CORE--CLINICAL

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The Clinical Core promotes the goals of the MADRC and serves the needs of individual projects by identifying men and women with neurodegenerative diseases associated with dementia who are interested in and appropriate to participate in clinical research studies. Satellite Diagnostic and Treatment Centers (SDTC) located in Detroit and in rural northern Michigan help achieve an ethnically diverse population of rural and urban residing subjects who reflect the full range of disease severity from minimally symptomatic to severely impaired. Potential research subjects, including normal controls identified through the Geriatric Research and Training Center at the University of michigan, are given comprehensive medical and neurological examinations and classified using explicit diagnostic, inclusion and exclusion criteria. Demographic data and the signs and symptoms of their neurological disease, including behavior, motor signs and dementia severity, are characterized using standardized procedures at each clinic visit. A subset of these subjects who have named a durable power of attorney for health decisions and indicate a wish to obtain an autopsy are followed longitudinally and serve as a resource for studies examining the clinical course of disease and clinicopathological correlations. They receive periodic clinical evaluations throughout the course of their illness including quantitative assessment of behavior and motor signs, and are contacted frequently by telephone, and furnished social work and nursing services to encourage continued cooperation. Core personnel provide patient and caregiver support that stimulates patient participation in research, and the cooperation of families in obtaining postmortem brain examinations. They coordinate and oversee the participation of patients in clinical research to assure appropriate subject selection and patient safety when multiple studies are performed. The Core also coordinates its activities with local, state and national programs for Alzheimer's disease, such as CERAD. The Clinical Core also provides consultation about clinical aspects of dementia and patient evaluation and management to projects and other cores of the MADRC and to approved projects with other funding. The staff of the Core also conducts presentations concerning the role of physicians, social workers, and nurses in the diagnosis, assessment, treatment and management of dementia for educational and outreach effects of the MADRC.