Core B: Clinical Core

项目摘要-临床核心 临床核心(CC)支持和促进研究，以促进ADC了解 不同老年人认知障碍和痴呆的复杂决定因素。核心招聘和 维持一个庞大的(410例活跃病例)纵向队列(LC)，该队列在民族和人口统计学上是多样化的， 这是多年来一直纵向跟踪的，其特点是采取了以下措施 包括复杂的神经心理测试和最先进的神经成像。此队列支持多个 R01s，并为200多篇论文提供了基础。这一群体的特征与这四个因素密切相关 美国艺术发展局的科学主题。与我们对研究临床前疾病和诊断的兴趣一致 过渡(主题1)，大多数队列参与者(60%)是在认知正常时登记的，31%的 总体而言，队列已过渡到更受损的诊断状态。认知衰退，甚至在认知方面也是如此 正常，一直是可以轻易衡量的。因此，LC为研究变化和变化提供了极好的资源 弹道。由于社区招募，LC是高度多样化的(40%西班牙裔或非裔美国人，20% 年龄在12岁以下。教育)，并在可能影响生命历程的因素中提供极好的异质性 认知储备和韧性(主题2)。这群人有共同的代表性流行。 血管危险因素和大多数病例在尸检时有多种病理改变，为 学习混合病理学(主题3)。协调委员会在招聘和保留以下人员方面与业务核心密切合作 LC。CC同意，每年对参与者进行评估，并获得尸检预先同意。消委会 支持资助研究项目的招聘，包括ADC试点研究。CC维持一项临床 进行行业和学术赞助的治疗试验的试验单位。CC提供可靠有效的 诊断。它提供了一系列广泛的措施，远远超出了UDS，这些措施是在 标准化的课表和选定的支持科学的主题。它与神经病理学合作 核心获取DNA、血清和血浆样本(支持生物标记物主题4)，促进大脑 采购/尸检，并每月举行临床病理学会议。CC与 神经成像核心，以获得系列结构磁共振/静息功能磁共振成像，以及分子成像PET研究。这个 协调委员会与行政核心密切合作，规划科目征聘和数据收集方案； 数据/生物统计迅速将CC数据传输到数据库并保持质量控制；与REC一起 教育/指导AD研究人员。相关性：CC支持许多与进展相关的研究项目 在痴呆症的早期发现、诊断和治疗中。消委会的目的是增进我们对 不同的风险和保护因素如何影响认知老化的认知轨迹 我们这个种族多元化的群体。了解加速或保护的因素(生物和生活方式) 抗认知功能减退可促进大脑健康老化，对公众健康有重大影响。

PROJECT SUMMARY – Clinical Core The Clinical Core (CC) supports and promotes research that advances the ADC's goal of understanding the complex determinants of cognitive impairment and dementia in diverse older adults. The Core recruits and maintains a large (410 active case) longitudinal cohort (LC) that is ethnoracially and demographically diverse, that has been followed longitudinally for many years, and that is richly characterized with measures that include sophisticated neuropsychological tests and state-of-the-art neuroimaging. This cohort supports multiple R01s and has provided the basis for over 200 papers. The features of the cohort are closely linked to the four scientific themes of the ADC. In accordance with our interest in studying preclinical disease and diagnostic transitions (Theme 1), most cohort participants (60%) were enrolled when cognitively normal and 31% of the overall cohort has transitioned to a more impaired diagnostic status. Cognitive decline, even in the cognitively normal, has been readily measurable. Thus, the LC provides an excellent resource for studies of change and trajectory. Due to community recruitment, the LC is highly diverse (>40% Hispanic or African American, >20% with under 12 yrs. education) and provides excellent heterogeneity in lifecourse factors that may influence cognitive reserve and resiliancy (Theme 2). The cohort has representative prevalences of the common vascular risk factors and most cases have multiple pathologies at autopsy, providing a valuble resource for studying mixed pathology (Theme 3). The CC works closely with the OR Core on recruitment and retention of the LC. The CC consents, evaluates participants annually, and obtains autopsy pre-consents. The CC supports recruitment for funded research projects, including ADC pilot studies. The CC maintains a Clinical Trials Unit that conducts industry and academic sponsored treatment trials. The CC provides reliable and valid diagnoses. It provides a broad set of measures, extending well beyond the UDS, which are collected on a standardized schedule and selected to support the scientific themes. It collaborates with the Neuropathology Core to obtain DNA, serum and plasma samples (supporting Theme 4 on Biomarkers), facilitate brain procurement/autopsy, and to present monthly Clinical Pathological Conferences. The CC coordinates with the Neuroimaging Core to obtain serial structural MRI/resting state fMRI, and molecular imaging PET studies. The CC works closely with the Administrative Core to plan subject recruitment and data collection protocols; with Data/Biostatistics to promptly transfer CC data into the database and maintain quality control; and with REC to educate/mentor AD researchers. RELEVANCE: The CC supports many research projects relevant to advances in the early detection, diagnosis, and treatment of dementia. The CC aims to advance our understanding of how various risk and protective factors affect cognitive trajectories across the spectrum of cognitive aging in our ethnically-diverse cohort. Understanding the factors (biological and lifestyle) which accelerate or protect against cognitive decline could foster healthy brain aging and have a major impact on the public health.