Clinical Core

摘要--临床核心 临床核心(CC)是纽约大学ADRC职能的核心，通过提供全面的评估和 为参与其长期纵向研究的参与者提供准确的研究诊断 病理性认知老化。CC在临床前TO的特征方面取得了重大进展 痴呆症阶段：建立主观认知衰退为先兆阶段，开发广泛使用的量表 用于临床表型鉴定，并帮助建立早期疾病的重要成像生物标志物。我们继续 我们的目标是了解影响痴呆症转变的机制。我们强调研究…… 关键的早期过渡(正常-临床前/前驱-MCI)及其与最先进的生物标记物的关系 ATN框架和AD/ADRD异质性。我们的方法将结合标准的UDS 3评估 具有创新的纽约大学专用方案，使用先进的MR和PET神经成像，强大的临床 表型方案和新的生物流体/疾病监测战略。我们提出了四个具体目标。目标1是 全面描述约500名社区居住的老年人的特征[70%正常，20%-25%MCI，40% 来自黑人/非裔美国人和拉丁裔群体]有(A)一种独特的纵向临床表型鉴定方案 和生物标志物分析，以评估临床前/前驱疾病和AD/ADRD异质性，(B)及时数据 向参与者和国家资料库报告，以及，(C)同意建立临床- 生物标记物-病理相关性。目标2是支持一个介入AD/ADRD试验的大型网络，并在- 关于多病因痴呆症的众议院附属研究--通过维护“研究准备”的动态注册 参与者。目标3是通过(A)开发新的方法来改善高危/早期受试者的临床表型 神经精神症状和SCD的特征方案和(B)利用新兴技术 研究与认知、睡眠和运动功能相关的数字生物标记物。目标4是提高患者的临床技能 痴呆症从业者，促进在早期职业调查人员中使用CC数据进行AD/ADRD研究， 并教育公众有关AD/ADRD以及正常对照和脑/生物制品捐赠的价值。这些 旨在使CC能够推进其最先进的计划，该计划已做好准备回答以下关键问题 目前的AD/ADRD研究框架，并有助于实现国家适应行动方案的研究执行里程碑。

ABSTRACT- CLINICAL CORE The Clinical Core (CC) is central to the function of the NYU ADRC by providing comprehensive evaluations and accurate research diagnoses for participants engaged in its long-standing longitudinal study of normal versus pathologic cognitive aging. The CC has made significant advances in the characterization of preclinical to dementia stages: establishing subjective cognitive decline as a prodromal stage, developing widely used scales for clinical phenotyping, and helping establish important imaging biomarkers of early stage disease. We continue our goal to understand mechanisms that influence transitions towards dementia. We emphasize the study of critical, early transitions (normal->preclinical/prodromal->MCI) and how they relate to state-of-the-art biomarkers of the ATN framework and AD/ADRD heterogeneity. Our approach will combine standard UDS 3 assessments with an innovative NYU-specific protocol that uses advanced MR and PET neuroimaging, robust clinical phenotyping schemes, and new biofluid/disease monitoring strategies. We propose 4 specific aims. Aim 1 is to comprehensively characterize a cohort of ~500 community-dwelling older adults [70% normal, 20-25% MCI, 40% from Black/African-American and Latino groups] with (a) a unique protocol for longitudinal clinical phenotyping and biomarker analysis to evaluate preclinical/prodromal disease and AD/ADRD heterogeneity, (b) timely data reporting to participants and national repositories, and, (c) brain donation consenting to establish clinical- biomarker-pathological correlations. Aim 2 is to support a large network of interventional AD/ADRD trials and in- house affiliated studies on multi-etiology dementia by maintaining a dynamic registry of “study-ready” participants. Aim 3 is to improve the clinical phenotyping of at-risk/early stage subjects by (a) developing novel characterization schemes for neuropsychiatric symptoms and SCD and (b) leveraging emerging technology to investigate digital biomarkers related to cognition, sleep, and motor function. Aim 4 is to improve clinical skills of dementia practitioners, promote the use of CC data for AD/ADRD research among early career investigators, and educate the public about AD/ADRD and the value of normal controls and brain/biospecimen donation. These aims allow the CC to advance its state-of-the-art program that is well poised to answer critical questions within the current AD/ADRD research framework and contribute to NAPA research implementation milestones.