The Clinical Core is responsible for the recruitment, evaluation, and follow-up of the research subjects for the Program Project Grant. The subject recruitment recruitment strategy has been changed in this renewal to obtain individuals at significantly higher risk for AS. Several new measures have been added to quantify arteriosclerosis, including carotid intima media thickness, retinal artery diameters, and vascular-related biomarkers. The addition of brain amyloid imaging for a subset of subjects will also prove extremely helpful in determining the extent of concurrent AD pathology, thereby allowing for more accurate estimation of the relative contributions of both AS and AD pathologies to cognition. To accomplish these goals, the Clinical Core proposes the following specific aims. 1) Expand current cohort to include individuals with substantial CVD risk as determined by high Framingham Cardiovascular Risk Profile (FCRP) scores as well as a subset of individuals with stroke or myocardial infarction. These individuals will be followed longitudinally to autopsy. 2) Emphasize retention and autopsies on current cohort to satisfy needs of the projects. 3) Directly measure arteriosclerosis via carotid intimal medial thickness (CIMT) and retinal arteriolar venous photography (RAVP) in addition to ascertaining FCRP and brain imaging on all active subjects. 4)Acquire high quality clinical data under standardized protocols so as to characterize subjects in ways that provide key data to the Projects and that support subjects'enrollment in the Projects. This process includes:,4a) Providing reliable and valid clinical diagnoses across the three sites. 4b) Implement standardized clinical data collection protocols, including the Uniform Data Set (DOS) thereby assuring collection of data specific to the Projects, including the ability to share data with the larger dementia research community. 4c) Collect biological specimens such as serum for specific risk factor studies, DMA and brain imaging in conjunction with the Neuropathology and Neuroimaging Cores. 4d) Maintaining quality assurance of all collected materials including validating clinical diagnoses by conducting regular clinical consensus and clinical pathological conferences.
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