PROJECT SUMMARY – CLINICAL CORE (CORE B) The primary objective of the Wisconsin Alzheimer’s Disease Research Center (ADRC) Clinical Core is to provide access to well-characterized, diverse participants with standardized clinical, cognitive, and neurobehavioral data coupled with neuroimaging (magnetic resonance imaging [MRI], positron emission tomography [PET]), cerebrospinal fluid (CSF), blood, and DNA data that are linked to electronic health records (EHR) and consent to brain donation to facilitate translational AD research in preclinical identification and early diagnosis and intervention. To that end, the Core conducts clinical evaluations in patients with mild dementia and mild cognitive impairment (MCI), as well as in cognitively unimpaired older (O-CU) (>65 years) and middle-aged (M-CU) adults (45-65 years). The Clinical Core works closely with all ADRC Cores to facilitate the mission of the Center by participating in outreach, recruitment, and screening activities; conducting standardized UDS clinical, cognitive, and neurobehavioral assessments; gathering ancillary aging-related cognitive and clinical data; coordinating neuroimaging and fluid biomarker collection; consenting Core participants for brain donation; facilitating and consulting on cognitive testing, CSF collection, and disclosure processes; identifying patient and caregiver dyads for care research; promoting linkage of EHRs to research data; providing faculty mentors and clinical research resources to research trainees; and ensuring timely availability of participants, data, and biospecimens to investigative teams. In the next grant cycle, the Core will accomplish the following aims: Aim 1: Conduct detailed annual (dementia, MCI, O-CU) or biennial (M-CU) clinical assessments with diverse participants and facilitate consent to link to EHRs to characterize longitudinal clinical trajectories and functional outcomes. Aim 2: Facilitate consent for brain donation across all participants and collection of longitudinal biennial biomarker data (MRI, CSF, blood) in MCI, O-CU, and M-CU participants, and one-time biomarker data in dementia participants. Facilitate collection of amyloid and tau PET in a subset of Clinical Core participants with MRI. Aim 3: Provide CSF Collection, Neuropsychology, and Disclosure Services to investigators to facilitate implementation of standardized quality data collection, training of study staff, and/or disclosure of research test results to participants. Aim 4: Integrate culturally-tailored assessment and education approaches to support Core participants from diverse, under-represented communities to encourage long-term engagement and retention in clinical and biomarker assessments. Incorporate feedback from participant advisory councils and underrepresented minority communities to foster ongoing relationships with participants and provide relevant education and feedback to the community. Aim 5: Align data collection with national ADRD research initiative...