Related Experiment Video
Updated: Mar 6, 2026

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
Published on: January 24, 2020
Cognitive screening biases in a secondary prevention Alzheimer's disease clinical trial
Isha Sai1, Joshua D Grill2,3,4, Kyan Younes1
1Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, California, USA.
Introduction:
Alzheimer's disease (AD) prevention trials have multiple steps to identify cognitively unimpaired individuals with AD biomarker evidence. Cognitive/functional screening tests may be biased in ethnoracial minorities, impacting trial eligibility.
Methods:
A total of 6669 participants screened for the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study were grouped by ethnoracial background and testing language. Ethnoracial/language differences in ineligibility reason, cognitive/functional test performance, and amyloid positivity rates were examined.
Results:
Ethnoracial minorities were least likely to meet eligibility criteria. Patterns of incorrect Mini-Mental State Examination items and impaired Clinical Dementia Rating functional domains differed between ethnoracial/language groups, suggesting potential test biases. The Free and Cued Selective Reminding Test yielded more similar exclusion rates across groups than Logical Memory. Cognitive/functional screening biases may impact subsequent biomarker screening as amyloid positivity rates were lowest in ethnoracial minorities.
Discussion:
Biases in cognitive/functional screening tests may be contributing to disproportionate exclusion of ethnoracial minorities in AD clinical trials.
More Related Videos
06:23The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
12:18A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Related Concept Videos
Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
Alzheimer's Disease: Treatment
Dementia
The progression of dementia is generally gradual....
Blind Procedures
Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists