Open Access Research article

Recruitment methods in Alzheimer's disease research: general practice versus population based screening by mail

Fred Andersen1*, Torgeir A Engstad2, Bjørn Straume1, Matti Viitanen34, Dag S Halvorsen2, Samuel Hykkerud2 and Kjell Sjøbrend5

  • * Corresponding author: Fred Andersen frea@online.no

  • † Equal contributors

Author Affiliations

1 Department of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway

2 Department of Geriatrics, University Hospital in Northern Norway, N-9038 Tromsø, Norway

3 Department of Geriatrics, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

4 University of Turku, Turku, Finland

5 Vefsn Health Centre, N-8656 Mosjøen, Norway

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BMC Medical Research Methodology 2010, 10:35  doi:10.1186/1471-2288-10-35

Published: 29 April 2010

Abstract

Background

In Alzheimer's disease (AD) research patients are usually recruited from clinical practice, memory clinics or nursing homes. Lack of standardised inclusion and diagnostic criteria is a major concern in current AD studies. The aim of the study was to explore whether patient characteristics differ between study samples recruited from general practice and from a population based screening by mail within the same geographic areas in rural Northern Norway.

Methods

An interventional study in nine municipalities with 70000 inhabitants was designed. Patients were recruited from general practice or by population based screening of cognitive function by mail. We sent a questionnaire to 11807 individuals ≥ 65 years of age of whom 3767 responded. Among these, 438 individuals whose answers raised a suspicion of cognitive impairment were invited to an extended cognitive and clinical examination. Descriptive statistics, chi-square, independent sample t-test and analyses of covariance adjusted for possible confounders were used.

Results

The final study samples included 100 patients recruited by screening and 87 from general practice. Screening through mail recruited younger and more self-reliant male patients with a higher MMSE sum score, whereas older women with more severe cognitive impairment were recruited from general practice. Adjustment for age did not alter the statistically significant differences of cognitive function, self-reliance and gender distribution between patients recruited by screening and from general practice.

Conclusions

Different recruitment procedures of individuals with cognitive impairment provided study samples with different demographic characteristics. Initial cognitive screening by mail, preceding extended cognitive testing and clinical examination may be a suitable recruitment strategy in studies of early stage AD.

Clinical Registration

ClinicalTrial.gov Identifier: NCT00443014