1Florida Alzheimer's Disease Research Center Clinical Core

佛罗里达ADRC的目标是促进对阿尔茨海默氏症和相关疾病的了解 (反兴奋剂)，特别是在代表性不足的少数群体中。在目前在芒特招募的370名参与者中 西奈医学中心(MSMC)，60%是西班牙裔，保留率为~80%，超过50%是正常或有 轻度认知障碍(MCI)的不同阶段。90%的人获得了结构磁共振成像，淀粉样蛋白PET (APET)扫描约70%的参与者(占NACC所有aPET扫描的三分之一)。验尸结果已经出来了 超过95%的人表示同意，其中包括50%的西班牙裔死者。新型神经心理学 英语和西班牙语的仪器已经被开发并用于在认知障碍发生之前检测它 可通过标准评估发现的。语言、文化、文化适应和双语对不同民族的影响 少数群体对认知和功能表现、人口统计学和遗传因素的影响 拉美裔美国人淀粉样蛋白阳性阈值和APOE基因对淀粉样蛋白负荷的差异 对非拉美裔美国人的研究一直很深入。 在目前的P30应用程序中，我们建议将临床核心扩展到包括MSMC和华盛顿大学 迈阿密(密歇根大学)，在那里，AA参与者的招聘和留住非常成功，并且在 评估血管并发症和痴呆症的作用是存在的，佛罗里达大学(UF)， 盖恩斯维尔，那里有相当多的专业知识来评估和研究路易体病(LBD)和 早期帕金森氏症。我们建议总共招募600名参与者(约40%西班牙裔，约40%非白人 西班牙裔[WNH]和~20%的AA)，包括三个地点每个地点的100名新参与者和至少200名追随者- MSMC的UPS以及密歇根大学和密歇根大学各100次跟进。所有新参与者都将接受核磁共振和aPET扫描。 后续参与者还将接受重复的MRI扫描，大多数人将接受aPET扫描。以血为本 生物标记物评估(Aβ42：40、美国国家橄榄球联盟和其他)将用于补充成像和 神经心理评估。 临床核心活动将与ORE、REC、Biomarker和病理核心紧密结合，以及 在评估、生物标记物、生物标志物的一致性方面协调三个临床地点 研究、标准化实施所有NACC模块、LBD和血管评估诊断 方法论。NIA-AA研究框架ATN分类要素的使用(淀粉样蛋白、Tau、 神经退行性变)将会实施。将使用方法和指标来确保 这些地点，包括招募和登记脑部尸检，这将在所有三个地点进行， 影像表现与局部脑病理和结构改变的相关性。合资格的调查员和 更大的ADRD社区将获得临床核心参与者及其数据和生物谱系的访问权限 用于研究项目和教育、培训目的。

The goal of the 1Florida ADRC is to advance the understanding of Alzheimer’s disease and Related Disorders (ADRDs), especially in underrepresented minority groups. Among 370 participants currently recruited at Mount Sinai Medical Center (MSMC), 60% are Hispanic, with a retention rate of ~80%, over 50% are normal or have various stages of Mild Cognitive Impairment (MCI). Structural MRI has been obtained on 90% and amyloid PET (aPET) scans on ~70% of participants (comprising 1/3 of all aPET scans in NACC). Autopsy has been obtained on over 95% of those consented, including > 50% from Hispanic decedents. Novel neuropsychological instruments in English and Spanish have been developed and utilized to detect cognitive impairment before it is detectable by standard assessments. The effects of language, culture, acculturation and bilingualism among minority groups on cognitive and functional performance, the demographic and genetic factors that affect the threshold for amyloid positivity and the differential effect of APOE genotype on amyloid load in Hispanics versus non-Hispanics have been studies in depth. In the current P30 application, we propose to expand the clinical core to include MSMC as well as University of Miami (UM), where recruitment and retention of AA participants has been very successful and expertise in evaluating vascular comorbidities and contributions to dementia exists, and the University of Florida (UF), Gainesville, where considerable expertise exists in evaluation and studies of Lewy Body Disease (LBD) and early Parkinson’s disease. In total we propose to recruit 600 participants (~40% Hispanic, ~40% White non- Hispanic [WNH], and ~20% AA), including 100 new participants at each of three sites and at least 200 follow- ups at MSMC and 100 follow-ups each at UM and UF. All new participants will receive MRI and aPET scans. Follow-up participants will also receive repeat MRI scans and most will receive aPET scans. Blood-based biomarker assessments (Aβ42:40, NFL, and others) will be used to complement the imaging and neuropsychological assessments. Clinical Core activities will be integrated closely with ORE, REC, Biomarker and Pathology Cores, and harmonized across the three clinical sites with respect to consistency of assessments, biospecimens, biomarker studies, standardized implementation of all NACC modules, LBD and vascular assessments diagnostic methodology. Utilization of elements of the NIA-AA Research Framework ATN classification (Amyloid, Tau, Neurodegeneration) will be implemented. Methods and metrics will be used to ensure full integration between the sites, including recruitment and enrollment for brain autopsies, which will be done at all three sites, with correlation of imaging findings to regional brain pathology and structural changes. Qualified investigators and the larger ADRD community will receive access to Clinical Core participants and their data and biospecimens for research projects and education, training purposes.