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@INPROCEEDINGS{Bosch:283077,
      author       = {Bosch, Iris and Lenér, Frida and Stankeviciute, Laura and
                      Singleton, Ellen Hanna and Öhman, Fredrik and Quitz, Kajsa
                      and Dottori, Maria and Berron, David and Franzmeier, Nicolai
                      and Kern, Silke and Zetterberg, Henrik and Blennow, Kaj and
                      Schöll, Michael},
      title        = {{F}rom zero to 6,000 in 9 months: {R}ecruitment and
                      innovation strategies for a remote longitudinal
                      {A}lzheimer's population‐based screening study –
                      {I}nsights from the {REAL} {AD} study},
      journal      = {Alzheimer's and dementia},
      volume       = {21},
      number       = {Suppl 6},
      issn         = {1552-5260},
      reportid     = {DZNE-2025-01484},
      pages        = {e106340},
      year         = {2025},
      abstract     = {The REAL AD study aims to validate the diagnostic and
                      prognostic performance of combining blood-based biomarkers
                      and remote cognitive testing as a screening approach for
                      early Alzheimer's disease (AD), leveraging an existing
                      healthcare infrastructure in Western Sweden. Here, we
                      discuss strategies for recruiting a large and representative
                      cohort, demographics and participant retention during the
                      first study phase, and evaluate the process of implementing
                      innovations enabling a fully remote study design.In April
                      2024, a recruitment campaign was launched in collaboration
                      with a PR company to recruit at least 3000 participants
                      between 50-80 years from the general population. Through an
                      online study platform, participants were enrolled and asked
                      to answer health and lifestyle questionnaires (Step 1),
                      guided to remotely administered cognitive testing (Step 2;
                      using the neotivTrials app or Cognitron battery), and blood
                      sampling at any of the 105 public regional primary care
                      units (Step 3; Figure 1). Additionally, optional remote
                      blood sampling complemented the primary study protocol.At
                      abstract submission, N = 6092 participants (mean age=63.9
                      years, $70\%$ female) were enrolled over a nine-month
                      period, with recruitment ongoing for another month (Table
                      1). Retention rates for initial study steps were N = 4785
                      participants at Step 1, N = 3860 at Step 2, and N = 2491 at
                      Step 3. These rates align with or exceed findings from a
                      cross-study evaluation of retention in remote digital health
                      studies (Pratap et al., 2020). Innovations enabling a fully
                      remote study design were critical in achieving these
                      recruitment and retention rates. However, attrition
                      highlights challenges in maintaining engagement in remote
                      study designs. Key innovations will be evaluated, focusing
                      on: (1) an online study platform with secure authentication,
                      (2) remote cognitive testing, (3) blood sampling via local
                      healthcare providers, and (4) remote sample collection, all
                      achieved through collaboration with relevant stakeholders.
                      Structured feedback reports from participants will
                      complement evaluations.REAL AD demonstrates the feasibility
                      of implementing a large-scale, fully remote screening
                      approach for early AD. Preliminary results highlight the
                      effectiveness of key innovations and stakeholder
                      collaboration, though attrition underlines the need to
                      address engagement barriers. Future improvements and
                      recommendations for other remote population-based screening
                      initiatives will be discussed.},
      month         = {Jul},
      date          = {2025-07-27},
      organization  = {Alzheimer’s Association
                       International Conference, Toronto
                       (Canada), 27 Jul 2025 - 31 Jul 2025},
      keywords     = {Humans / Female / Male / Aged / Middle Aged / Alzheimer
                      Disease: diagnosis / Alzheimer Disease: blood / Public
                      Health / Aged, 80 and over / Biomarkers: blood / Sweden /
                      Neuropsychological Tests / Surveys and Questionnaires /
                      Telemedicine / Patient Selection / Biomarkers (NLM
                      Chemicals)},
      cin          = {AG Berron},
      ddc          = {610},
      cid          = {I:(DE-2719)5000070},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)1 / PUB:(DE-HGF)16},
      pubmed       = {pmid:41435182},
      pmc          = {pmc:PMC12726296},
      doi          = {10.1002/alz70860_106340},
      url          = {https://pub.dzne.de/record/283077},
}