Clinical Core

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

Investigators

Linked publications, trials & patents

Abstract

Clinical Core Abstract Disease (AD) depends : Progress in early risk detection, diagnosis, treatment, and prevention of Alzheimer’s critically on the availability of large “trial-ready” cohorts of participants spanning a spectrum from cognitively unimpaired to MCI-risk stages including subjective cognitive decline, mild cognitive impairment (MCI), and early AD, and ultimately autopsy-confirmed AD and related dementias (ADRD). The PITT- ADRC Clinical Core has effectively accomplished this with clinical evaluation and characterization of a cohort of more than 5300 participants since 1985, enrolling over 430 new participants in this funding cycle thus far. The Clinical Core is both a vital local research resource, providing participant referrals, biologic samples, diagnostic expertise, and training for numerous federally funded grants to local investigators, and a leading contributor to large scale national and international collaborative investigations including genetic and imaging biomarker studies and large-scale prevention trials. In the current grant cycle, the Clinical Core implemented measures to reduce barriers to recruitment and retention of economically disadvantaged participants; those residing in neighborhoods with the most disadvantaged national quartiles of Area Deprivation Index (ADI) now account for just over 50% of initial visits. ADI and other key metrics will be monitored monthly in a new dashboard to be implemented in the next funding cycle to track recruitment goals in real time, including autopsy program recruitment, to ensure diverse and equitable representation. In the current cycle, in collaboration with the NIC, AT(N) neuroimaging biomarkers were systematically incorporated into the diagnostic consensus process. In the next funding cycle, in collaboration with the Biomarker and Neurogenetics Core, ATX(N) blood biomarkers will be similarly incorporated, to evaluate how these biomarkers might be practically utilized in clinical diagnosis and biological staging. Other new initiatives in the renewal cycle include a pilot study evaluating remote digital cognitive assessment platforms for future adoption; and new data collection of participant residential address history, enabling linkage to a range of life-course regional exposome data, a significant expansion of structural and social determinants of health measures. New initiatives will be implemented within the following set of proposed Specific Aims: 1) To perform evaluations at study entry and at annual follow-up of participants in the PITT-ADRC, across the spectrum of cognition from cognitively unimpaired (CU) through AD and related dementias; 2) To assure maximum participation in clinical, intervention, brain imaging, biomarker, and autopsy studies by providing appropriate research study referrals and clinical services during longitudinal follow up; 3) To provide clinical data, research participants, blood and DNA samples, and scientific leadership to research projects within and outside the University of Pittsburgh; 4) In collaboration with the ORE Core, facilitate recruitment and retention of diverse participants; 5) To support the Research and Education Core (REC) in training a diverse workforce as the next generation of dementia researchers and caregivers.