Adult Changes in Thought (ACT) Research Program Core B: Clinical Core

临床核心(核心B)的首要目标是收集数据以支持成人思维的变化 (ACT)使用ACT数据的U19计划项目、核心和其他研究。临床核心负责 参与者交流以及从ACT研究参与者那里收集诊所和家访数据，以及 与包括其他数据收集活动的其他项目和核心协调。一项科学挑战 临床核心必须解决的问题是保持向后兼容性，同时促进使用 更新、更现代的方法，并保持与同伴研究的协调。这些考虑因素告诉我们 临床核心的所有方面的活动。临床核心的具体目标是：(1)遵循和保持最新 表演参与者。U19项目的改进包括对大量认知信息的数字捕获 超出了以前使用传统方法收集的数据。临床核心中心将继续收集数据 来自基于家庭的访问，这是队列保留的一个基本设计特征。临床核心将：(1) 扩展、更新和改进已建立的ACT数据收集，以跟踪认知、身体功能和 在日常生活中的功能、危险因素、健康和社会状况的间歇性变化，并持续识别事件 痴呆症和阿尔茨海默氏症病例；和(1b)支持拟议的项目和核心以及与行动相关的 附属研究，有针对性的新数据收集，增加新的流程，使认知数字化和现代化 测试。(2)招收、跟踪和留住新的ACT参与者。临床核心计划将注册人数增加到 从2,000名活跃的无痴呆症患者增加到3,000名。我们将扩大我们的地理覆盖范围，包括 大普吉特湾地区在社会人口统计和种族/民族方面更加多样化，并将 对少数族裔进行过抽样，以实现少数族裔入学率超过20%的目标。(3)收购 和维持验尸审批，并加强与参与者及其家人的沟通，以 优化尸检死者的死后间隔时间(PMI)。ACT研究的范围很广 到目前为止，基础设施已经导致了ACT队列中的850例身体解剖。临床核心将与 神经病理学核心使用持续质量改进(CQI)方法来最大化比例 接受快速尸检的自愿死者的名单。(4)与行政和数据部门协调 分析核心，以确保最先进的质量控制和对由 临床核心。ACT临床核心建立在四分之一个世纪以来从以人口为基础的 老年人队列，并将扩大、现代化和改进ACT数据收集，提供杰出的 支持项目、核心和附属研究以及通过广泛的数据共享获得ACT数据的项目、核心和附属研究 基础设施，并拥有更大和更多的社会人口和种族/族裔多样化的人口基础。 通过U19的扩展，临床核心可以大幅增加ACT对科学研究的贡献 对衰老、痴呆症和阿尔茨海默病的认识。

The overarching goal of the Clinical Core (Core B) is to collect data in support of the Adult Changes in Thought (ACT) U19 Program Projects, Cores, and other studies using ACT data. The Clinical Core is responsible for participant communication and clinic and home visit data collection from ACT study participants, and coordinates with other Projects and Cores that include other data collection activities. One scientific challenge the Clinical Core must address is maintaining backwards compatibility while facilitating data collection using newer, modern methods and maintaining harmonization with companion studies. These considerations inform all aspects of the Clinical Core’s activities. The Clinical Core’s Specific Aims are: (1) Follow and retain current ACT participants. Refinements in the U19 Program include digital capture of extensive information on cognition beyond that previously collected using traditional approaches. The Clinical Core will continue data collection from home-based visits, an essential design characteristic for cohort retention. The Clinical Core will: (1a) expand, modernize, and improve established ACT data collection to follow cognition, physical function and function in daily life, interval changes in risk factors, health and social status and continue to identify incident cases of dementia and Alzheimer’s disease; and (1b) support proposed Projects and Cores and ACT related affiliated studies with targeted new data collection adding new processes to digitize and modernize cognitive tests. (2) Enroll, follow, and retain new ACT participants. The Clinical Core plans to increase enrollment to grow from 2,000 to 3,000 active dementia-free individuals. We will increase our geographic reach to include more sociodemographically and racially/ethnically diverse areas in the greater Puget Sound area and will oversample racial/ethnic minorities to achieve a goal of over 20% racial/ethnic minority enrollment. (3) Acquire and maintain antemortem autopsy approval and enhance communication with participants and their families to optimize postmortem intervals (PMI) for decedents who come to autopsy. The ACT study’s extensive infrastructure has led to >850 autopsies to date from the ACT cohort. The Clinical Core will work closely with the Neuropathology Core to use continuous quality improvement (CQI) approaches to maximize the proportion of consenting decedents who receive a rapid autopsy. (4) Coordinate with the Administrative and Data and Analysis Cores to ensure state-of-the-art quality control and data documentation of all data collected by the Clinical Core. The ACT Clinical Core builds on a quarter century of data collection from a population-based cohort of older adults and will expand, modernize and improve ACT data collection, provide outstanding support of Projects, Cores, and affiliated studies and those receiving ACT data through extensive data sharing infrastructure and have a larger and more sociodemographic and racially/ethnically diverse population base. With this U19 expansion, the Clinical Core can substantially increase ACT’s contributions to scientific understanding of aging, dementia and Alzheimer’s disease.