The Clinical Core of the UC Davis ADCC will serve the research program of ADCC investigators by developing a large pool of uniformly diagnosed and comprehensively evaluated demented patients and normal control subjects. Standard diagnostic workups will be performed at the referral clinics, and appropriate patients referred on the ADCC. There patients will receive further evaluation with an emphasis neurobehavioral features. Extensive neuropsychological testing of mild and moderate patients will quantitate a variety of cognitive processes. Structured behavioral assessments of all patients will quantitatively measure psychiatric and behavioral disturbance, behavioral manifestations of cognitive failure, and functional capacity. These data, along with findings from the history, physical and neurologic examinations, laboratory and neuroimaging results will be entered into an electronic data base. Results obtained at autopsy, through the Neuropathology Core, will also be entered into this data base. The Clinical Core will manage the data base and make it easily accessible to ADCC investigators. This wide ranging data base will facilitate data analysis and help to promote multidisciplinary research. ADCC patients and controls will be re-evaluated annually, and appropriate supportive services will be made available to families with the twin goals of keeping behavioral data current and of promoting families' continued involvement with the ADCC. These practices will help to maximize autopsy rates, and will increase the value of the data from the neuropathology core. The activities of the Clinical Core will build upon a base of personnel, procedures, and resources developed over the past five years at two separate U.C. Davis Alzheimer's Disease Diagnostic and Treatment Centers (ADDTCs). The ADDTCs, one in Berkeley and one 70 miles east in Sacramento, are state funded clinical centers for the diagnosis and management of demented patients. As they stand, the ADDTCs conduct parallel clinical evaluations and each directs patients to local, externally supported researchers (the ADDTCs themselves do not have a direct research mission). The Clinical Core will create a network of 5 referral clinics, including the 2 ADDTCs, that will send patients with dementia diagnoses to two ADCC performance sites, thus increasing the availability of patients to researchers at UC Davis and Lawrence Berkeley Laboratory. This integrated network of referral and performance sites will make the ADCC easily accessible to the diverse population of Northern California.
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