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Author Notes:

Correspondence: William T. Hu, wthu@emory.edu

JCH is responsible for design/conception of the study; acquisition and analysis of the data; and drafting of the manuscript.

MWP is responsible for design/conceptualization of the study; acquisition, analysis and interpretation of the data; and critical revision of the manuscript for important intellectual content.

KDW is responsible for design/conception of the study; analysis and interpretation of the data; and critical revision of the manuscript for important intellectual content.

AK is responsible for acquisition and analysis of the data; and critical revision of the manuscript for important intellectual content.

DZT is responsible for acquisition, analysis and interpretation of the data; and critical revision of the manuscript for important intellectual content.

WTH is responsible for the design/conception of the study; acquisition, analysis and interpretation of data; and drafting of the manuscript.

Conflict of Interest Statement: WTH has a patent on cerebrospinal fluid-based diagnosis of Alzheimer’s disease and frontotemopral lobar degeneration through Emory University; consults for AARP, Inc. and Locks Law Firm; has received research support from Avid Pharmaceuticals; and has received travel support from Eli Lilly and Hoffman LaRoche. Other authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Subjects:

Research Funding:

This work was supported by NIH AG43885, AG42856 and AG25688.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Geriatrics & Gerontology
  • Neurosciences
  • Neurosciences & Neurology
  • Alzheimer's disease
  • cerebrospinal fluid
  • health disparity
  • MEMORY
  • WILLINGNESS
  • PARTICIPATE
  • PAIN
  • KNOWLEDGE
  • ANXIETY

Research Lumbar Punctures among African Americans and Caucasians: Perception Predicts Experience

Tools:

Journal Title:

Frontiers in Aging Neuroscience

Volume:

Volume 8, Number DEC

Publisher:

, Pages 296-296

Type of Work:

Article | Final Publisher PDF

Abstract:

African Americans are under-represented in Alzheimer's disease (AD)-related biomarker studies, and it has been speculated that mistrust plays a major factor in the recruitment of African Americans for studies involving invasive procedures such as the lumbar puncture (LP). We set out to determine factors associated with non-participation in a biomarker study aiming to explore cerebrospinal fluid (CSF) AD biomarker differences between older African Americans and Caucasians. We also surveyed participants' procedure-related perception (a standard medical procedure vs. a frightening invasive procedure) and reluctance, as well as the rate and type of post-procedure discomfort and complications. Among 288 subjects approached for study participation, 145 (50.3%) refused participation with concerns over LP being the most commonly reported reason. Relatively more African Americans than Caucasians reported concerns over LP as the main reason for non-participation (46% vs. 25%, p = 0.03), but more African Americans also did not provide a specific reason for non-participation. Among those who completed study participation (including the LP), African Americans and Caucasians were similar in pre-LP perceptions and reluctance, as well as post-LP rates of discomfort or complication. Perceiving LP as a frightening invasive procedure, not race, is associated with increased likelihood of post-LP discomfort or complication (RR 6.2, 95% confidence interval 1.1-37.0). Our results indicate that LP is a well perceived procedure in a cohort of African American and Caucasian research participants, and is associated with few serious complications. The pre-procedure perception that the LP is a frightening invasive procedure significantly increases the risk of self-reported discomfort of complications, and African Americans may be more likely to turn down study participation because of the LP. Future studies will need to address factors associated with negative LP perceptions to further assure participants and reduce complication rates.

Copyright information:

© 2016 Howell, Parker, Watts, Kollhoff, Tsvetkova and Hu.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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