The USC Clinical Trial Recruitment Lab will fund four projects testing how AI can strengthen recruitment for Alzheimer’s trials.

The initiative, dedicated to accelerating and improving Alzheimer’s clinical trials, selected the projects from more than 30 applicants to explore digital approaches.

Alzheimer’s clinical trials are more complex, costlier and take longer than those in other therapeutic areas, despite the pressing need for new treatments.

The lab evaluates innovative recruitment strategies to improve access and representation in trials, with the goal of identifying scalable evidence-based recruitment practices.

The USC Clinical Trial Recruitment Lab is a collaboration between the USC Schaeffer Center for Health Policy and Economics and the USC Epstein Family Alzheimer’s Therapeutic Research Institute.

The four projects will explore the following strategies.

• Miriam Ashford at University of California, San Francisco will develop and test a generative AI voice agent to support remote informed consent and assess patient capacity for Alzheimer’s clinical trials.
• Erika Cottrell at OCHIN, a national network of community health centres, and Vijaya Kolachalama at Cognimark will integrate an AI-enabled diagnostic platform into primary care electronic health record workflows to support earlier identification and referral of patients.
• Andrew Kiselica at University of Georgia will establish a digitally enabled, trial-ready cohort of rural older adults to improve recruitment, participant selection and engagement.
• Raeanne Moore at University of California, San Diego will leverage electronic health record portals and digital cognitive assessments to accelerate prescreening and better match potential participants.

An estimated 5.6 million Americans are living with Alzheimer’s and related dementias, a number expected to increase dramatically in the coming decades as the population ages.

An extensive therapeutic development pipeline and new early-detection approaches, such as diagnostic blood tests and advanced digital tools, have the potential to reduce the burden of the disease.

However, fewer than one per cent of eligible individuals participate in Alzheimer’s therapeutic trials due to barriers that include limited patient awareness, health system resource constraints and lack of access to diagnostics, according to research from USC Schaeffer.

Certain populations at higher risk for the disease, including Black and Hispanic patients, remain underrepresented.

“We can only innovate as quickly as we can test new therapies,” said Dana Goldman, founding director of the USC Schaeffer Institute.

“That’s why it’s crucial we keep expanding the toolkit of evidence-based recruitment strategies for running faster, better trials.”

The lab previously funded six pilots, some of which have already yielded insights.

For example, one found remote blood collection could help identify potential participants, while another showed that offering a small gift card significantly increased enrolment in an online memory concerns registry.

“Faster and more effective recruitment is essential, and we’re excited to incorporate these solutions in an integrated way as part of our clinical trials,” said Paul Aisen, founding director of the USC Epstein Family Alzheimer’s Therapeutic Research Institute.

“As studies move earlier into pre-symptomatic disease, this opens the door to new recruitment paradigms, and continuing to push forward the science of recruitment will be critical to what comes next in Alzheimer’s research.”

Sharp rises in blood sugar after meals may raise Alzheimer’s risk, according to genetic analysis of more than 350,000 adults.

The findings point to after-meal glucose, rather than overall blood sugar, as a possible factor in long-term brain health.

Researchers examined genetic and health data from over 350,000 UK Biobank participants aged 40 to 69, focusing on fasting glucose, insulin, and blood sugar measured two hours after eating.

The team used Mendelian randomisation, a genetic method that helps test whether biological traits may play a direct role in disease risk.

People with higher after-meal glucose had a 69 per cent higher risk of Alzheimer’s disease.

This pattern, known as postprandial hyperglycaemia (elevated blood sugar after eating), stood out as a key factor.

The increased risk was not explained by overall brain shrinkage (atrophy) or white matter damage, suggesting after-meal glucose may affect the brain through other pathways not yet fully understood.

Dr Andrew Mason, lead author, said: “This finding could help shape future prevention strategies, highlighting the importance of managing blood sugar not just overall, but specifically after meals.”

Dr Vicky Garfield, senior author, added: “We first need to replicate these results in other populations and ancestries to confirm the link and better understand the underlying biology.

“If validated, the study could pave the way for new approaches to reduce dementia risk in people with diabetes.”