{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:09:47Z","timestamp":1765278587821,"version":"3.46.0"},"posted":{"date-parts":[[2025,12,4]]},"group-title":"Neurology","reference-count":58,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T00:00:00Z","timestamp":1764806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,12,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>INTRODUCTION<\/jats:title>\n                  <jats:p>Alzheimer\u2019s disease (AD) prevention trials have multiple screening steps to identify cognitively unimpaired individuals with AD biomarker evidence. Cognitive\/functional screening tests may be biased in underrepresented groups, thereby impacting trial eligibility.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>6669 participants screened for the Anti-Amyloid Treatment in Asymptomatic Alzheimer\u2019s (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.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>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 groups excluded for impaired cognition\/function, suggesting 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.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>DISCUSSION<\/jats:title>\n                  <jats:p>Biases in cognitive\/functional screening tests may disproportionately exclude ethnoracial minorities in AD prevention trials.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2025.11.28.25341235","type":"posted-content","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T18:10:37Z","timestamp":1765217437000},"source":"Crossref","is-referenced-by-count":0,"title":["Cognitive screening biases in a secondary prevention Alzheimer\u2019s disease clinical trial"],"prefix":"10.64898","author":[{"given":"Isha","family":"Sai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4215-7589","authenticated-orcid":false,"given":"Joshua D.","family":"Grill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyan","family":"Younes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4069-3158","authenticated-orcid":false,"given":"Joseph R.","family":"Winer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5996-2560","authenticated-orcid":false,"given":"Karly A.","family":"Cody","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reisa","family":"Sperling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth C.","family":"Mormino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina B","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025120902573476000_2025.11.28.25341235v1.1","unstructured":"Medications for Memory, Cognition & Dementia-Related Behaviors | alz.org. 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