The principal goal of Core B is to identify prognostic factors in a cohort of patients with Alzheimer's disease (AD). During the past four years, the professional staff of Core B, with expertise in psychiatry, neurology, neuropsychology, epidemiology, and analytical approaches to data management, has studied 210 patients with AD and 57 controls. Evaluated every six months, subjects have had complete medical, neurological, psychiatric, and neuropsychological examinations and careful assessments of family histories. Our investigations focus on: neuropsychological profiles; clinical subtypes delineated by age of onset, severity and nature of language impairments, presence of psychiatric manifestations, and family history; and predictors of various outcome measurements (i.e., low [<5] Mini-Mental State Examination Scores, institutionalization, and death). Cases of familial AD are being identified, and blood and tissue samples will be obtained for future investigations of genetic factors implicated in the disease. The great majority of cases entered into our ADRC will be autopsied at our institution, and brain tissue will be used for clinical-pathological correlations (Core C). Of particular interest in this respect are our studies of AD-associated depression and the relationships of this syndrome to brain monoamine systems (Project 5). Moreover, brain tissues will be used to investigate mechanisms that lead to cellular abnormalities in the brains of individuals with AD (Projects 1-5). In concert, these strategies should provide new information concerning the biological basis for AD and, possibly, for designing and testing new diagnostic and therapeutic approaches (Project 6) to this disorder.
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