Calamia Matthew, Bernstein John P K, Keller Jeffrey N
Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, United States of America.
Pennington Biomedical Research Center, Institute for Dementia Research and Prevention, Baton Rouge, Louisiana, United States of America.
PLoS One. 2016 Jul 20;11(7):e0159664. doi: 10.1371/journal.pone.0159664. eCollection 2016.
Alzheimer's disease (AD) ranks as the 6th leading cause of death in the United States, yet unlike other diseases in this category, there are no disease-modifying medications for AD. Currently there is significant interest in exploring the benefits of pharmacological treatment before the onset of dementia (e.g., in those with mild cognitive impairment); however, recruitment for such studies is challenging. The current study examined interest in pharmacological intervention trials relative to other types of clinical interventions. A total of 67 non-demented older adults enrolled in a longitudinal cognitive aging study completed a questionnaire assessing interest in participating in a variety of hypothetical research study designs. Consistent with past research, results showed that the opportunities for participants to advance science, receive feedback about their current health, and help themselves or others, were associated with increased interest in clinical trial participation. Some factors were not associated with change in interest (e.g., a doctor not recommending participation) while others were associated with decreased interest (e.g., having to come in for multiple visits each week). Relative to other types of interventions, pharmacological intervention trials were associated with the least interest in participation, despite pharmacological interventions being rated as more likely to result in AD treatment. Decreased interest was not predicted by subjective memory concerns, number of current medications, cardiovascular risk, or beliefs about the likely success of pharmacological treatments. These results highlight the challenges faced by researchers investigating pharmacological treatments in non-demented older individuals, and suggest future research could contribute to more effective ways of recruiting participants in AD-related clinical trials.
阿尔茨海默病（AD）是美国第六大死因，但与该类别中的其他疾病不同，目前尚无针对AD的疾病修饰药物。目前，人们对在痴呆症发作前探索药物治疗的益处（例如，在轻度认知障碍患者中）有着浓厚兴趣；然而，招募此类研究的参与者具有挑战性。本研究考察了相对于其他类型临床干预，人们对药物干预试验的兴趣。共有67名参与纵向认知衰老研究的非痴呆老年人完成了一份问卷，该问卷评估了他们参与各种假设研究设计的兴趣。与过去的研究一致，结果表明，参与者推动科学发展、获得有关自身当前健康状况的反馈以及帮助自己或他人的机会，与参与临床试验的兴趣增加相关。一些因素与兴趣变化无关（例如医生不推荐参与），而其他因素则与兴趣降低相关（例如每周必须多次前来就诊）。相对于其他类型的干预措施，尽管药物干预被认为更有可能带来AD治疗效果，但药物干预试验的参与兴趣最低。主观记忆担忧、当前用药数量、心血管风险或对药物治疗可能成功的信念，均未预测到兴趣降低。这些结果凸显了研究人员在非痴呆老年人中研究药物治疗所面临的挑战，并表明未来的研究可能有助于找到更有效的方法来招募AD相关临床试验的参与者。
