CORE--CLINICAL

临床核心将定义神经心理学和神经学 在波士顿入组的两个患者人群的属性 大学阿尔茨海默病研究中心（BU ADCC） 弗吉尼亚州贝德福德 医疗中心是一个机构化的晚期病人的来源 阿尔茨海默病（AD）和早期阶段的非卧床患者 痴呆 与急性病医院的典型阿尔茨海默病诊所不同 在这种情况下，患者不会失访，密切接触者 在疾病的所有阶段都由护理人员维持。 这 密切关系是患者/家庭和提供者的伙伴关系， 促进了患者和护理人员的招募， 研究项目，并在过去保持了75%的尸检率 6年 这一示范性的护理和研究标准将适用于 在种族、族裔和文化上具有多样性的城市贫困人口 波士顿大学家庭医疗服务（Boston University Home Medical Service，HMS） 在 与在贝德福德退伍军人医疗中心服务的人群形成对比， 是同质和中产阶级，约40%的HMS患者不是 白人，60%是医疗补助，72%是女性。 所有HMS患者 接受完整的医疗评估，将进行审查，以确定 早期或症状前患者入组临床试验 核心 贝德福德退伍军人管理局和HMS的入组受试者将接受 标准化，有效的神经心理学评估，每6小时 每年进行一次神经系统评估和抽血。 DNA将 提取并储存，并确定Apo E基因型。 在 在选定的病例中，将建立成淋巴细胞系。 所有数据 收集的数据将输入标准化数据库。 结合 在教育核心的主要目标下，患者和对照受试者将 鼓励他们捐献大脑用于研究。 家庭 将招募护理人员，并对护理人员进行标准化评估 负担将每年进行。 该数据库将提供一个 未来研究减轻照顾者负担的干预措施基金会 以及有关AD对情绪和经济影响的研究。

The Clinical Core will define the neuropsychological and neurological attributes of the two patient populations enrolled in the Boston University Alzheimer's Disease Research Center (BU ADCC). The Bedford VA Medical Center is a source of institutionalized patients with late stage Alzheimer's disease (AD) and ambulatory patients with earlier stages of dementia. Unlike the typical Alzheimer clinic in an acute hospital setting, patients are not lost to follow up and close contact is maintained with caregivers throughout all stages of the disease. This close relationship is a patient/family and provider partnership that has facilitated the recruitment of patients and caregivers into several research projects and has sustained an autopsy rate of 75% over the past 6 years. This exemplary standard of care and research will be applied to characterize the racially, ethnically and culturally diverse poor urban population served by the Boston University Home Medical Service (HMS). In contrast to the population served at the Bedford VA Medical Center, which is homogenous and middle class, about 40% of HMS patients are not caucasian, 60% are on Medicaid and 72% are female. All HMS patients receive a complete medical evaluation which will be reviewed to identify early stage or presymptomatic patients for enrollment in the clinical core. Enrolled subjects at the Bedford VA and the HMS will undergo a standardized, validated one hour neuropsychological evaluation every 6 months and an annual neurological evaluation and blood drawing. DNA will be extracted and stored and Apo E genotype will be determined. In selected cases, lymphoblastic cell lines will be created. All data collected will be entered into a standardized database. In conjunction with a major aim of the Education Core, patients and control subjects will be encouraged to donate their brains for research purposes. Family caregivers will be enrolled and a standardized assessment of caregiver burden will be performed annually. This database will provide a foundation for future research on interventions to reduce caregiver burden and studies concerning the emotional and financial impact of AD.