Adult Changes in Thought (ACT) Research Program Core B: Clinical Core

临床核心（核心B）的总体目标是收集支持成人思想变化的数据 (ACT)U19 Program Projects，Cores，and other studies using ACT data.临床中心负责 参与者沟通以及ACT研究参与者的诊所和家庭访视数据收集，以及 与包括其他数据收集活动的其他项目和核心协调。一个科学挑战 临床核心必须解决的问题是保持向后兼容性，同时使用 更新，现代的方法和保持与同伴研究的协调。这些考虑告知 临床核心活动的各个方面。临床核心的具体目标是：（1）遵循并保持当前 ACT参与者U19计划的改进包括对认知方面的广泛信息进行数字化捕获 超过了以前使用传统方法收集的数据。临床中心将继续收集数据 从家庭访问，一个基本的设计特点，为队列保留。临床核心将：（1a） 扩展、现代化和改进现有的ACT数据收集，以跟踪认知、身体功能和 日常生活中的功能、危险因素的间隔变化、健康和社会状况，并继续确定事件 痴呆症和阿尔茨海默氏病的病例;以及（1b）支持拟议的项目和核心以及ACT相关 有针对性的新数据收集的附属研究增加了新的流程，以实现认知能力的提升和现代化 试验. (2)注册、跟踪和留住新的ACT参与者。临床核心计划增加入组人数， 从2,000人增加到3,000人。我们将扩大我们的地理覆盖范围， 在大普吉湾地区，社会人口和种族/民族更加多样化， 对少数种族/民族进行过度抽样，以实现少数种族/民族入学率超过20%的目标。(3)获取 并保持死前尸检的批准，加强与参与者及其家属的沟通， 优化死亡时间间隔（PMI）的死者谁来验尸。ACT研究的范围很广 迄今为止，基础设施已为ACT队列进行了超过850例尸检。临床中心将与 神经病理学核心使用持续质量改进（CQI）方法，以最大限度地提高 接受快速尸检的自愿死者(4)与行政部门和数据部门协调， 分析核心，以确保最先进的质量控制和数据文件的所有数据收集的 临床核心。ACT临床核心建立在基于人群的四分之一世纪的数据收集基础上。 老年人的队列，并将扩大，现代化和改善ACT数据收集，提供杰出的 支持项目、核心和附属研究，以及通过广泛的数据共享接收ACT数据的研究 基础设施和社会人口以及种族/族裔多样化的人口基础更大、更广泛。 随着U19的扩展，临床核心可以大大增加ACT对科学的贡献。 对衰老、痴呆和阿尔茨海默病的理解。

The overarching goal of the Clinical Core (Core B) is to collect data in support of the Adult Changes in Thought (ACT) U19 Program Projects, Cores, and other studies using ACT data. The Clinical Core is responsible for participant communication and clinic and home visit data collection from ACT study participants, and coordinates with other Projects and Cores that include other data collection activities. One scientific challenge the Clinical Core must address is maintaining backwards compatibility while facilitating data collection using newer, modern methods and maintaining harmonization with companion studies. These considerations inform all aspects of the Clinical Core’s activities. The Clinical Core’s Specific Aims are: (1) Follow and retain current ACT participants. Refinements in the U19 Program include digital capture of extensive information on cognition beyond that previously collected using traditional approaches. The Clinical Core will continue data collection from home-based visits, an essential design characteristic for cohort retention. The Clinical Core will: (1a) expand, modernize, and improve established ACT data collection to follow cognition, physical function and function in daily life, interval changes in risk factors, health and social status and continue to identify incident cases of dementia and Alzheimer’s disease; and (1b) support proposed Projects and Cores and ACT related affiliated studies with targeted new data collection adding new processes to digitize and modernize cognitive tests. (2) Enroll, follow, and retain new ACT participants. The Clinical Core plans to increase enrollment to grow from 2,000 to 3,000 active dementia-free individuals. We will increase our geographic reach to include more sociodemographically and racially/ethnically diverse areas in the greater Puget Sound area and will oversample racial/ethnic minorities to achieve a goal of over 20% racial/ethnic minority enrollment. (3) Acquire and maintain antemortem autopsy approval and enhance communication with participants and their families to optimize postmortem intervals (PMI) for decedents who come to autopsy. The ACT study’s extensive infrastructure has led to >850 autopsies to date from the ACT cohort. The Clinical Core will work closely with the Neuropathology Core to use continuous quality improvement (CQI) approaches to maximize the proportion of consenting decedents who receive a rapid autopsy. (4) Coordinate with the Administrative and Data and Analysis Cores to ensure state-of-the-art quality control and data documentation of all data collected by the Clinical Core. The ACT Clinical Core builds on a quarter century of data collection from a population-based cohort of older adults and will expand, modernize and improve ACT data collection, provide outstanding support of Projects, Cores, and affiliated studies and those receiving ACT data through extensive data sharing infrastructure and have a larger and more sociodemographic and racially/ethnically diverse population base. With this U19 expansion, the Clinical Core can substantially increase ACT’s contributions to scientific understanding of aging, dementia and Alzheimer’s disease.