Enrolling older adults with cognitive impairment in research: lessons from a study of Tai Chi for osteoarthritis knee pain.

Exercise is an adjunct intervention for treating osteoarthritis (OA) knee pain, but many older adults, especially those with cognitive impairment, refuse to participate because of their frailty. Tai chi is a gentle alternative to Western-style aerobic exercise. In this article, we report recruitment experiences based on older adults' comments and on staff's observations and reports in a pilot randomized controlled trial (RCT) using tai chi as an intervention to reduce OA knee pain in a population of older adults with cognitive impairment. Recruitment challenges included issues with retirement apartment site staff, the older adults, study criteria or study design, and insufficient research staff. Strategies included networking and staying connected with site staff, using various recruiting approaches, providing incentives/motivation, and using informal leaders or residents as a way to recruit participants. Finally, modifying strict study criteria, securing staff for recruiting, and considering alternative designs to the classical RCT can also help overcome recruitment challenges.