Friday, September 27, 2002: 9:45 AM-11:15 AM

Research with Older Adults: Overcoming the Challenges

Trying to screen, recruit, and enroll older adults into studies is complicated by communication and cognitive problems, such as decreased hearing and vision, stroke and/or dementia. Certainly extra time is needed to help these individuals hear and understand what the research project is about, and what their options are in terms of participation. Special consideration must also be given to assessing the individuals’ capacity to give informed consent for participation. There are a variety of tools used to do this, although standard measures of cognition and severity of dementia should not be taken as direct measures of ability to give consent. Determination of ability to consent may need to be made on a case by case basis, with inclusion of both a proxy for consent as well as assent by the cognitively impaired older subject.

Measurement issues related to research with older adults include developing and testing age appropriate scales, determining the most appropriate method of administration of the scale, and consideration of the scale length to avoid participant burden and fatigue. Repeatedly attempts have been made to use scales developed for adults with older individuals. Such attempts indicated that the measures for adults may use wording and contain items that are irrelevant for older adults. If a paper and pencil measure is given to older adults it is less likely that they will be able or willing to complete the measure. However, if an interview is done they are more likely to participate. Recommendations for choosing/developing appropriate measures for older adults should focus on: (1) method of administration; (2) item selection; and (3) length of the measure.

There are special concerns with regard to research with older adults who have cognitive impairment. In addition to recruitment issues and obtaining consent, the collection of reliable data with these individuals is especially challenging. Moreover, the method of data collection used (i.e. proxy report versus observation) influences outcomes. In some situations proxy data may be acceptable, depending on what the focus of the research is. A comprehensive review of prior research in terms of data collection is essential to knowing how to proceed with regard to current research questions.

Innovative technological strategies, such as web based research, are increasingly being considered with older adults. This is a particularly enticing option for researchers as it is a way to reach a large number of participants at a low cost. Moreover, it is a way to reach a select group of older adults who are currently using computers. There are, however, many challenges to developing web/computer based surveys. These include sampling issues, overcoming visual changes and physical challenges older adults commonly endure. Techniques to appropriately deal with these issues will be described as well as the way in which to development a Web survey questionnaire will be demonstrated. Specifically, decisions regarding regarding appropriate reading level, size of font for older adults, user friendly format, order of the questions, organization of words and graphics will be supported and a step approach for how the survey was loaded on a Web page using the Microsoft FrontPage® program which was then linked to an Access® database.

Participation in this symposium will increase awareness of the many issues and challenges related to research with older adults, and participants will be exposed to techniques to overcome these challenges and facilitate the advancement of the science in the care of older adults.