CORE-- CLINICAL

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The Clinical Core of the UC Davis Alzheimer's Disease Center (UCD ADC) seeks to facilitate research on Alzheimer's disease in Northern California by creating for investigators a centralized source of carefully evaluated and well characterized dementia patients and normal controls and maintaining a database of clinical and neuropathological findings on these subjects. The UCD ADC has a large and diverse catchment area, encompassing the major cities and suburban areas of San Francisco, San Jose, Oakland, and Sacramento, large portions of the agricultural Central Valley, and rural areas to the east and north. Patients are referred from an extensive network of UC Davis clinics and facilities to 4 ADC performance sites; 2 main clinics (Berkeley and Sacramento) and 2 satellite clinics (Oakland and Yolo County). The Clinical Core provides the resources and personnel to combine these clinical dementia evaluation facilities into an integrated program with a shared research mission. The major functions of the Core are: 1) to create an ethnically diverse subject pool consisting of carefully diagnosed and well characterized dementia patients and normal controls, 2) to collect comprehensive and standardized clinical data on these subjects, 3) to create and manage a central database of diagnostic, clinical, and neuropathological findings, 4) to provide longitudinal follow-up, 5) to support research by identifying and recruiting patients and controls for specific studies, and 6) to operate satellite clinics to facilitate access of minority and under-served populations to Alzheimer's disease research. The Core recruits and evaluates demographically matched control subjects using the same protocols and methods as for patients and devotes considerable attention to issues of cross-site and inter-rater reliability, and to the development of innovative methods for quantitating clinical data. Finally, the Core facilitates autopsy for patients of research interest. In this renewal the Clinical Core proposes evolutionary modifications of the methods it employed in its first funding cycle. The Core will evaluate approximately 300 new patients and 100 new controls per year obtaining standardized histories, neurological exams, neuroimaging, laboratory, neuropsychological, behavioral and psychiatric data on all. It will maintain its longitudinal cohort of approximately 300 patients who are high quality research subjects and create a comparable longitudinal follow-up cohort of 200 control subjects who have consented to autopsy. The Core's two satellite clinics have evolved effective outreach methods which have resulted in substantial numbers of ethnic minority patients; the Core will build upon this clinical base to achieve an ethnically diverse and balanced research and autopsy sample. Data from all subjects will be entered to an extensive database and the Core will help enlist these subjects in individual research projects, track research participation, and help obtain autopsy.