CORE--CLINICAL AND RESEARCH

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The continuing scientific progress in Alzheimer's disease (AD) relies on the availability of carefully evaluated patients and controls for study. The main goal of the Clinical Research Development Core is to facilitate genetic family studies and other multi-disciplinary efforts of the Bryan ADRC by providing the basic diagnostic assessment of patients with memory complaints. We have evaluated over 5000 new patients in the Neurological Disorders Clinic (NDC) of the Bryan ADRC since 1990. We plan to focus on continued high-quality evaluation and treatment of patients with AD and other related dementias. We also propose methods to continue to develop our multi-cultural clinical services to elderly African American and other people of color in the community. Identify families for genetic studies of AD and other late onset dementias. There are over 75 families enrolled in the Center in which there is multi- generated evidence of AD with autopsy confirmation. We plan to continue to develop and evaluate additional informative families. In conjunction with the Duke Center for Human Genetics (DCHG), we also intend to study unaffected siblings of AD patients using new genetic methods of sib-pair analysis, in an effort to identify other susceptibility genes. Continue the active enrollment of selected patients and normal controls in the Bryan ADRC autopsy program. Currently, we conduct at least 70 autopsies per year and follow over 100 patients with AD and approximately 200 non-demented controls. During the grant period we will continue our current enrollment and clinical evaluation practices but we will also make a strong focused effort on increasing minority enrollment in both the normal control and dementia protocols of the autopsy program. Facilitate clinical research studies of Alzheimer's disease. The Clinical Core will continue to be a resource to the research studies of the Bryan ADRC, and to external studies continues to be to define the earliest clinical phenotype of AD through systematic longitudinal study of cognitively normal subjects at enhanced risk of AD.