Dyadic Enrollment in a Phase 3 Mild Cognitive Impairment Clinical Trial

Alzheimer Dis Assoc Disord. 2022 Jul-Sep;36(3):192-199. doi: 10.1097/WAD.0000000000000506. Epub 2022 Apr 29.

Abstract

Background: Dyadic enrollment of a participant and study partner is required in mild cognitive impairment (MCI) clinical trials, despite participants being functionally independent. Research examining how the study partner requirement impacts MCI trials remains limited.

Methods: Using the Alzheimer's Disease Cooperative Study donepezil and vitamin E MCI trial data, we quantified the proportions of enrolled spouse, adult child, and other dyads. We used multinomial regression to identify which baseline participant characteristics (age, sex, race and ethnicity, apolipoprotein E ε4 status, education, residence type) were associated with dyad type.

Results: Among 769 randomized dyads, 73% were spousal, 14% adult child, and 13% other dyads. Adjusting for multiple comparisons, underrepresented racial and ethnic background (eg, comparing Hispanic to non-Hispanic White participants: adult child vs. spouse odds ratio = 5.86; 95% confidence interval: 2.09, 16.5; other vs. spouse odds ratio = 4.95; 95% confidence interval: 1.83, 13.4), female sex, age, nonhouse residence, and apolipoprotein E ε4 noncarriage were each associated with a higher odds of having an adult child, as well as an other, study partner at enrollment.

Discussion: Increasing participation among nonspousal dyads may facilitate more inclusive and representative MCI trial samples.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult Children / psychology
  • Adult Children / statistics & numerical data
  • Alzheimer Disease / drug therapy
  • Apolipoprotein E4 / genetics
  • Clinical Trials, Phase III as Topic*
  • Cognitive Dysfunction* / drug therapy
  • Donepezil / therapeutic use
  • Female
  • Humans
  • Male
  • Patient Participation* / statistics & numerical data
  • Spouses / psychology
  • Spouses / statistics & numerical data

Substances

  • Apolipoprotein E4
  • Donepezil