Tennessee Alzheimer's Project

Study Overview
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Brief Summary
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The primary objective of the Vanderbilt Alzheimer's Disease Research Center (VADRC) is to provide local and national researchers with access to a well-characterized and diverse clinical cohort, including participant referrals, biosamples, clinical data, and neuroimaging data. The VADRC Clinical Core will create an infrastructure to support research efforts of both local and national investigator studies to develop early detection, prevention, and treatment strategies for Alzheimer's disease. The Clinical Core intends to enroll up to 1000 participants, including individuals who are cognitively unimpaired, have mild cognitive impairment, or have Alzheimer's disease. This cohort of about 1000 participants will be called the Tennessee Alzheimer's Project. Participants will be seen annually for comprehensive clinical characterization and then referred to other studies to enhance Alzheimer's disease research activities.

Detailed Description
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Alzheimer's disease (AD) is a growing public health crisis affecting 5.8 million Americans. With the aging population, AD prevalence is expected to double by 2040. Successful AD prevention and effective therapies require distilling complexities of the disease to better model disease onset, progression, and treatment response. The purpose of the Vanderbilt Alzheimer's Disease Research Center (VADRC) is to provide a better understanding of AD and related dementias, and to serve as the institutional hub of clinical, research, and educational initiatives in AD. The Center will play an essential role in expanding AD discoveries and reducing the burden of AD locally and nationally. To do so, the VADRC will support multiple human studies and model systems research over the coming years. For the Tennessee Alzheimer's Project, the team will establish, phenotype, and annually follow a cohort of adults age 60 and older with and without memory problems. Phenotyping will include standardized protocols implemented across the entire national ADRC network as part of the National Alzheimer's Coordinating Center as well as protocols specific to our local site, including (but not limited to) venous blood draw, questionnaires, physical examination, echocardiogram, neuropsychological assessment, multi-modal neuroimaging, and cerebrospinal fluid acquisition via lumbar puncture. As part of the Center's autopsy program, the investigators will ask all Tennessee Alzheimer's Project participants to consider post-mortem donation of their brain, eyes, and a small skin sample. While fluid and neuroimaging biomarkers exist for some neuropathologies associated with AD and related dementias, postmortem characterization is the only current way to definitively confirm the presence and severity of disease. Locally, a robust tissue bank with excellent ante-mortem phenotyping will provide invaluable tissue for analyses distilling the complexities of AD.

Official Title
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Tennessee Alzheimer's Project

Conditions
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Aging, Alzheimer Disease, Biomarker, Cognitive Dysfunction, Mild Cognitive Impairment, Dementia, Cognition

Intervention / Treatment
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* Other: none, observational study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 60 or older Meet standard criteria for (a) cognitively unimpaired, (b) mild cognitive impairment, or (c) Alzheimer's disease English speaking Individuals who lack decisional capacity to provide informed consent at baseline will not be enrolled in the study Exclusion Criteria: No available reliable study partner (reliable is defined as someone who interacts significantly with the participant and is available to participate in study visits in person or by phone) History of major psychiatric illness (e.g., schizophrenia, bipolar), neurological illness (e.g., epilepsy, multiple sclerosis, Parkinson's disease), or head injury with significant loss of consciousness. Unable to undergo MRI (e.g., claustrophobia, ferrous metal in body)

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cognitively unimpaired<br>A consensus team determined cognitive status according to the National Institute on Aging and Alzheimer's Association Workgroup guidelines. | Other: none, observational study<br>* none, observational study<br>|
| Mild cognitive impairment<br>A consensus team determined cognitive status according to the National Institute on Aging and Alzheimer's Association Workgroup guidelines. | Other: none, observational study<br>* none, observational study<br>|
| Alzheimer's disease<br>A consensus team determined cognitive status according to the National Institute on Aging and Alzheimer's Association Workgroup guidelines. | Other: none, observational study<br>* none, observational study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive status | Change in cognitive status assessed by the Uniform Dataset according to the National Institute on Aging and Alzheimer's Association Workgroup guidelines determined by a consensus team. | baseline to year 3 | 
| APOE Genotype | APOE e4 allele status | baseline to year 3 | 
| White matter hyperintensities Volume | White matter lesion volume measured by FLAIR imaging modality | baseline to year three | 
| Grey Matter Volume | Grey matter volume measured by T1 imaging modality | baseline to year three | 
| Cerebral Blood Flow | Resting cerebral blood flow to brain regions measured by T3 perfusion | baseline to year three | 
| Lacunar infarcts | Number of lacunar infarcts measured by MRI | baseline to year three | 
| Microbleeds | Number of microbleeds measured by MRI | baseline to year three | 
| Left ventricular ejection fraction | Left ventricular ejection fraction measured by echocardiogram | baseline to year three | 
| Cardiac output | Amount of blood the heart pumps from each ventricle per minute (litres per minute (L/min)), measured by echocardiogram | baseline to year three | 
| Stroke volume | Stroke volume measured by echocardiogram | baseline to year three | 
| Heart rate | Heart rate measured by echocardiogram | baseline to year three | 
| Biological markers for Alzheimer's disease | Tau, amyloid, and neurodegenerative levels in cerebrospinal fluid samples | baseline to year three | 
| Blood based biological marker for Alzheimer's disease | Tau, amyloid, and neurodegenerative levels in blood samples | baseline to year three | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Alzheimer's disease, biomarkers, brain MRI, mild cognitive impairment, vascular risk factors, longitudinal studies