Improving Recruitment to Prodromal Alzheimer’s Disease Clinical Trials

Joshua Grill, PhD
University of California, Irvine (Irvine, CA)
Year Awarded:
Grant Duration:
July 1, 2018 to June 30, 2021
Alzheimer's Disease
Award Amount:
Grant Reference ID:
Award Type:
Award Region:
US Southwestern
Joshua Grill, PhD

Improving Recruitment to Prodromal Alzheimer’s Disease Clinical Trials


The single greatest barrier to advances in Alzheimer’s disease (AD) treatment is poor recruitment to clinical trials of promising therapies. Most of these clinical trials now enroll patients with mild cognitive impairment (MCI), which in many cases may be a “prodromal” form of AD that exists before full-blown dementia develops. This project will identify the challenges to enrolling these patients in clinical trials and identify methods to improve recruitment to these critical studies.


The goal of this project is to better understand how patients diagnosed with mild cognitive impairment (MCI) and their families approach decisions about biomarker testing and clinical trial participation, and whether these decisions intersect or interact. We will interview people who have received a diagnosis of MCI and their family members to better understand their reactions to the diagnosis and how they approach two major decisions: 1) whether to undergo biomarker testing for Alzheimer’s disease, and 2) whether to participate in clinical trials of investigational therapies. Because clinical trials in people with MCI generally struggle to complete enrollment, we will also investigate incentives that might increase rates of participation. To date, few studies of decision making have focused on people with MCI, which in many cases may be a “prodromal” form of AD that exists before full-blown dementia develops. More and more clinical trials focus on MCI as a population. Better understanding of these issues and improved methods of recruitment are critically needed. This proposal will provide important information to guide efforts to improve recruitment to these studies, with the overarching goal of hastening advances in AD treatments and cures.  

About the Researcher

Joshua D. Grill, PhD, earned his bachelor’s degree with a double major in zoology and psychology and a minor in neuroscience from Miami University in Oxford, OH. He then completed his doctorate in neuroscience in the Department of Neurobiology and Anatomy at the Wake Forest University School of Medicine. After a brief stint in industry, he joined the faculty at UCLA in the Alzheimer’s Disease Research Center (ADRC) and Department of Neurology in 2007. In 2015, he joined the faculty at the University of California, Irvine (UCI), as an associate professor of Psychiatry and Human Behavior and the associate director of the UCI ADRC. He is now the director of the Institute for Memory Impairments and Neurological Disorders (UCI MIND). He also directs the Outreach, Recruitment, and Education Core for the UCI ADRC and is the leader of the Accrual and Retention Consult service for the UCI Institute for Clinical and Translational Science (ICTS). Dr. Grill’s research is focused on clinical trials across the spectrum of Alzheimer’s disease, including work on trial design, recruitment and retention, and research ethics.

Personal Story

Alzheimer’s disease (AD) is the most important medical problem we face. In 2007, I was incredibly lucky to have the opportunity to join UCLA and focus my career on tackling this problem, with mentorship from a pillar in the field, Dr. Jeffrey Cummings. In the years that preceded, I learned a lot about the neurobiology of aging and drug development, but coming to UCLA gave me the chance to retrain in clinical research and work with a world’s authority on this hugely important topic. As I began to develop my own research ideas, fortune struck again, when Dr. Jason Karlawish agreed to also mentor me, from 2700 miles away, as I began studies of clinical trial recruitment and ethics. Ten years later, I still count these individuals as mentors and myself as remarkably lucky. But my passion for studying Alzheimer’s disease has evolved. I’ve grown to know countless families afflicted with this disease through my research and work in the community and I want nothing more than to be a part of a solution for all of them. And like so many in the world today, this disease has now touched my own family. Though I didn’t need any additional motivation, my work has become even more personal.

I am thrilled that the BrightFocus Foundation’s leadership, reviewers, and donors have placed trust in my colleagues and me, and that they agree the work we are doing will guide the field. It is an exciting and critically important time in the history of Alzheimer’s disease research and we are honored to have this opportunity to contribute. 

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