Clinical Core

摘要-临床核心 临床核心（CC）是纽约大学ADRC功能的核心，提供全面的评估， 对参与长期纵向研究的参与者进行准确的研究诊断， 病理性认知老化CC在临床前表征方面取得了重大进展， 痴呆阶段：将主观认知下降确定为前驱期，开发广泛使用的量表 用于临床表型分析，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向痴呆症转变的机制。我们强调研究 关键的早期转变（正常->临床前/前驱->MCI）以及它们与最先进的生物标志物的关系 的ATN框架和AD/ADRD异质性。我们的方法将结合联合收割机标准的UDS 3评估 凭借创新的纽约大学特定方案，使用先进的MR和PET神经成像， 表型分析方案和新的生物流体/疾病监测策略。我们提出了四个具体目标。目标1： 全面描述了一个约500名社区老年人的队列[70%正常，20-25% MCI，40% 来自黑人/非洲裔美国人和拉丁美洲人组]与（a）用于纵向临床表型分析的独特方案 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 向参与者和国家知识库报告，以及（c）同意建立临床- 生物标志物-病理相关性。目的2是支持一个大型的干预性AD/ADRD试验网络， 通过保持“研究就绪”动态登记来容纳多病因痴呆的附属研究 参与者目的3是通过（a）开发新的抗肿瘤药物来改善风险/早期受试者的临床表型。 神经精神症状和SCD的表征方案，以及（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志物。目的4是提高临床技能， 痴呆症从业者，促进早期职业调查人员使用CC数据进行AD/ADRD研究， 教育公众关于AD/ADRD以及正常对照和脑/生物标本捐赠的价值。这些 目标使CC能够推进其最先进的计划，该计划已准备好回答内部的关键问题 目前的AD/ADRD研究框架，并为国家适应行动方案研究执行里程碑作出贡献。

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.