Recruitment and Retention of Older Adults in Aging Research

(See editorial comments by Dr. Stephanie Studenski, pp 2351–2352)

Authors

  • Lona Mody MD, MSc,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Douglas K. Miller MD,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Joanne M. McGloin M Div, MS, MBA,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Marcie Freeman MEd,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Edward R. Marcantonio MD, MSc,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Jay Magaziner MD, MSc,

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author
  • Stephanie Studenski MD, MPH

    1. From the *Geriatrics Research Education and Clinical Center (GRECC) VA Ann Arbor Healthcare SystemDivision of Geriatrics, University of Michigan, Ann Arbor, MICenter for Aging Research and Regenstrief Institute, Inc., Indiana University, Indianapolis, Indiana§Claude D. Pepper Older Americans Independence Center, School of Medicine, Yale University, New Haven, ConnecticutInstitute for Aging Research, Hebrew SeniorLife, Harvard Cooperative Program on Aging#Divisions of General Medicine and Primary Care**Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts††Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland‡‡Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania§§Geriatric Research, Education and Clinical Center, Pittsburgh Veterans Affairs Healthcare System, Pittsburgh, Pennsylvania.
    Search for more papers by this author

Address correspondence to Lona Mody, MD MSc, VA Ann Arbor Healthcare System, 11-G GRECC, 2215 Fuller Rd, Ann Arbor, MI 48105. E-mail: lonamody@umich.edu

Abstract

Older adults continue to be underrepresented in clinical research despite their burgeoning population in the United States and worldwide. Physicians often propose treatment plans for older adults based on data from studies involving primarily younger, more-functional, healthier participants. Major barriers to recruitment of older adults in aging research relate to their substantial health problems, social and cultural barriers, and potentially impaired capacity to provide informed consent. Institutionalized older adults offer another layer of complexity that requires cooperation from the institutions to participate in research activities. This paper provides study recruitment and retention techniques and strategies to address concerns and overcome barriers to older adult participation in clinical research. Key approaches include early in-depth planning; minimizing exclusion criteria; securing cooperation from all interested parties; using advisory boards, timely screening, identification, and approach of eligible patients; carefully reviewing the benefit:risk ratio to be sure it is appropriate; and employing strategies to ensure successful retention across the continuum of care. Targeting specific strategies to the condition, site, and population of interest and anticipating potential problems and promptly employing predeveloped contingency plans are keys to effective recruitment and retention.

Ancillary