South Texas Alzheimer's Disease Center Clinical Core

南德克萨斯阿尔茨海默病中心临床核心

• 批准号: 10662340
• 负责人: GABRIEL Alejandro DE ERAUSQUIN
• 金额: $ 61.15万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662340
• 关键词: Acceleration; Acculturation; Affect; Alzheimer' s Disease; Alzheimer' s disease pathology; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Amyloid; Apolipoprotein E; Autopsy; Biological; Biological Assay; Biological Markers; Biology; Blood; Blood Vessels; Caregivers; Caring; Clinic; Clinical; Clinical Research; Clinical Trials; Cognitive; Cognitive aging; Collaborations; Collection; Comprehensive Health Care; Consent; Data; Data Collection; Data Set; Dementia; Diabetes Mellitus; Diagnosis; Diet; Disease; Disease Progression; Education; Elements; Eligibility Determination; Enrollment; Ensure; Environment; Ethnic Origin; Family; Gait; Genetic; Genomics; Genotype; Geography; Health; Hearing; High Prevalence; Hispanic Populations; Image; Individual; Life Style; Magnetic Resonance Imaging; Measures; Medical; Mexican Americans; Minority; Moods; Motor; Neurologic; Neurosciences; Outcome; Participant; Pathologic; Pathology; Patient Care; Patients; Pennsylvania; Persons; Phase; Phenotype; Physical activity; Population; Positron-Emission Tomography; Prevalence; Preventive Clinical Trial; Process; Prognosis; Protocols documentation; Race; Recording of previous events; Registries; Research; Risk; Risk Factors; Sampling; Sensory; Site; Sleep; Social support; South Texas; Syndrome; Testing; Translational Research; United States; Vision; Visit; advanced dementia; behavior measurement; bilingualism; biobank; biomarker identification; biotypes; brain morphology; care outcomes; clinical center; cohort; comorbidity; data management; data quality; data sharing; dementia care; dementia risk; diagnostic criteria; genome wide association study; health care availability; high risk; hispanic community; imaging biomarker; improved; machine learning method; multiple omics; neuroimaging; neuropathology; novel; novel marker; observational cohort study; outreach; precision medicine; primary caregiver; recruit; resilience; resilience factor; risk stratification; rural residence; social; social determinants; socioeconomics; tau Proteins; trial readiness; underserved area; underserved community; vascular factor; vascular risk factor; web site

Abstract The Mexican-American (MA) Hispanic community is the most rapidly growing minority and is disproportionately affected by Alzheimer’s disease and related dementias (ADRDs). Nonetheless, the prevalence, predictors, biology and clinical course of dementia, and the care needs of this population remain understudied. The Clinical Core (CC) of the South Texas Alzheimer Center (STAC) will establish a new culturally, socioeconomically, and geographically diverse cohort in this underserved region. Recruitment will be done at 3 core sites (San Antonio, Laredo and Harlingen, TX) using identical protocols. The CC will collect all the prescribed Uniform Dataset (UDS) data and collaborate with the Imaging (IC), Biomarker (BC), Genetics and Multiomics (GMC) and Neuropathological (NPC) cores to establish the brain morphology (ADNI3 protocol MRI, amyloid and tau PET), biomarker (blood, CSF, sensory-motor), genomic (clinical tests, APOE, GWAS, WGS) and pathological correlates of clinical syndromes to advance our understanding of the heterogeneous pathophysiological processes underlying ADRDs, especially in MA, using precision medicine approaches. In partnership with the Population Neuroscience Core (PNC), the CC will define risk and resilience factors for dementia by examining the impact of vascular, lifestyle, medical comorbidities, environment, culture, and social determinants (UDS+ data) on the transition from normal cognitive aging to dementia. In addition, the CC will create a trial-ready caregiver registry, examine a caregiver sample (same tests as patients except for PET and LP), and will study the interactional effect of the patient/caregiver dyad on disease course, care needs, and health outcomes. The CC will annually enroll 140 individuals with MCI or dementia and 60 cognitively normal controls; >50% will be of MA ancestry and at least 30% from underserved areas to establish a diverse longitudinal clinical cohort of ~700- 800 persons by year 4 (Aim 1a). The CC will also recruit all care partners of individuals in the clinical cohort into the caregiver registry and intensively study all willing caregivers, ~45/year from dyad and ~20 who provide care to ADRD patients who may be too advanced to enroll (Aim 1b). Within these cohorts, the CC will assess the prevalence of novel and established ADRD biomarkers of pathology, risk, and resilience with disease course and prognosis (Aim 2a). The CC will provide comprehensive care throughout illness, enabling deep longitudinal phenotyping and annual collection of biospecimens (BC, NPC), assessing serial change in imaging (IC), and clinicopathological correlations at autopsy (NPC). The approach will promote engagement (OREC), education (REC), and clinical trials for all disease stages (Aim 2b). The CC will also genetically characterize the cohort (Aim 3) and identify biomarkers for biological characterization of Suspected Non-Alzheimer Pathology (SNAP, A-/N+) in persons with and without diabetes (Aim 4). The DMSC will ensure timely, quality data collection and sharing. In summary, the CC will identify risk/resilience factors, utilize precision medicine approaches to improve risk-stratification, diagnosis, and prognosis, and enhance research recruitment of a predominantly MA cohort.

抽象的 墨西哥裔美国人（MA）西班牙裔社区是最迅速增长的少数群体，而且比例不成比例 受阿尔茨海默氏病和相关痴呆症（ADRDS）的影响。但是，患病率，预测因素， 痴呆症的生物学和临床过程以及该人群的护理需求尚未被理解。临床 南德克萨斯州阿尔茨海默氏症中心（STAC）的核心（CC）将在文化，社会经济上建立新的 在这个服务不足的地区，地理上的人队列。招聘将在3个核心地点进行（圣安东尼奥， Laredo和Harlingen，德克萨斯州）使用相同的协议。 CC将收集所有规定的统一数据集（UDS） 数据并与成像（IC），生物标志物（BC），遗传学和多组学（GMC）和 神经病理学（NPC）核心建立脑形态（ADNI3方案MRI，淀粉样蛋白和Tau PET）， 生物标志物（血液，CSF，感觉运动），基因组（临床测试，APOE，GWAS，WGS）和病理学 临床综合征的相关性，以促进我们对异质性病理生理的理解 使用精确医学方法的ADRD的过程，特别是在MA中。与 人群神经科学核心（PNC），CC将通过检查痴呆症的风险和韧性因素 血管，生活方式，医学合并症，环境，文化和社会决定者的影响（UDS+ 数据）关于正常认知衰老到痴呆的过渡。此外，CC将创建一个可以试用的 护理人员注册表，检查护理人员样本（与PET和LP以外的患者相同的测试），并将研究 患者/护理人员二元组对疾病课程，护理需求和健康结果的互动效果。 CC每年将招募140名MCI或痴呆症和60个认知正常对照的人； > 50％将是 MA血统和至少30％来自服务不足的地区，以建立〜700-的潜水员纵向临床队列 到4年，有800人（AIM 1A）。 CC还将招募临床队列中个人的所有护理伙伴 护理人员注册表并深入研究所有愿意的照顾者，〜45/年，来自dyad，约20人提供护理 对于可能无法入学的ADRD患者（AIM 1B）。在这些队列中，CC将评估 新颖和既定的病理学，风险和疾病韧性的生物标志物的患病率 和预后（AIM 2A）。 CC将在整个疾病中提供全面的护理，从而实现深度纵向 生物测量的表型和年度收集（BC，NPC），评估成像中的序列变化（IC）和 尸检（NPC）的临床病理相关性。该方法将促进参与（OREC），教育 （REC）和所有疾病阶段的临床试验（AIM 2B）。 CC还将以基因表征该队列 （AIM 3）并确定可疑非阿尔茨海默病理学生物学表征的生物标志物（SNAP， 在患有和没有糖尿病的人中A-/N+）（AIM 4）。 DMSC将确保及时，高质量的数据收集和 分享。总而言之，CC将确定风险/弹性因素，利用精确医学方法来改进 风险分层，诊断和及时，并增强主要是MA队列的研究募集。