CORE--CLINICAL

临床核心将定义神经心理学和神经学 在波士顿登记的两个患者群体的属性 大学阿尔茨海默病研究中心(BU ADCC)。贝德福德退伍军人事务部 医疗中心是住院晚期患者的来源 阿尔茨海默病(AD)和门诊患者早期 痴呆症。与急诊医院的典型阿尔茨海默病诊所不同 设置，患者不会丢失随访和密切接触是 在疾病的所有阶段都与照顾者保持联系。这 亲密关系是指患者/家人和提供者之间的伙伴关系 促进将患者和护理人员招募到几个 研究项目，并在过去保持了75%的尸检率 六年了。这一堪称典范的关怀和研究标准将应用于 描述具有种族、民族和文化多样性的城市贫民 波士顿大学家庭医疗服务(HMS)服务的人群。在……里面 相比之下，在贝德福德退伍军人医疗中心接受服务的人口 是同质和中产阶级，大约40%的HMS患者不是 高加索人中，60%接受医疗补助，72%是女性。所有HMS患者 收到一份完整的医疗评估，将进行审查以确定 早期或症状前患者参加临床试验 核心。贝德福德退伍军人管理局和HMS的注册受试者将接受 每6小时进行一次标准化、有效的神经心理评估 几个月，每年一次的神经学评估和抽血。DNA将会 提取并储存，将确定载脂蛋白E基因。在……里面 在选定的病例中，将建立淋巴母细胞系。所有数据 收集的数据将被输入一个标准化的数据库。结合 以教育为核心的主要目标，患者和对照对象将 鼓励捐献他们的大脑用于研究目的。家庭 照顾者将被登记，并对照顾者进行标准化评估 负担将每年进行一次。该数据库将提供一个 为未来研究减轻照顾者负担的干预措施奠定基础 以及关于AD的情绪和经济影响的研究。

The Clinical Core will define the neuropsychological and neurological attributes of the two patient populations enrolled in the Boston University Alzheimer's Disease Research Center (BU ADCC). The Bedford VA Medical Center is a source of institutionalized patients with late stage Alzheimer's disease (AD) and ambulatory patients with earlier stages of dementia. Unlike the typical Alzheimer clinic in an acute hospital setting, patients are not lost to follow up and close contact is maintained with caregivers throughout all stages of the disease. This close relationship is a patient/family and provider partnership that has facilitated the recruitment of patients and caregivers into several research projects and has sustained an autopsy rate of 75% over the past 6 years. This exemplary standard of care and research will be applied to characterize the racially, ethnically and culturally diverse poor urban population served by the Boston University Home Medical Service (HMS). In contrast to the population served at the Bedford VA Medical Center, which is homogenous and middle class, about 40% of HMS patients are not caucasian, 60% are on Medicaid and 72% are female. All HMS patients receive a complete medical evaluation which will be reviewed to identify early stage or presymptomatic patients for enrollment in the clinical core. Enrolled subjects at the Bedford VA and the HMS will undergo a standardized, validated one hour neuropsychological evaluation every 6 months and an annual neurological evaluation and blood drawing. DNA will be extracted and stored and Apo E genotype will be determined. In selected cases, lymphoblastic cell lines will be created. All data collected will be entered into a standardized database. In conjunction with a major aim of the Education Core, patients and control subjects will be encouraged to donate their brains for research purposes. Family caregivers will be enrolled and a standardized assessment of caregiver burden will be performed annually. This database will provide a foundation for future research on interventions to reduce caregiver burden and studies concerning the emotional and financial impact of AD.