A recruitment protocol shift—emphasizing personally relevant symptoms like sleep disturbance rather than leading with the clinical label 'delirium'—raised enrollment rates in a wearable EEG study from 18.5% (68/367 patients) to 30.1% (58/188), a statistically significant jump (p<0.001) that held across adults over 65 and those on non-neurologic services. Contrary to investigators' initial assumptions, wearable device aversion was a minor barrier: only 8.8% of decliners cited the EEG hardware. A seven-member community panel of patients, family members, and caregivers identified personal relevance as the dominant enrollment driver. Adding formal educational materials about delirium, however, produced no additional benefit (p=0.61).
This preprint, posted on medRxiv and not yet peer-reviewed, addresses a chronic bottleneck in geriatric clinical research: older, acutely ill patients are chronically underrepresented in studies, limiting the evidence base for their care. The finding that symptom-framing—not device anxiety or health literacy campaigns—drives consent decisions reframes how research teams should design recruitment scripts. For delirium specifically, which affects 14–56% of hospitalized older adults and is independently linked to accelerated cognitive decline and mortality, better study enrollment could meaningfully advance monitoring and intervention research. Limitations include the small community panel (n=7), a single academic center context, and the observational, non-randomized protocol comparison. Nonetheless, the practical implication is actionable and low-cost: clinical trial teams recruiting vulnerable older populations may see substantial gains simply by anchoring their pitch to the patient's lived symptom experience rather than disease nomenclature.