Michael Weiner, MD, University of California, San Francisco, San Francisco, CA, discusses the benefits and limitations of the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Overall, ADNI can be considered impactful, as many successful clinical trials use its data. However, the most significant limitation is that most participants are well-educated, relatively affluent white people. Only 10-11% of participants are non-white, despite 35% of the US population over 60-years-old being non-white. Most participants hold graduate degrees, despite 40% of over 65-year-olds in the US only having high school education or less. Altogether, the research population is different from the general population. This is not unique to ADNI, with most clinical research having the same demographic. One of the reasons for this discrepancy is that participants volunteer to be part of the research, and educated people interested in research are more likely to do so – making up the majority of participants. Additionally, under-represented populations tend to be suspicious of research establishments due to a history of discrimination. Healthcare disparities are also a cause of under-representation in clinical trials. Worst healthcare means more comorbidities, such as diabetes and obesity, and exclusion criteria will consequently reject these participants from clinical trials. This interview took place at the AD/PD™ 2022 International Conference on Alzheimer’s and Parkinson’s Diseases hosted in Barcelona, Spain.
