Aging
Mobile Phlebotomy to Enhance Diversity in Alzheimer’s Disease Biomarker Research: The California Blood Biomarker Study Yodit Goshu* Yodit Goshu Goshu Goshu Goshu Goshu Goshu Goshu Goshu Goshu Goshu Goshu Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
Ongoing advances in biomarker research have led to development of plasma biomarkers for Alzheimer’s disease and related dementias (AD/ADRD), offering a minimally invasive, cost-effective, and scalable alternative to neuroimaging and cerebrospinal fluid biomarkers, typically limited to major medical centers. Mobile phlebotomy, where phlebotomists travel to participants’ homes for blood draws, may facilitate broader participation in biomarker research. The California Blood Biomarker Study (CABBS) evaluated the feasibility of participant enrollment and completion of mobile phlebotomy for plasma AD/ADRD biomarkers and genetic analysis in a racially and ethnically diverse sample of participants aged 55+ in the California Brain Health Registry (CAL-BHR), a web-based AD/ADRD research registry. Out of 7,379 CAL-BHR participants invited, 498 (6.7%) enrolled in CABBS and 407 (5.5%) completed a blood draw. CABBS participants who completed a blood draw were demographically similar to CAL-BHR participants who did not complete a blood draw. Compared to the California population aged 55+ represented by the 2022 Behavioral Risk Factor Surveillance System, CABBS participants who completed a blood draw tended to be younger, included a higher proportion of women, displayed greater racial and ethnic diversity, had higher average levels of education, and reported a higher prevalence of memory concerns. Some CABBS participants reported scheduling and communication challenges with the mobile phlebotomy company; however, they remained interested in participating in this study and future research. Our study team resolved these issues as the study progressed. Among CABBS participants with a blood draw, 10% had biomarker values consistent with preclinical Alzheimer’s disease. Our findings support mobile phlebotomy as a feasible strategy for enhancing diversity in AD/ADRD biomarker research, while highlighting the importance of pilot testing and logistical infrastructure in future studies.