South Texas Alzheimer's Disease Center Clinical Core

南德克萨斯阿尔茨海默病中心临床核心

• 批准号: 10270729
• 负责人: GABRIEL Alejandro DE ERAUSQUIN
• 金额: $ 62.53万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10270729
• 关键词: Acculturation; Affect; Alzheimer' s Disease; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Amyloid; Autopsy; Biological; Biological Assay; Biological Markers; Biology; Blood; Blood Vessels; Caregivers; Caring; Clinic; Clinical; Clinical Research; Clinical Trials; Cognitive; Cognitive aging; Collection; Comprehensive Health Care; Consent; Data; Data Collection; Data Set; Dementia; Diabetes Mellitus; Diagnosis; Diagnostic; Diet; Disease; Disease Progression; Education; Elements; Enrollment; Ensure; Environment; Ethnic Origin; Family; Gait; Genetic; Genetic Markers; Genomics; Genotype; Geography; Health; Hearing; High Prevalence; Hispanics; Image; Individual; Life Style; Magnetic Resonance Imaging; Measures; Medical; Mexican Americans; Minority; Moods; Motor; Neurologic; Neurosciences; Observational Study; Outcome; Participant; Pathologic; Pathology; Patient Care; Patients; Pennsylvania; Persons; Phase; Phenotype; Physical activity; Population; Positron-Emission Tomography; Prevalence; Preventive Clinical Trial; Process; Prognosis; Protocols documentation; Recording of previous events; Registries; Research; Risk; S-nitro-N-acetylpenicillamine; Sampling; Sensory; Site; Sleep; Social support; South Texas; Syndrome; Testing; Time; Translational Research; Vision; Visit; advanced dementia; base; behavior measurement; bilingualism; biobank; brain morphology; care outcomes; clinical center; cohort; comorbidity; data management; data quality; data sharing; dementia care; dementia risk; genome wide association study; health care availability; high risk; imaging biomarker; improved; machine learning method; multiple omics; neuroimaging; novel; novel marker; outreach; precision medicine; primary caregiver; racial and ethnic; recruit; resilience; risk stratification; rural residence; social; social determinants; socioeconomics; tau Proteins; underserved area; underserved community; vascular factor; vascular risk factor; web site

Abstract The Mexican-American (MA) Hispanic community is the most rapidly growing minority and is disproportionately affected by Alzheimer’s disease and related dementias (ADRDs). Nonetheless, the prevalence, predictors, biology and clinical course of dementia, and the care needs of this population remain understudied. The Clinical Core (CC) of the South Texas Alzheimer Center (STAC) will establish a new culturally, socioeconomically, and geographically diverse cohort in this underserved region. Recruitment will be done at 3 core sites (San Antonio, Laredo and Harlingen, TX) using identical protocols. The CC will collect all the prescribed Uniform Dataset (UDS) data and collaborate with the Imaging (IC), Biomarker (BC), Genetics and Multiomics (GMC) and Neuropathological (NPC) cores to establish the brain morphology (ADNI3 protocol MRI, amyloid and tau PET), biomarker (blood, CSF, sensory-motor), genomic (clinical tests, APOE, GWAS, WGS) and pathological correlates of clinical syndromes to advance our understanding of the heterogeneous pathophysiological processes underlying ADRDs, especially in MA, using precision medicine approaches. In partnership with the Population Neuroscience Core (PNC), the CC will define risk and resilience factors for dementia by examining the impact of vascular, lifestyle, medical comorbidities, environment, culture, and social determinants (UDS+ data) on the transition from normal cognitive aging to dementia. In addition, the CC will create a trial-ready caregiver registry, examine a caregiver sample (same tests as patients except for PET and LP), and will study the interactional effect of the patient/caregiver dyad on disease course, care needs, and health outcomes. The CC will annually enroll 140 individuals with MCI or dementia and 60 cognitively normal controls; >50% will be of MA ancestry and at least 30% from underserved areas to establish a diverse longitudinal clinical cohort of ~700- 800 persons by year 4 (Aim 1a). The CC will also recruit all care partners of individuals in the clinical cohort into the caregiver registry and intensively study all willing caregivers, ~45/year from dyad and ~20 who provide care to ADRD patients who may be too advanced to enroll (Aim 1b). Within these cohorts, the CC will assess the prevalence of novel and established ADRD biomarkers of pathology, risk, and resilience with disease course and prognosis (Aim 2a). The CC will provide comprehensive care throughout illness, enabling deep longitudinal phenotyping and annual collection of biospecimens (BC, NPC), assessing serial change in imaging (IC), and clinicopathological correlations at autopsy (NPC). The approach will promote engagement (OREC), education (REC), and clinical trials for all disease stages (Aim 2b). The CC will also genetically characterize the cohort (Aim 3) and identify biomarkers for biological characterization of Suspected Non-Alzheimer Pathology (SNAP, A-/N+) in persons with and without diabetes (Aim 4). The DMSC will ensure timely, quality data collection and sharing. In summary, the CC will identify risk/resilience factors, utilize precision medicine approaches to improve risk-stratification, diagnosis, and prognosis, and enhance research recruitment of a predominantly MA cohort.

摘要 墨西哥裔美国人（MA）西班牙裔社区是增长最快的少数民族， 受阿尔茨海默病和相关痴呆症（ADRD）的影响。尽管如此，患病率，预测因素， 痴呆症的生物学和临床过程，以及这一人群的护理需求仍然没有得到充分研究。临床 核心（CC）的南得克萨斯州阿尔茨海默病中心（STAC）将建立一个新的文化，社会经济， 在这个服务水平低下的地区，将在3个核心研究中心（圣安东尼奥， 拉雷多和Harlingen，TX）。CC将收集所有规定的统一数据集（UDS） 数据并与成像（IC），生物标记（BC），遗传学和多组学（GMC）和 神经病理学（NPC）核心，以建立脑形态学（ADNI 3方案MRI、淀粉样蛋白和tau PET）， 生物标志物（血液、CSF、感觉运动）、基因组（临床试验、APOE、GWAS、WGS）和病理学 临床综合征的相关性，以促进我们对异质性病理生理学的理解。 ADRD的潜在过程，特别是在MA中，使用精准医学方法。伙伴合作下 人口神经科学核心（PNC），CC将通过检查 血管、生活方式、医学合并症、环境、文化和社会决定因素（UDS+）的影响 数据）从正常认知老化到痴呆症的转变。此外，CC将创建一个试验就绪 护理人员登记，检查护理人员样本（除PET和LP外，与患者相同的测试），并将研究 病人/照顾者二元体对疾病进程、护理需求和健康结果的干预作用。的 CC每年将招募140名MCI或痴呆患者和60名认知正常的对照者; >50%将是 MA血统和至少30%来自服务不足地区，以建立一个约700- 每年800人4（目标1a）。CC还将招募临床队列中个人的所有护理伙伴， 照顾者登记和深入研究所有愿意照顾者，约45/年从二分体和约20谁提供照顾 可能因病情进展而无法入组的ADRD患者（目标1b）。在这些队列中，CC将评估 新的和确定的ADRD病理学、风险和恢复力生物标志物的患病率与病程 和预后（目标2a）。CC将在整个疾病期间提供全面护理， 生物标本（BC、NPC）的表型分型和年度采集，评估成像（IC）的系列变化，以及 尸检时的临床病理学相关性（NPC）。该方法将促进参与（OREC）、教育 (REC)和所有疾病阶段的临床试验（目标2b）。CC还将对队列进行遗传表征 (Aim 3）并鉴定用于疑似非阿尔茨海默病病理学的生物学表征的生物标志物（SNAP， A-/N+）在有和没有糖尿病的人（目的4）。灾害管理支助中心将确保及时、高质量的数据收集， 共享总之，CC将确定风险/弹性因素，利用精准医学方法， 风险分层、诊断和预后，并加强主要MA队列的研究招募。