PROJECT SUMMARY – CLINICAL CORE (CC) Consistent with the overall theme of the New Mexico Alzheimer’s Disease Research Center, the Clinical Core will develop a longitudinal cohort that will support research addressing key gaps in the literature, such as 1) common and unique early disease mechanisms in Alzheimer’s disease (AD) and vascular cognitive impairment dementia (VCID); 2) the development and validation of fluid- and imaging- based biomarkers in diverse cohorts; and 3) evaluating factors that contribute to dementia disparities in American Indian (AI) and Hispanic/Latino (H/L) groups. To address these gaps, the NM ADRC Clinical Core will work closely with the other cores to recruit and retain a diverse, community-based cohort of individuals with AD and VCID spectrum and healthy controls (Aim 1). As a young center, we will focus on recruiting preclinical subjects with biomarker evidence of AD and/or a high risk of VCID to be followed over time. We will strategically oversample AI and H/Ls to obtain equal representation of these groups (1/3 AI; 1/3 H/L; and 1/3 non-Hispanic white) to support collaborative research efforts to develop and validate imaging and fluid biomarkers and evaluate the role of early inflammation and neurovascular unit dysfunction (Aim 2). We will expand our assessment procedures to include evaluation of sociocultural factors that may impact performance on neuropsychological assessments (e.g. bilingualism, quality of education, and factors that affect risk and resilience in AI and H/L communities (e.g. healthcare literacy, access; Aim 3). We will modify our return of results procedures to first incorporate systematic assessment of interest in feedback and effectiveness. This framework will support the development and testing of socioculturally tailored feedback procedures to ensure effective communication of results to foster long-term brain health across the literacy spectrum (Aim 4). Finally, we will support the training of the next generation of diverse ADRD researchers in collaboration with the Research Education Component (Aim 5). Consistent with the National Plan to Address Alzheimer’s disease and corresponding NIA/NINDS’ Alzheimer’s Disease Related Dementias 2022 Summit, the Clinical Core will advance equity in AD/ADRD research through increasing representation of diverse populations in projects that aim to develop and validate biomarkers in these populations. Our integration with the Imaging and Biomarker Cores will support multi-modal imaging, biospecimens, and clinical markers to evaluate early disease mechanisms and their contributions to the clinical heterogeneity seen in diverse groups. Finally, in collaboration with the REC, we will provide training and support to groups of persons historically underrepresented in biomedical, behavioral, and social sciences. Ultimately, this work will reduce inequities and foster resilience of the region’s diverse communities by promoting healthy aging and reducing risk factor...