Core B: Clinical Core

项目总结-临床核心 临床核心（CC）支持和促进研究，推进ADC的目标，了解 不同老年人认知障碍和痴呆的复杂决定因素。核心招募人员， 维持了一个大的（410例活动病例）纵向队列（LC），该队列在种族和人口统计学上是多样化的， 多年来一直在纵向跟踪，其特点是采取了各种措施， 包括复杂神经心理学测试和最先进的神经成像。此队列支持多个 R 01 s，并为200多篇论文提供了基础。该群体的特征与四个方面密切相关， ADC的科学主题。根据我们对研究临床前疾病和诊断的兴趣， 过渡（主题1），大多数队列参与者（60%）在认知正常时入组，31%的 整个队列已转变为更受损的诊断状态。认知能力下降，即使在认知能力 正常，是可以测量的。因此，LC提供了一个很好的资源研究变化， 弹道由于社区招聘，LC高度多样化（>40%西班牙裔或非洲裔美国人，>20% 12岁以下教育），并提供了可能影响的生活过程因素的极好异质性 认知储备和认知能力（主题2）。该队列具有代表性的常见 血管危险因素，大多数病例在尸检时有多种病理，为 研究混合病理学（主题3）。CC与OR核心密切合作，招聘和保留 LC的。CC同意，每年评估参与者，并获得尸检预同意。的CC 支持资助研究项目的招聘，包括ADC试点研究。CC保持临床 试验单位进行行业和学术赞助的治疗试验。CC提供可靠和有效的 诊断。它提供了一套广泛的措施，远远超出了UDS，这些措施收集在一个 标准化的时间表，并选择支持科学主题。它与神经病理学合作 获取DNA、血清和血浆样本的核心（支持生物标志物主题4）， 采购/尸检，并提交每月临床病理学会议。CC与 Neuroimaging Core获得系列结构MRI/静息状态fMRI和分子成像PET研究。的 CC与行政核心密切合作，计划受试者招募和数据收集方案; 数据/生物统计部及时将CC数据转移到数据库中，并保持质量控制;与REC一起， 教育/指导AD研究人员。相关性：CC支持许多与进步相关的研究项目 早期发现、诊断和治疗痴呆症。CC旨在提高我们对 各种风险和保护因素如何影响认知老化的认知轨迹， 我们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） 对抗认知能力下降可以促进健康的大脑老化，并对公众健康产生重大影响。

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.