CORE--CLINICAL

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The Clinical Core promotes the goals of the MADRC and s3erves individual projects by recruiting patients for clinical research studies. Patients with Alzheimer' s disease and Alzheimer's mimics are identified at the University of Michigan with the help of collaborators in the Neurology and Geropsychiatry Clinics and the Neuropsychology Division and at Satellite Diagnostic and Treatment Centers located in Detroit and in rural Northern Michigan. This provides an ethnically diverse research population including rural and urban residing subjects reflecting the full range of disease severity from minimally symptomatic to severely impaired. Recruitment of normal control subjects is coordinated with the Human Subjects Core of the Pepper Older Americans Independence Center at the University of Michigan. Potential research subjects receive exclusion criteria. Demographic and caregiver data, dementia severity, neuropsychological performance, motor signs and behavior are characterized using standardized procedures. A subset of these patients who have named a health care advocate and are given provisional consent for an autopsy, and a cohort of normal individuals who have consented to an autopsy are periodically reassessed and serve as a resource for studies examining the clinical course of dementing disorders and clinico-pathological correlations Nurses and social workers help recruit patients to research studies and provide patient and caregiver support and telephone contacts that encourage research participation and the cooperation of families in obtaining postmortem brain examinations. They assure appropriate subject selection and patient safety by coordinating participation in multiple studies. The Clinical Core provides consultation about clinical aspects of dementia to investigators and other Cores and plays a major role in educational and outreach activities of the Center. It promotes collaboration with other Alzheimer Disease Centers for datasharing and joint projects such as the Alzheimer Disease Cooperative Study. Data collected are linked to ongoing epidemiological studies of aging at the University of Michigan including the Assets and Health Dynamics Study of community dwelling elderly and the National Nursing Home Resident Assessment Instrument for elderly receiving institutional care.