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P4‐038: Factors influencing lumbar puncture participation in Alzheimer's research
Author(s) -
Moulder Krista L.,
Monsell Sarah E.,
Beekly Duane,
Besser Lilah M.,
Blennow Kaj,
Kukull Walter,
Morris John C.
Publication year - 2015
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2015.06.1742
Subject(s) - likert scale , medicine , lumbar , complication , lumbar puncture , physical therapy , surgery , statistics , mathematics , cerebrospinal fluid
Background: Lumbar puncture (LP) in both the clinical care and research of Alzheimer disease (AD) is becoming increasingly more common; however, agreement to undergo LP varies widely across country, culture, and region. We sought to determine the factors that influence consent for research LP at the 27 Alzheimer’s Disease Centers (ADCs) in the United States. Data were collected on LP procedure methods, participant LP experience, and complication rates. Methods: A three-part survey was distributed to all ADCs in September of 2011, consisting of 1) ADC LP Experience; 2) LP Requestor Experience; and 3) Patient LP Experience (Initial and Follow-up). Surveys were collected from September 1, 2011 through December 31, 2013 at participating ADCs. 64 LP Requestor surveys, 606 Patient/Initial, and 424 Patient/Follow-up surveys were collected through the National Alzheimer’s Coordinating Center website. Chi-square and Fisher’s exact tests were used for statistical analyses as appropriate. Results:ADC LP Requestors considered LP to be valuable for research (5.560.5 [mean6SD] on a six-point Likert scale with 6 as “extremely valuable”), causing a relatively low amount of discomfort (2.460.4 [mean6SD] on a six-point Likert scale with 1 being “no discomfort”). Requestor perceptions of LP did not, however, influence the rate of participant agreement to undergo LP at individual ADCs. Factors influencing LP agreement included sex (p1⁄40.02), race (p<0.0001), diagnosis (p<0.0001), previous LP experience (p<0.0001), previous LP complication (p1⁄40.01), and participant view of the LP procedure (p<0.0001). Among participants who agreed to undergo LP, 29.7% reported a complication, with LP headache occurring in 10.8% and blood patch required in 1.3%. Development of a complication (any type) was associated with older age (p1⁄40.003), female sex (p1⁄40.01), use of aspiration (p1⁄40.03), and LP-induced bleeding (p1⁄40.001). Conclusions: LP was viewed at ADCs as a valuable tool for AD research. Understanding of factors influencing agreement to undergo LP could increase research participant/patient acceptance of the procedure. Of note, individuals who previously had undergone LP were more likely to agree to subsequent LP than those who had not undergone LP (90.2% vs. 73.1%; p<0.0001), suggesting that overcoming perceived barriers to LP is critical for greater acceptance.