readiness educational program to improve future trial engagement. This community-engaged and mixed-methods research proposal has three specific aims. In Aim 1, we will identify and explore domains of explore barriers and facilitators to AD/ADRD clinical trial participation through 8 to 10 focus groups (n=60). These findings will help to inform Aim 2 and the identification of intersectional correlates. In Aim 2, we will examine intersectional correlates of willingness to participate in AD/ADRD clinical trials among SGM older adults aged 50 and above (n=400). This survey will target four underrepresented groups—Black/African Americans, Hispanic/Latino/a/e/x, gender minorities, and low socioeconomic status individuals. Next, working with our community advisory board (CAB), we will co-design and evaluate the acceptability and usability of a community-tailored AD/ADRD clinical trial readiness educational program (Aim 3) for diverse SGM older adults aged 50+ (n=80). This study will enhance understanding of the barriers and facilitators of diverse SGM communities’ participation in AD/ADRD clinical trials; develop a community-tailored educational program and tools to ensure greater knowledge and promote opportunities for the community to participate AD/ADRD clinical trials; and disseminate lessons learned back to diverse SGM communities and AD/ADRD researchers and clinical trialists. Future studies will test the efficacy of our educational program, aiming to diversify enrollment and increase participation in AD/ADRD trials among SGM populations, with promise for advancing clinical care for diverse aging populations.