The primary aim of the Clinical Core will be to enroll, characterize and follow a cohort maintained at 500-600 elders to support many types of research into Alzheimer?s Disease and Related Disorders. People who are enrolled will include some with normal cognition, some of whom may have markers of Alzheimer?s in their brain already, people with mild cognitive impairment and mild Alzheimer?s, and people with other types of neurodegenerative disorders, including Lewy Body Disease and Fronto-Temporal Lobar Degeneration. The core will enroll minority subjects as part of the groups that are followed, in particular Latinos. In addition to collecting and storing data about the ADRC participants at UCSD, the core will include components that are part of a national effort across centers, called the Uniform Data Set (UDS). The Core will submit UDS data on all subjects it follows to the national Alzheimer?s Coordinating Center (NACC). This will allow data sharing with a large national database. The Clinical Core will perform further testing beyond the tests required for the UDS. The core will draw a sample of blood for DNA, plasma and serum from participants, and will obtain CSF samples by lumbar puncture from those who agree. The core will obtain skin biopsies to be used to transform the cells in the skin into cells that can change into many identities (called pluripotent stem cells). Participants will have MRI brain imaging and PET imaging to support research into brain changes and pathology. Blood, CSF, skin biopsies and imaging will be stored at UCSD to allow for further analysis, and it may be available to share with collaborators. All participants will be invited to undergo follow-up research assessments once per year, to determine change in brain functioning, memory and other abilities. In subjects who consent, after their death the core will arrange for autopsy removal of the brain, for pathology analysis and to support further research. Some of the particular areas where the core will focus its efforts are in novel cognitive tests and assessing the brain through biomarkers related to structure, function, pathology and chemistry of the brain. This may help in early detection of change before major symptoms of dementia have arisen. Alzheimer?s disease has different features and progresses at varying rates, and we will try to identify factors that may account for this variation. Another area of interest for the core is in developing better ways to assess Latino participants, supported through social, cultural, and research expertise of the Latino Core. Finally, the core will work with other members of the ADRC to maintain and expand a Registry of research- ready volunteers.
