CORE--CLINICAL CORE

临床核心为项目提供临床、医学、神经心理学和流行病学数据以及临床结果，包括诊断和重大的生活转变。临床中心负责获得参与研究和尸检的同意，并进行诊断评估。具体目标是对我们诊所周围地区从医疗保险公鸡（HCFA/CMS）招募的基于社区的样本以及明确同意尸检的志愿者进行临床评估和跟踪。对所有受试者进行面对面临床核心评价，包括基线时的评估，以及随后的12个月间隔，如果检测到认知障碍，则更早。当有临床指征时，进行诊断性检查（神经成像和血液测试）。 召开病例会议，以分配每个受试者在每个波的临床结局。临床结局包括：1）诊断DSM-IV痴呆与“无痴呆”，2）对于患有痴呆的受试者，使用标准标准诊断亚型，3）认知障碍的中间状态（轻度认知障碍、临床痴呆评级0.5、遗忘性认知障碍、非遗忘性认知障碍），和4）记录显著的生活转变（例如，养老院安置、死亡）。临床中心还负责收集不再返回现场评价的研究受试者的随访医学和神经心理学信息。来自临床核心的数据用于确定研究受试者参加项目和子研究的资格。

The Clinical Core provides the Projects with clinical, medical, neuropsychological and epidemiological data as well as clinical outcomes including diagnoses and significant life transitions. The Clinical Core is responsible for obtaining consents for study participation and for autopsy, and conducting diagnostic assessments. The specific aims are to clinically evaluate and follow a community-based sample recruited from the Medicare rooster (HCFA/CMS) for the area surrounding our clinic as well as volunteers who specifically consent to autopsy. All subjects are administered an in-person Clinical Core evaluation including assessments at baseline, and subsequent 12-month intervals and sooner if cognitive impairment is detected. Diagnostic work-ups (neuroimaging and blood testing) are obtained when clinically indicated. Case conferences are held to assign clinical outcomes for each subject at each wave. Clinical outcomes include: 1) Diagnosis of DSM-IV Dementia versus 'No Dementia', 2) for subjects with dementia, subtypes are diagnosed using standard criteria, 3) Intermediate States of Cognitive Impairment (Mild Cognitive Impairment, Clinical Dementia Rating 0.5, Amnestic Cognitive Impairment, Non Amnestic Cognitive Impairment), and 4) Documentation of significant life transitions (e.g., nursing home placement, death). The Clinical Core is also responsible for collecting follow-up medical and neuropsychologicat information for study subjects who no longer return for in-person evaluation. Data from the Clinical Core is used to determine eligibility of study participants for Projects and substudies.