School of Medicine Publications and Presentations

Disparities in Research Participation within a Multi-Racial SARS-CoV-2 Cohort for Evaluation of Ultrahigh Field (7T) MRI and Clinical Precursors of Alzheimer’s Disease and Related Dementias

Document Type

Article

Publication Date

12-25-2023

Abstract

Background

The COVID-19 pandemic has disproportionately affected ethno-racial minority populations and people with greater social deprivation. It is unknown whether such disparities influence research participation for investigations of long-term neuro-cognitive effects of SARS-CoV-2 infection.

Method

Across 3 US and 1 UK sites, we are enrolling a multi-racial cohort of SARS-CoV-2 infected individuals and age, sex, race-matched non-infected controls. Utilizing harmonized protocols for cognitive assessments and 7-Tesla MRI, we aim to provide ultra-high-field data on natural history of COVID-19 driven microstructural and microvascular cerebral changes and associated cognitive trajectories. We will also compare the imaging markers to those observed in an existing cohort of early onset Alzheimer’s Disease and Related Dementias (ADRD). We analyzed screening and enrollment data to determine potential age, sex, race, ethnicity, and social deprivation disparities in research participation. We derived address-based Area Deprivation Index (ADI) (scale 1 -10), with higher ADI indicating greater deprivation. Logistic regression models were fit to evaluate associates of non-response and refusal. Odds Ratios (OR) and 95% confidence intervals (CI) are reported.

Result

Over a 11-month period, at a single US site, a total of 1,046 SARS-CoV-2 infected people and their controls were contacted, and 379 (36.2%) responded. In univariable analyses, non-response was associated with younger age, male sex, non-White race, and higher ADI (Table 1). In the fully adjusted model, non-White race was independently associated with higher likelihood of non-response [OR (CI) for Black vs. White: 1.49 (1.04, 2.12) and for Asian vs. White: 1.88 (1.28, 2.76)]., Independent of race, higher ADI was also associated with likelihood of non-response (Table 2 and Figure 1). Among the responders, 228 (60.2%) refused. Although, no socio-demographic factors were significantly associated with likelihood of refusal, the point estimates in the fully adjusted model suggest potential racial disparities in providing consent (Tables 1 and 2). Aggregated data from all sites will be presented.

Conclusion

It is imperative to recognize and mitigate persistent disparities in the COVID-19 pandemic, particularly pertaining to participation in long-COVID research. Mechanisms of such persistent disparities need to be studied in context of cultures, beliefs, access, and clinical factors.

Comments

University of Texas Health Science Center at San Antonio

© 2023 the Alzheimer's Association.

Publication Title

Alzheimer's & dementia : the journal of the Alzheimer's Association

DOI

10.1002/alz.077318

Academic Level

faculty

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