New Mexico Alzheimer's Disease Research Center

摘要（总体核心） 这项建议是在新墨西哥州建立一个探索性的阿尔茨海默病研究中心（NM eADRC）。该中心的目标是：1）建立基础设施和雇用教师，以提高阿尔茨海默病 (AD)研究; 2）满足存在健康差距的农村社区的需求，以及3）使用 多模式生物标志物，包括CSF和MRI，将血管疾病纳入新的NIA-AA 阿尔茨海默病（AD）的生物学定义，改善患者策略。该P20 NM eADRC将 向P30 ADRC迈进。我们计划聘请具有阿尔茨海默病（AD）专业知识的新教师， 相关性痴呆（RD）照顾老年人的基础设施需求将通过建造新的 700万美元的建筑，将容纳三个中心：运动障碍，老年医学和中心 记忆和衰老，创造协同作用，在照顾老年人。NM eADRC将解决未满足的 痴呆症护理的需求与差距有关，特别是在大量的美洲印第安人（AI）人口中。 改善对AI的痴呆症护理存在挑战，包括文化不敏感，低收入和 教育水平和长途旅行的专家护理。我们将克服这些障碍， 利用社区卫生代表进行认知筛查，并在现场实施移动的项目， 包括神经心理学测试和移动的1.5T MRI， 显像这将填补国家广告数据库中关于少数群体数据的空白。血管疾病是一种 AD的主要共病，加速认知能力下降。据估计，高达70%的 非遗传性AD是混合性痴呆（MX），这使得这是在尸检前识别的重要群体。我们 已经开发出了可以成功地对患者进行分层的生物标志物。这涉及使用CSF和MRI 研究，并允许将血管特征（V）添加到淀粉样蛋白（A），tau（T）， 用于诊断AD的NIA-AA公式的神经变性（N）组分。CSF中的生物标志物 已经被MarkVCID协会鉴定为指示炎症，当两者都 存在AD和血管疾病。NM eADRC将测量这些独特的生物标志物， 新招募的参与者，并提供这些服务给其他有兴趣的ADRC。血- 脑屏障（BBB）与AD的病理生理学有关。我们计划测量BBB AD和RD患者的灰质和白色物质的渗透性沿着与VCID和MX更好 了解它在痴呆症中的作用。NM eADRC将成为AD研究的一个大社区， 研究人员在国家，并将在医学院行政结构的主要中心。 有能力引进新的教师，建造新的建筑，并将科学家社区聚集在一起 对NM的痴呆症感兴趣，它将产生巨大的影响，为 成功的P30中心应用。

ABSTRACT (Overall Core) This proposal is to establish in New Mexico an exploratory Alzheimer's Disease Research Center (NM eADRC). The Center goals are: 1) to build infrastructure and hire faculty to enhance Alzheimer's disease (AD) research; 2) to meet the needs of rural communities with health disparities, and 3) to use multimodal biomarkers, including CSF and MRI, to incorporate vascular disease into the new NIA-AA Alzheimer's disease (AD) biological definition, improving patient stratefication. This P20 NM eADRC will build toward the P30 ADRC. We plan to hire new faculty with expertise in Alzheimer's disease (AD) and related dementias (RD). Infrastructure needs for care of the elderly will be met by the construction of new 7 million dollar building that will house three centers: Movement disorders, Geriatrics, and Center for Memory and Aging, creating synergy in care of the elderly. The NM eADRC will address the unmet needs in dementia care related to disparities, particularly in the large American Indian (AI) population. There are challenges to improving dementia care to AI that include cultural insensitivity, low income and educational levels, and long distances to travel for specialist care. We will overcome these barriers by using community health representatives to perform cognitive screening and a program for mobile on-site screening and testing (MOSST) that includes neuropsychological testing and mobile 1.5T MRI for imaging. This will fill a gap in the national AD databases for data on minorities. Vascular disease is a major co-morbidity with AD that accelerates the cognitive decline. It is estimated that up to 70% of nongenetic AD is mixed dementia (MX), making this an important group to identify prior to autopsy. We have developed biomarkers that can successfully stratify patients. This involves the use of CSF and MRI studies, and allows for the addition of the vascular feature (V) to the amyloid (A), tau (T), and neurodegeneration (N) components of the NIA-AA formula for diagnosis of AD. Biomarkers in the CSF have been identified by the MarkVCID consortium that indicate inflammation, which occurs when both AD and vascular disease are present. The NM eADRC will measure these unique biomarkers in the newly recruited participants, and provide these services to other ADRCs that are interested. The blood- brain barrier (BBB) has been implicated in the pathophysiology of AD. We plan to measure BBB permeability in gray and white matter in patients with AD and RD along with VCID and MX to better understand its role in dementia. The NM eADRC will be nidus for AD research to a large community of researchers around the state and will be major center within the Medical School Administrative structure. With the ability to bring in new faculty, build new buildings, and bring together the community of scientists interested in dementia in NM, it will make a huge impact that will provide the infrastructure for a successful P30 Center application.