Wednesday, November 18, 2020

Enrolling as a Research Subject


About a year ago, I volunteered for a study at the state university examining cognitive decline as people age.  Appropriately, they recruited subjects from a table set up in the lobby at the Osher Lifelong Learning Institute.  Being always on the prowl for something to do, I offered my contact information, underwent screening and was assigned as a healthy control.  I attended two on-site sessions, getting a university parking ticket at one that I successfully challenged.  I read my own uncontrasted cranial MRI which freaked out the technicians a bit, but never got the formal radiology interpretation.  On exercise testing they measured oxygen consumption but neither I nor my physician ever got results.  They did psychometric testing which my self-interpretation would suggest limitations of spatial orientation and maybe some immediate memory. My honorarium arrived in due time.

OLLI has gone virtual due to Covid-19 but the computerized face pages still recruit us for university studies.  I followed the link, somebody contacted me, and ran a miniscreening.  They performed over the phone a mini-mental status exam, where I had great difficulty repeating the words I had just heard, both immediately and a few minutes later.  All else seemed intact, but the deficit qualified me for the next stage.

My professional research experience, despite an endocrinology fellowship, was quite minimal.  I had written an NIH Training Grant Proposal as a program requirement, did not get selected, and really graduated without understanding stages of clinical studies until I became a subject who had to give consent.  The current project has an honorarium far larger than the last one and is subdivided into two main grants and some lesser offshoots.  While I thought the first screening qualified me, that was not the case.  I underwent a second more detailed screening, including my wife's presence part of the time to provide information about me while I was sent someplace else.  Then the exam, a more detailed mental status exam with a language component, much like we were taught in neurology class in medical school to assess a mixture of dementia and aphasia.  I did a lot better, even the repeating of words.  As I listened to the dozen or so words being presented, I did not think of them as isolated words but as categories: gemstones, animals, and dwellings.  By classifying them, I was able to repeat a lot more of them this time than last, so I may not qualify for a memory impairment study, though had I not categorized the words and just tried to remember them as words, I probably would.  Is it a short term memory deficit that's compensated but still a deficit?  The person administering the questions couldn't tell me.  But it's not a functional deficit.  While the first study kept my scores hidden from me, the consent on this one requires them to disclose them to me.

But if I am demented at all, it's pretty subtle, exposed only by testing for that purpose.

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