The University of Washington (UW) Alzheimer Disease Research Center (ADRC) Clinical Core is a valuable component the center's overall aim of supporting meaningful and innovative ADRD research. Advances in human genetics, pathological and imaging technologies have revealed the biological diversity of ADRD. The UW Clinical Core aims to capture this spectrum of ADRD heterogeneity in its longitudinal cohort to support multi-modal study of participants. Sensitive phenotyping is critical to the interpretation of post-mortem pathology and ante-mortem imaging heterogeneity. To that end, we have expanded our neuropsychological evaluation to identify relative vulnerable and resilient cognitive domains. Acknowledging that effective ADRD therapies for all requires improving study of ADRD in under-represented groups, we have developed a strategy with our Outreach Recruitment and Engagement Core to enhance the diversity of our ADRC. Over the last 5 years the UW ADRC has built a strong collaborative relationship with the Partners for Native Health, led by Dr. Dedra Buchwald. In this cycle we continue this effort through developing consensus algorithms for longitudinal cognitive and clinical data collected by Dr. Buchwald's team. Additionally, we work with the UW ADRC's Native Research and Resource Core (NRRC) to build upon data derived from community based participatory research approaches in the AI/AN population and develop community sensitive uniform ADRD clinical evaluations. The rationale driving the Clinical Core composition is to a) reflect the UW ADRC scientific theme of heterogeneity and resilience b) respond to the scientific needs of the ADRC research community and c) increase the racial, socioeconomic and educational attainment diversity of the Clinical Core. In this cycle, the Clinical Core will 1) Characterize clinically and follow longitudinally persons with normal aging, prodromal and symptomatic ADRD representing the clinical, anatomic and risk heterogeneity of disease, and promote their inclusion into research 2) Promote the inclusion of underrepresented groups in ADRD research and collaborate to establish diagnostic algorithms in AI/AN studies 3) Use modern psychometric approaches to co-calibrate cognitive scores across UDS, pre-enrollment clinical tests, and external studies to integrate pre-enrollment cognitive data and facilitate interoperability across and 4) obtain longitudinal CSF, blood and skin biospecimens from a well-characterized cohort of research participants presenting with normal and pathological aging, prodromal dementia and ADRD.
