How many Black men in cognitive intervention trials? A persistent barrier to equity

Abstract

AbstractBackgroundThere has been sparse attention paid to the cognition of older men and potential race differences in cognitive ability among older men. Men’s health disparities are likely to continue to increase in the next few decades, likely due to an aging baby boom cohort; increases in racial diversity in the US; and increases in life expectancy among both Black and White men. Our objective was to examine the completed cognitive intervention trials to ascertain the proportion of Black men and racial differences in such trials.MethodWe conducted a scoping review of reported cognitive intervention trials between the years 2000 and 2020. We searched PubMed, Google Scholar, CINHAL, Cochrane, and Clinicaltrials.gov for cognitive intervention trials using the following MeSH terms – “cognitive intervention”, “mild cognitive impairment”, “dementia”, “Alzheimer’s disease”, and “cognitive disorder”. Inclusion criteria included U.S, based interventions intended to improve cognition.ResultWe found 293 unique trials that met our search terms of which 66 were included for final analysis. The rest were excluded due to not being in the US, only including healthy participants, and use of non‐cognitive interventions. We were able to assess the number of Black men in 9 out of the 66 trials, because the trials were either all White (n=8) or all Black (n=1). Of the 9 trials we could assess, 8 had no Black participants (thus no Black men) and the one with all Black participants had 21% men. Of the remaining 57 trials, 32 did not report race and 25 included race and sex data but did not include race‐sex categories and thus we were unable to determine the number of black men included.ConclusionWe were unable to determine if cognitive intervention trials included sufficient proportions of Black men due to non‐reporting of race, race‐sex categories, and lack of inclusion of Black persons in trials. Our results beg the question of how we can understand cognitive health disparities and improve representation in trials if we don’t include the information that would allow us to make that determination.