CLINICAL CORE

亚利桑那州ADCC的临床核心是由五个招聘网站组成的联盟，这些网站的职能是 由单一临床核心主任领导的标准化单位。临床核心保持500人的目标 老年痴呆症所有阶段的参与者包括200名正常对照组，100名患有老年痴呆症的患者 轻度认知障碍(MCI)，200人患有阿尔茨海默病(AD)和其他形式的退行性疾病 痴呆症。在这些诊断类别中嵌入了定义为拉丁裔和美洲原住民的队列。 临床核心利用我们的多机构诊断共识会议，集中化数据 管理计划，并与其他每个核心建立密切的工作关系。它的目的是 充分利用我们的多机构协作模式，应对与多站点相关的挑战 核心，并优化利用临床核心科目和数据，以支持异常早期 检测和跟踪AD，我们在脑成像、认知神经科学、神经基因组学、我们的 对几个假定的风险因素的研究，以及我们参与的几个国家和国际 协作项目。所有受试者都要接受标准化的诊断测试，1)满足严格的入学要求 标准，2)包括人口、历史、医学、神经学、精神病学、神经心理学和 遗传测量，3)纳入NACC统一数据集(UDS)，以及4)采用文化敏感性 测试程序。符合登记条件的患者和完成年度随访的患者将在 两周一次的诊断共识会议。所有人在进入时都要接受载脂蛋白E(APOE)基因分型，以及 每年在所有地点进行标准化的神经心理学测试。患者的资格和参与 对正在进行的研究项目进行跟踪和审查。所有课程均已登记参加 用于确认临床诊断的神经病理诊断的脑捐赠计划，尽管脑捐赠是 不要求文化敏感的多样性亚群(拉丁裔和美洲原住民)的成员。这个 临床核心的特殊优势包括： 1.以一种新的合作模式为基础，在整个亚利桑那州建立集水区，其中包括所有 主要的三级护理转诊中心(BNI、MCA、SHRI、VA、UA) 2.临床核心神经科医生与 亚利桑那州(和其他地方)所有主要研究机构的生物医学研究人员 3.拉美裔外联方案(通过经济、社会和技术中心和临床核心的合作努力)，目标是 登记至少100名痴呆症/MCI患者和对照 4.美国原住民外联方案(通过EIT和临床核心的合作努力)， 鼓励美洲原住民参与临床核心项目。 5.纵向研究的老年正常对照组的辅助计划也得到nacc UDS的支持。 通过其他筹资机制。这些群体为研究转型提供了独特的机会。 阿尔茨海默病不同风险人群的认知正常和MCI之间的关系并利用我们的优势 在成像、基因组学、认知神经科学等研究方法上。要实现 来自独立资助项目的ADCC、主题和数据现在可以作为资源提供给其他 研究人员在其他研究中使用，并将使用UDS进行前瞻性跟踪。

The Clinical Core of the Arizona ADCC is a consortium of five recruitment sites that function as a standardized unit under a single Clinical Core Director. The Clinical Core maintains a target of 500 participants at all stages of the aging-dementia spectrum including 200 normal controls, 100 patients with mild cognitive impairment (MCI), and 200 with Alzheimer's disease (AD) and other forms of degenerative dementia. Embedded within these diagnostic categories are defined Latino and Native American cohorts. The Clinical Core capitalizes on our multi-institutional diagnostic consensus conference, centralized data management program, and close working relationships with each of the other Cores. It is intended to capitalize on our multi-institutional collaborative model, address the challenges associated with a multi-site core, and optimize the utilization of Clinical Core subjects and data in support of the unusually early detection and tracking of AD, our strengths in brain imaging, cognitive neuroscience, neurogenomics, our studies of several putative risk factors, and our participation in several national and international collaboration projects. All subjects undergo standardized diagnostic testing that 1) fulfills strict entrance criteria, 2) includes demographic, historical, medical, neurological, psychiatric, neuropsychological, and genetic measures, 3) incorporates the NACC Uniform Data Set (UDS), and 4) employs culturally sensitive test procedures. Patients eligible for enrollment and those completing annual follow-up are discussed in a biweekly diagnostic consensus conference. All undergo apolipoprotein E (APOE) genotyping at entry, and an annual standardized neuropsychological battery of tests at all sites. Patient eligibility for, and participation in ongoing research projects is tracked and reviewed on an ongoing basis. All are offered enrolled in the Brain Donation Program for neuropathological confirmation of clinical diagnoses, though brain donation is not required of members of culturally sensitive diversity subgroups (Latino and Native Americans). The particular strengths of the Clinical Core include: 1. catchment areas throughout the state of Arizona based on a novel collaborative model that includes all major tertiary care referral centers (BNI, MCA, SHRI, VA, UA) 2. a scientific network of established collaborative relationships between Clinical Core neurologists and biomedical researchers at all major research institutions in Arizona (and elsewhere) 3. a Latino outreach program (through the collaborative efforts of the EIT and Clinical Cores) with a target enrollment of at least 100 dementia/MCI patients and controls 4. a Native American outreach program (through the collaborative efforts of the EIT and Clinical Cores) that encourages the participation of Native Americans in the Clinical Core. 5. ancillary programs of longitudinally studied aging normal controls also receive the NACC UDS supported through other funding mechanisms. These cohorts provide unique opportunities to study the transition between cognitive normality and MCI in persons at differential risk for AD and to capitalize on our strengths in imaging, genomics, cognitive neuroscience, and other research methods. To address the goals of the ADCC, subjects and data from independently funded projects are now available as a resource to other researchers, being used in other studies, and will be followed prospectively using the UDS.