The Alzheimer's Disease Center (ADC) has as its long-range goal to continue to develop and expand its Clinical Core functions to evaluate and follow comprehensively, selected patients with memory loss, Alzheimer's Disease (AD), and other dementias, and similarly to longitudinally follow and evaluate control subjects and encode pertinent data in a central database. Patients will be assigned to appropriate follow- up and study protocols and a computerized tracking system to monitor and document progress will be employed. Minority recruitment has been emphasized to increase our number of patients who are African- American, Hispanic, and Native-American. It is our plan to evaluate potential predisposing events to AD, clinical course and complications of AD, clinical course and complications of AD, quantify emotional/behavioral symptoms and quality of life, utilization of imaging studies in the diagnosis of AD, and obtain clinical pathologic correlations. It will be our intent to achieve an 80% follow-up rate for persons designated for long-term studies. Well-studied subjects, clinical data and body fluids will be supplied to investigators, and in particular ante- mortem and perimortem information to investigators using post-mortem tissues from our controls and patients. Patients and control subjects will be evaluated with comprehensive neuropsychological testing, brain imaging, CSF and neuropathologic findings, in order to detect and assess preclinical and early AD. A Memory Disorders for Native Americans will be developed in Dallas to study their prevalence and clinical features of AD. The collaboration with the Alzheimer's Disease Clinical Studies Unit will continue. ADC patients and controls will be autopsied to provide an accurate diagnosis of AD or other basis of dementia. The Brain Bank will be expanded over the next five years from these autopsy studies and banked tissues will be made available to be utilized by investigators on our campus and at other ADC's. The Clinical Core will also supply information about the ante mortem state of control and AD patients for correlation with cellular and molecular analyses. Genotyping of AD autopsied cases for apolipoprotein E will be conducted as will ELISA assays for synaptophysin and tau proteins, and quantification of neocortical neuritic dystrophy in immunostained sections using image analysis. It is our intent as well to expand the isolation and banking of DNA from frozen and fixed autopsied tissue samples to facilitate ongoing and new studies of molecular alterations in AD and aging. The Statistics and Data Management Core will enter, store and analyze additional new patient data for comparative studies. The functionality of the existing centralized database will be enhanced with appropriate security over a central network to authorized ADC investigators at our institutions. The Education Core has extensive plans that have been developed over the past five years to extend knowledge about AD and specifically, availability of patient services to minority populations and also to primary health care providers. Educational videotapes and TV announcements will be developed both in English and Spanish. The Alzheimer's Researcher Newsletter will be published semi-annually and distributed to our 5000 subscribers in this five-state region. The number and scope of research projects will be increased during the next five years.
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