BROWNSVILLE, Texas — Gladys Maestre is on a scouting mission. The Alzheimer’s disease researcher is driving through Southmost, a Mexican American neighborhood just north of looming sections of the border wall and a checkpoint that leads to Mexico. She passes barking dogs and “no trespassing” signs, but doesn’t see a single person outside, despite the comfortable stuffed recliners, refrigerators, and shade canopies that furnish many yards.

“A house outside the house,” Maestre laughs, delighting in seeing these elaborate living spaces while acknowledging that the clear wariness of outsiders here demonstrates the need for her unorthodox approach to engaging the people she studies. “That’s where we could put a community center,” she says, pointing to a vacant house. “For yoga, or art classes.”

For decades, and really for as long as the field has existed, Alzheimer’s researchers have recruited patients for clinical trials in largely the same way: pulling them from specialty clinics, often at elite medical institutions that house the bulk of the nation’s federally funded Alzheimer’s Disease Research Centers. That’s led to patients in these trials, which sometimes offer new therapies available through no other channels, being overwhelmingly privileged, well-insured, and white.