CLINICAL CORE

亚利桑那州ADCC的临床核心是一个由五个招募网站组成的联盟， 一个标准化的单位下的一个临床核心主任。临床核心维持500人的目标 参与者在所有阶段的老龄痴呆症谱，包括200名正常对照，100名患者， 轻度认知障碍（MCI），200名阿尔茨海默病（AD）和其他形式的退行性疾病 痴呆在这些诊断类别中嵌入定义的拉丁美洲人和美洲原住民队列。 临床核心利用我们的多机构诊断共识会议，集中数据 管理程序，并与其他核心的密切工作关系。其旨在 利用我们的多机构合作模式，解决与多站点相关的挑战 核心，并优化临床核心主题和数据的利用，以支持异常早期的 AD的检测和跟踪，我们在脑成像、认知神经科学、神经基因组学、 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 合作项目。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）包括人口统计学、历史、医学、神经学、精神病学、神经心理学和 遗传措施，3）纳入NACC统一数据集（UDS），4）采用文化敏感 试验程序.符合入组条件的患者和完成年度随访的患者在 双周诊断共识会议所有患者在入组时均接受载脂蛋白E（APOE）基因分型， 每年在所有地点进行一次标准化神经心理学成套测试。患者资格和参与 对正在进行的研究项目中的信息进行持续跟踪和审查。所有人都参加了 脑捐赠计划用于临床诊断的神经病理学确认，尽管脑捐赠是 对文化敏感的多样性亚群体（拉丁美洲人和美洲原住民）的成员不需要。的 临床核心的具体优势包括： 1.整个亚利桑那州的集水区基于一种新的合作模式，包括所有 主要的三级医疗转诊中心（BNI、MCA、SHRI、VA、UA） 2.临床核心神经学家之间建立合作关系的科学网络， 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 3.一个拉丁裔外展计划（通过EIT和临床核心的合作努力），目标是 招募至少100名痴呆/MCI患者和对照 4.美洲原住民外展计划（通过EIT和临床核心的合作努力）， 鼓励美国原住民参与临床核心。 5.对老年正常对照进行纵向研究的辅助项目也得到了NACC UDS的支持 通过其他融资机制。这些群体提供了独特的机会，研究过渡 在AD不同风险人群中认知正常和MCI之间的关系，并利用我们的优势 成像、基因组学、认知神经科学和其他研究方法。为了实现联合国的目标， ADCC，独立资助项目的主题和数据现在可作为其他资源 研究人员，正在使用其他研究，并将使用UDS进行前瞻性随访。

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.