The age range for our study cohort is relatively large and cannot address the age-specific challenges of recruiting a geriatric population. However, the underlying principles are the same. Our longitudinal study will provide the opportunity for us to assess through middle age to old age the factors that facilitate continued study participation over a 20-year period. This will provide a window into minority aging and the factors that enhance participation rates or become barriers or disincentives. We cannot elucidate which specific element of our multidimensional strategy was most successful because we did not collect data from successfully enrolled participants or from those who declined. It must also be stated that we have crafted and used these strategies in an urban environment so they may or may not be applicable to a rural or suburban environment. Another limitation is that we included only two races in HANDLS because we based our sampling expectations on the 2000 census. Had we started later, we might have included Latinos because their numbers are increasing in Baltimore. Finally, although our sample is demographically representative of Baltimore City, we may have a healthy bias because potential participants with underlying medical diseases may have declined participation.
