Setting blood pressure guidelines for an Alzheimer's Disease and Related Dementia Study for American Samoans. Grace-Damona Tuato’o, Tulimalefoi Mauga Vaofanua, Fenumia’i Iosia, Helen Aitaoto, Katherine Tong, Joyce Niko, James Galvin, Va’atausili Tofaeono

Culturally grounded protocols allow for improved inclusivity in research participation forindigenous populations.

Background: Native Hawaiian and Pacific Islanderspopulations are underrepresented in Alzheimer’s Disease and Related Dementia (ADRD) research,limiting the generalizability and equity of theevidence base. National data sources illustrate thisgap. In American Samoa, 58.4% of adults aged 65years and older have hypertension, a recognizedvascular risk factor for ADRD. However,standardized blood pressure (BP) screeningthresholds derived from predominantly non-Indigenous populations may inadvertently excludeindividuals at highest vascular risk from ADRDstudies. Standards from the American HeartAssociation in table 1 were used to inform programprocedures but it introduced selection bias andlimited the ability to examine vascular contributionsto cognitive impairment. The team hypothesized thatby modifying program protocols through combiningWesternized and Indigenous frameworks, it willimprove inclusivity of the Samoan population inADRD studies and maintain participant safety.

Method: We conducted a data-informed,consensus-driven evaluation of BP screeningprocedures used inthePuipui MaluManatu(PMM) study (RF1AG075904).Thestructured consensus group consisted ofPMM’s Principal Investigator, nursing staff,and research coordinators who revieweddescriptive BP data from794 PMMparticipants. BP measurements weresummarized overall across age groups (Table2).