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Special Cohorts

The UCI Clinical Core plays a central role in the ADRC, providing longitudinally well-characterized subjects for clinical, genetic, neuroimaging, and pathological studies. The Clinical Core provides resources to ADRC projects, as well as UCI basic science investigations, clinical trials in normal aging, dementia and Down syndrome, neuroimaging studies, investigations in the epidemiology of the Oldest Old, and Telemedicine Reliability. In return, the Clinical Core benefits from increased research productivity, sources of subject recruitment, and leveraging of study resources.

The overarching goal of the ADRC is to longitudinally characterize a variety of subjects relevant to the study of dementia and aging, and encourage these individuals to participate in research projects and eventual autopsy to allow clinical-pathological investigations and studies of diagnostic accuracy. The Clinical Core supports this goal in four ways. First, as the Longitudinal Cohort spans the full spectrum of cognitive states associated with aging (i.e., normal, very mild complaints, MCI, and dementia), we can supply well-characterized participants to investigators studying normal brain aging, dementia, and most importantly, the transition between these two states. We have augmented the Longitudinal Cohort with two special interest groups, the adult Down Syndrome Cohort and the 90+ Autopsy Cohort. Unique contributions to the ADC system, these two subject groups provide clinical data and biological samples that extend studies of aging and AD to new paradigms. Using adults with Down syndrome, who uniformly develop AD pathology at a relatively young age (i.e., 40 years), our scientists are assessing the temporal events associated with AD neurodegeneration and developing models for clinical trials and other interventions in these subjects.

Also at a high risk of developing dementia, our 90+ Autopsy Cohort subjects enable researchers to investigate the clinical, genetic, and pathological features of extreme old age. Americans 90+ are the fastest growing segment of the population and expected to total almost four million by 2030 (U.S. Census Bureau, 2008). By maintaining a cohort of 90+ subjects who receive a comprehensive evaluation every 6 months, the UCI ADRC is addressing a weakness in prior neuropathological investigations of the oldest old, in which subjects had not been prospectively well characterized during life. Secondly, to ensure that researchers have access to well-characterized populations, the Clinical Core conducts comprehensive annual evaluations that incorporate both the UDS and customized tests for our two special populations. Thirdly, by only recruiting subjects interested in research participation, we make certain that investigators can draw from a stable pool of willing participants. Finally, requiring all Clinical Core subjects, with the exception of minorities, to consent to brain autopsy ensures final neuropathological confirmation of the clinical diagnosis and provision of biological data beyond that obtained in the annual clinical assessments.