Alzheimer's Disease Center

Overview

	Administrative Core

	Clinical Core

	Biostatistics and Data Management Core

	Neuropathology Core

	Education & Information Transfer Core

The Administrative Core provides Center leadership, sets the Center research agenda, and maintains an environment that promotes quality research on normal aging and diseases of the brain. The ADC is administratively a part of the UK Sanders-Brown Center on Aging and is housed in the Sanders-Brown Building. This core promotes the integration of Center cores, pilot projects, and educational programs of the ADC. The core is managed by an Executive Committee composed of core leaders who meet twice monthly to assist the core director, Dr. Markesbery, with Center management and decision making. A major function of the Administrative Core is to recruit new faculty and maintain essential faculty and staff. An External Advisory Committee of nationally recognized experts meets yearly to evaluate research progress and a Local Advisory Committee, chaired by the dean of the College of Medicine, provides an annual administrative review. The director of the Administrative Core serves as the primary liaison with the Center on Aging Foundation, whose major focus is to raise funds for AD programs.

Core Director:
William R. Markesbery, MD

Staff:
Mary Fern Waechter, Financial Officer
Amy Walls, Administrative Assistant

Clinical Core

The Sanders-Brown Center on Aging at the University of Kentucky has been funded by the National Institute on Aging (NIA) as an Alzheimer's Disease Center (ADC) since 1986. As one of the original ten ADCs, the University of Kentucky (UK) has conducted Alzheimer's disease (AD) related research for over 20 years and as the only ADC in Kentucky, serves as a resource for clinicians and researchers throughout the Commonwealth and region. The ADC consists of the following components: an Administrative Core, a Clinical Core, a Biostatistics and Data Management Core, a Neuropathology Core, and an Education and Information Transfer Core along with two pilot projects.

The major goals of the UK ADC are: 1) to provide clinical data and biological samples from "brain healthy" control participants and participants with AD and other dementing diseases who are tested yearly and agree to donate their brain when they die; 2) to emphasize the longitudinal study of early memory disorders - presymptomatic AD, mild cognitive impairment, early AD, mixed dementias, and other memory disorders as well as normal brain aging with autopsy as an end point; 3) to develop innovative research and attract cutting edge investigators; 4) to emphasize and expand clinical and research programs for minorities; and 5) to participate in work that involves collaboration with other NIA-funded Centers.

The Clinical Core provides thoroughly evaluated, longitudinally followed brain healthy control participants and patients with AD and other dementing disorders for innovative research. The 500 healthy volunteers receive yearly neurological and neuropsychological evaluations that are designed to identify subtle changes in cognitive and neurological function; these volunteers are followed through autopsy. The Clinical Core's Dementia Research Clinic follows 200 patients with memory disorders who also are evaluated yearly using similar cognitive measures and agree to brain donation. Research studies at the Clinical Core emphasize normal aging and transition to preclinical AD, mild cognitive impairment, and early AD. The detailed evaluation of control and dementia volunteers provides a database for use by UK investigators and other collaborators nationwide. With permission, the Clinical Core obtains serum, plasma, buffy coats, and cerebrospinal fluid from control participants and dementia patients. The Clinical Core also maintains a satellite memory care clinic for African Americans at its Kentucky Clinic North site. Patients and controls are followed at Kentucky Clinic North using the same standardized testing protocol used with non African American participants. Approximately 100 patients with dementing disorders are followed at Kentucky Clinic North as well as healthy older African Americans who agree to yearly neurological examinations and are available for other research conducted by the Center. Educational outreach in the African American community is organized through the African American Dementia Outreach Partnership and involves local African American churches.

Core Director:
Charles D. Smith, MD

Senior Investigators:
William R. Markesbery, MD
Gregory Cooper, MD, PhD
Gregory Jicha, MD, PhD
Fred Schmitt, PhD
Nancy Stiles, MD

Clinical Core Staff:
Sarah Carr, Research Assistant
Kay C. Gaines, Staff Support Associate
Kathy Grossman, Clinical Research Assistant
Robin Hamon, Social Worker
Lindsey Heyer, Clinical Research Assistant
Jeffrey Howe, Clinical Coordinator
Carrie Probst, Clinical Research Assistant
Marie Smart, Social Worker
Diane Spencer, Clinical Research Assistant
Paula Thomason, Clinical Research Coordinator

Kentucky Clinic North Satellite:
Charles Smith, MD, Core Leader
Alise Brickhouse, Administrative Coordinator
Deborah Danner, PhD, Senior Investigator
JoAnna Hudson, RN, Research Nurse Coordinator
Peace Jessa, MD, Senior Investigator

Biostatistics and Data Management Core

One of the primary objectives of this core is to maintain a centralized database of all information collected by the ADC cores, pilot projects, and AD and aging research studies. Activities that support this objective include: ensuring confidentiality and security of data, developing data collection forms and entering data, providing monthly summaries to the ADC Executive Committee, creating appropriate subsets of the database for approved projects and investigators, and reporting accurate and complete datasets to the National Alzheimer's Coordinating Center. The second objective is to provide expertise on experimental design and analysis to ADC cores, pilot projects, and other aging and AD research initiatives. Activities that support this objective include: consultation for investigators of all projects, grant submissions, presentations, and manuscripts; reviewing all ADC pilot projects for statistical content, collaborating with other ADCs on special projects of mutual interest, and incorporating advances in statistical methodology for the interpretation and analysis of data collected. This core contributes to the literature with innovative studies on statistical methodology in AD research and participates in the training of graduate students, postdoctoral researchers, and young investigators.

This core also sponsors a conference held periodically in Lexington, Kentucky that focuses on special aspects of biostatistical methods as they relate to AD. The proceedings of the first conference can be found in a special issue of Statistics in Medicine (Volume 19, Number 11/12, June 2000) while the proceedings of the second conference can be found in a special issues of the Journal of Alzheimer's Disease (Volume 5, Number 5, October 2003) and Statistics in Medicine (Volume 23, January, 2004).

Core Director:
Richard Kryscio, PhD

Senior Investigators:
Marta Mendiondo, PhD
Frederick A. Schmitt, PhD

Neuropathology Core

The overall objective of this core is to support and stimulate research on AD and other age-related dementias by providing researchers with brain specimens from well documented patients with dementing disorders and normal control participants. The Neuropathology Core uses a rapid autopsy team to perform autopsies of short postmortem interval (PMI) according to a standardized protocol on longitudinally followed patients with AD and other dementing disorders and cognitively normal aged control participants. This core maintains a bank of brain specimens, cerebrospinal fluid, serum, plasma, and buffy coals from these short PMI autopsied subjects. The core provides consensus conference-determined postmortem diagnoses; quantitation of neurofibrillary tangles, and neuritic and diffuse plaques in eight brain regions; Aβ 1-40 and 1-42 quantitation; Braak staging; and CERAD and National Institute on Aging-Reagan Institute staging for all autopsied cases. This core evaluates the effectiveness and validity of the neuropathological guidelines for the diagnosis of AD developed by the National Institute on Aging-Reagan Institute Working Group.

The Neuropathology Core emphasizes changes that occur in the brain of longitudinally followed normal aged control participants, especially those with mild cognitive impairment and early AD. The core emphasizes neuropathological findings in the brains of the oldest old (>85 years old) and provides investigators with specimens from cognitively normal control subjects with no Aβ and few neurofibrillary tangles (Braak 0-II; successful cerebral aging) and cognitively normal subjects with abundant Aβ and neurofibrillary tangles (Braak IV-VI; preclinical AD).

The core correlates the clinical, neuropsychological and neuropathological features of demented and control subjects in conjunction with the Clinical Core. This unique opportunity to conduct clinical-pathological correlative studies on longitudinally followed control subjects and patients with dementia affords a better understanding of normal brain aging and the transition to dementia. The identification of those factors involved in this transition could contribute to early interventions and possible preventive measures.

The core also supports two UK AD program project grants, numerous R01 AD related grants, and two longitudinal neuroepidemiologic studies with autopsy end points: the Nun Study and the Georgia Centenarian Project. In addition, Dr. Markesbery serves as a consultant for the Honolulu-Asian Aging Study.

Core Director:
William R. Markesbery, MD

Senior Investigators:
Peter Nelson, MD, PhD
Dianne Wilson, MD

Rapid Autopsy Team:
William R. Markesbery, MD
Greg Jicha, MD, PhD
Peter Nelson, MD, PhD
Stephen Scheff, PhD

Staff:
Sonya Anderson, Tissue Bank Coordinator
Ela Patel, Neuropathology Technician
Dianne Tudor, Neuropathology Technician
Huaichen Liu, MD, Neuropathology Analyst

Education and Information Transfer Core

A primary function of this core is to support the recruitment and retention of participants for research and to provide programs that stimulate research by faculty and students. Efforts developed with the African American population at the Kentucky Clinic North Satellite have expanded so that ADC research studies reflect greater participation by African Americans, the largest minority group in Kentucky. Research by University of Kentucky faculty and students has been enhanced through a variety of regularly scheduled programs to educate investigators about AD and to foster collaboration among faculty and students from diverse disciplines.

The Education and Information Transfer Core designs outreach to increase awareness of AD and other dementias for patients, family members and the general public and to community organizations that provide care for dementia patients. Community awareness programs emphasize the importance of research and encourage participation in studies available through our Center. Through partnerships with national, state and local organizations and other ADCs, this core designs and offers dementia-specific training to meet the needs of health care and other professional audiences. These programs promote improved health and services for patients and their family members throughout Kentucky. All programs developed by this core are evaluated to aid in decision making.

Core Director:
Deborah D. Danner, PhD

Senior Investigator:
Greg Jicha, MD, PhD

Staff:
Roberta Davis, Information Coordinator