CORE--CLINICAL

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With the dramatic expansion and increased methodological sophistication in neurodegenerative dementia research, demands on the Clinical Core for clearly defined samples of persons with AD and related dementias, mild cognitive impairment (MCI), Lewy body spectrum disease, and age-matched controls have become more complex. A sample of subjects appropriate for one type of investigation (such as a clinical treatment outcome trial) is often not appropriate for other types of studies (for example, a case-control epidemiologic study or genetic linkage analysis). Still other types of samples are needed for training clinicians to manage the multiple clinical problems expressed during the course of dementia. To meet these multiple demands, the Clinical Core has developed and will continue to provide multiple samples of AD patients, non-AD dementia patients, MCI, and normal healthy control subjects suitable for supporting the subject recruitment needs of a broad range of research and clinical training in neurodegenerative dementias. The Clinical Core will continue to include probable AD and nondemented older controls selected for maximum appropriateness for participation in clinical studies. To comply with NIA guidance to focus on earlier stages of AD and the transition from normal aging, we will focus on increasing subject samples with early AD, MCI, and cognitively normal older controls. In addition, subjects with non-AD neurodegenerative dementing disorders and Lewy body spectrum disease will be recruited and followed in the Clinical Core. Clinical Core personnel support and interact with population-based cohorts of late life dementia and normal control subjects appropriate for epidemiologic studies and which provide additional sources for accession of postmortem brain tissue. Clinical Core personnel will continue to collect cerebrospinal fluid (CSF), plasma and serum on these subject samples and through collaborative efforts with multiple ADCs, continue to expand the large UW ADRC CSF bank to support the search for biomarkers for diagnosis and monitoring disease progression of dementing disorders. Through all these subject populations, subjects, biological fluid samples, and data are provided to meet the research needs of ADRC investigators, other appropriate investigators in the broader University of Washington research community, and investigators at other institutions.