CLINICAL CORE

为了对早期阿尔茨海默病(AD)和相关痴呆的特征和机制进行有效和可靠的研究，必须从具有良好特征的患者队列中获得数据。这群人应该具有广泛的教育水平和社会经济地位以及种族多样性。它应该包括具有各种疾病严重程度的症状的患者，包括临床前AD和轻度认知障碍。必须建立一个系统，根据新的临床信息重新考虑和每年更新诊断，以便在疾病过程中记录完整的一系列临床印象。这种灵活的系统对于容纳和审查除阿尔茨海默病以外的痴呆症病例也是至关重要的，例如路易体痴呆的诊断标准。匹兹堡大学阿尔茨海默病研究中心的临床核心完成了这些功能。临床核心为记忆障碍诊所的患者和对照受试者提供评估和随访，并在ADRC注册登记中登记。具体地说，核心在研究开始时以及在年度评估中提供对所有患者和对照对象的详细评估，直到受试者退出项目或死亡。CORE还努力通过对这些患者和对照提供纵向跟踪，最大限度地参与ADRC的尸检计划。它还负责提供临床数据、研究对象、培训以及技术和科学领导力，以支持匹兹堡ADRC和 相关的地方、区域、国家和国际研究。ADRC将通过我们的卫星诊所阿尔茨海默氏症外展中心继续开展外展计划，为医疗服务不足的市中心人口提供护理和支持，该中心的总部设在匹兹堡以非裔美国人为主的山区。弗吉尼亚大学的第二个卫星诊所已经建立，并在下一个周期的第一年开始评估患者。这颗卫星将招募农村高加索人和非裔美国人，目的是为红十字与红新月会群体提供更大的多样性，并更多地参与这些服务不足的人群的研究。外部确认阿尔茨海默病临床诊断的准确性对于确保临床核心采用的不断演变的诊断程序是适当的也是至关重要的。在当前资助期间，ADRC的所有尸检病例中，临床诊断为可能AD的验尸确认率为91%。

In order to perform valid and reliable research into the characteristics and mechanisms of early stage Alzheimer's disease (AD) and related dementias, it is imperative to have data available from a well-characterized cohort of patients. The cohort should have a broad range of levels of education and socioeconomic status as well as racial diversity. It should contain patients with symptoms across the spectrum of disease severity including preclinical AD and Mild Cognitive Impairment. A system must be in place for the reconsideration and annual update of diagnoses based on new clinical information such that a complete series of clinical impressions can be recorded over the course of the disease. Such a flexible system is also essential to accommodate and review cases of dementias other than AD such as the diagnostic criteria for Dementia with Lewy Bodies. The Clinical Core of the Alzheimer's Disease Research Center at the University of Pittsburgh fulfills these functions. The Clinical Core provides evaluation and follow-up to patients and control subjects followed in the Memory Disorders Clinic and enrolled in the ADRC Registry. Specifically, the Core provides a detailed evaluation of all patients and control subjects at study entry, and at annual evaluations until the subject drops from the project or dies. The Core also strives towards maximal participation in the autopsy program of the ADRC by providing longitudinal follow-up to these patients and controls. It is also responsible for providing clinical data, research subjects, training, and technical and scientific leadership for support of new and ongoing research at the Pittsburgh ADRC and associated local, regional, national, and international studies. The ADRC will continue outreach programs developed to provide care and support for members of the medically underserved inner-city populations through our satellite clinic, the Alzheimer Outreach Center, which is based in the predominantly African American Hill District of Pittsburgh. A second satellite clinic at the University of Virginia has been established and begins evaluating patients during the 1st year of the coming cycle. This satellite will recruit rural Caucasian and African American subjects with the goal of providing greater diversity to the ADRC cohort and greater participation in research from these underserved populations. External confirmation of the accuracy of the clinical diagnosis of AD is also vital to ensure that the evolving diagnostic procedures employed by the Clinical Core are appropriate. Autopsy confirmation of a clinical diagnosis of Probable AD was 91 % for all cases from the ADRC coming to autopsy during the current funding period.