Date of Award

Spring 3-14-2025

Embargo Period

3-14-2026

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Daniel Brinton

Second Advisor

Jillian Harvey

Third Advisor

Kesley Holmes

Abstract

Retention in Alzheimer’s disease clinical trials is a critical challenge, with participant withdrawal impacting statistical power, data integrity, and generalizability. Underrepresented racial and ethnic groups (URGs) face disproportionately high dropout rates, necessitating a deeper understanding of withdrawal predictors. This retrospective cohort study analyzed demographic and site-related factors influencing withdrawal in ADNI1, ADNI2, and ADNI-GO trials using publicly available data from the Laboratory of Neuro Imaging (LONI) database. After data cleaning, the final dataset included 3,008 participants, with 1,324 withdrawn and 1,684 retained. Logistic regression identified younger age (p < .001, OR = 0.977), retired status (p = .005, OR = 1.309), race (p = .003, OR = 0.784), and site number (p < .001, OR = 1.004) as significant predictors of withdrawal, while gender, marital status, handedness, primary language, and education level were non-significant. These findings suggest that targeted retention strategies for younger and retired participants, culturally tailored engagement for URGs, and site-specific monitoring could improve retention and enhance the diversity and generalizability of Alzheimer’s disease research.

Rights

Copyright is held by the author. All rights reserved.

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