Current opportunities for participation in research studies:

A major advantage of being part of the NIH-funded ADRC network is that it provides opportunities for participants with dementia to participate in clinical trials of novel treatments. ADRCs serve as sites for such trials with experimental drugs. 

Our NM ADRC will engage participants, with a specific focus on rural or medically underserved communities. Upon proper approvals, data collected will be shared to several national data centers for imaging and other research purposes. The ADRC network has one of the largest and oldest Alzheimer’s datasets. Researchers are able to request data to combine from multiple ADRCs and identify novel disease markers and drug targets on underrepresented populations, which is otherwise not possible to accomplish by a single ADRC. 

To be designated as an ADRD will be of great benefit to the state of New Mexico, and the NM ADRC team hopes that the outcome from the Center will make a positive impact on the health and well-being of New Mexicans.

Description of the NM ADRC Cores:

1. Administrative Core (AC): The NM ADRC's Administrative Core (AC) unifies its seven cores and ensures efficient operations. Expanding on the exploratory NM eADRC, the AC spearheaded partnerships to enhance dementia care in diverse communities, such as Zuni and Acoma Pueblos. Overcoming geographical barriers, we utilized a mobile scanner and telehealth resources. Collaborating with state agencies, AC expanded dementia care access. With a commitment to diversity, AC will facilitate coordination with all cores, collaborate with NIH/NIA, National Alzheimer’s Coordinating Center (NACC) and National Centralized Repository for Alzheimer's Disease and Related Dementias (NCRAD), internal and external advisory committees, timely submission of regulatory documents and reports, hiring, providing seed funds for developmental (pilot) studies, and giving oversight to the Center’s budget.  
   
2. Clinical Core: The NM ADRC's Clinical Core aligns with its mission by developing a diverse longitudinal cohort to address key research gaps. This includes investigating early disease mechanisms in AD and vascular contributions to cognitive impairment and dementia (VCID), validating biomarkers, and evaluating factors contributing to dementia disparities in AI and H/L groups. To achieve this, the Clinical Core collaborates with the Outreach, Recruitment, and Engagement Core (OREC) to recruit and retain a diverse cohort, oversampling AI and H/L individuals at equal ratios to develop and validate imaging and fluid biomarkers with a focus on inflammation and neurovascular unit dysfunction. It expands assessment procedures to include sociocultural factors impacting neuropsychological assessments and modifies return of results procedures to ensure effective communication tailored to diverse populations. Additionally, it supports the training of diverse ADRD researchers and aims to reduce inequities and promote healthy aging in diverse communities.  
   
   
3. Neuro Imaging Core (NIC): In collaboration with the Clinical Core and the Data Management and Statistics Core (DMSC), NIC will develop susceptibility/risk and disease progression biomarkers for vascular contributions to ADRD. The NIC will also provide ante-mortem, post-mortem, and fixed brain MRI images to the Neuropathology Core to compare with histopathology results. Standardized Centralized Alzheimer’s & Related Dementias Neuroimaging (SCAN) MRI protocol, providing access to new and advanced MRI techniques, including methods for measuring blood-brain barrier permeability, quantitative MRI methods for T1 and T2 measurement, and cerebrovascular reactivity (CVR) measurement are major goals of the NIC. Furthermore, NIC will scan rural NM American Indian and Hispanic populations using a 1.5T mobile MRI scanner and initiate a positron-emission tomography (PET) program for amyloid and tau imaging – NIA/Alzheimer’s Association (NIA-AA) defined criteria for AD diagnosis. The NIC will collaborate with the OREC to educate and train researchers in advanced MRI imaging and analysis methods and offer community-based lectures on the benefits of neuroimaging.  
   
   
4. Biomarker Core (BMC): During the NMeADRC, we identified specific MRI- and fluid (blood and cerebrospinal fluid or CSF)-based biomarkers to classify dementias into vascular and neurodegenerative contributions. Currently, AD diagnosis uses the NIA/AA formula with A+ (Ab), T+ (phosphorylated tau at threonine 181), and N+ (neurodegeneration) as surrogates in diagnosis. These require invasive lumbar puncture for CSF or costly PET scans. The biomarker core has developed a clustering method to separate patients based on CSF AD proteins and MRI white matter injury (the double dichotomy method) that classified subjects into AD, vascular dementia, mixed dementia, and cognitively unimpaired controls. The core further improved this approach with a larger cohort from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database and the addition of a cognitive axis (trichotomy method). This expands the diagnostic formula to A+T+N+V+I+ formula by adding neurovascular (V) and neuroinflammatory biomarkers (I). Early identification of at-risk individuals provides the basis for studies of prevention in these populations of H/L and AI that are rarely included in such studies. The BMC will also share fluid samples and biomarker data (where allowed) with the NACC to support national initiatives in understanding the etiological factors of AD/ADRDs in diverse populations and thus aims to meet the goals of the National Alzheimer’s Project Act (NAPA).  
   
   
5. Neuropathology Core: The Neuropathology Core aims to collect post-mortem specimens, diagnose brain pathologies precisely, and freely share data, aligning with NM ADRC's focus on vascular and inflammatory contributions to AD/VCID in underrepresented groups. Led by two neuropathologists, the core targets both younger and older individuals with diverse dementia causes, including neuroinflammation and vascular abnormalities, in New Mexico's rural and minority populations. Utilizing UNM Brain Bank resources, it prospectively collects brains with antemortem imaging and biomarker data. Innovations include MR imaging correlations and spatial transcriptomics. The Core is also responsible for material acquisition, histopathological strategy development, spatial transcriptomics exploration, and educational material creation and delivery. The Core focuses on white matter, vascular, and inflammatory disease, benefiting local and broader research communities.  
   
   
6. Outreach, Recruitment, and Engagement (ORE) Core: To facilitate the representation of persons from H/L and AI groups, traditional recruitment-focused and ad hoc outreach activities must be replaced by intentional bidirectional engagement with community leaders and members. This new OREC will support the aims of the NM ADRC by engaging multiple levels of stakeholders from underrepresented groups to help address disparities in AD/ADRD research. The OREC will cultivate mutually respectful and beneficial relationships by giving first before any research requests, promoting sustainable programming, and listening carefully to community leaders. The OREC will also create more dementia-friendly communities of care and participation while honoring the critical contributions to science by persons living with AD/ADRD and their caregivers. OREC aims to align rigorous ADRC trial protocols with the expressed needs and comfort levels of New Mexican and tribal communities. The OREC will interact with all other NM ADRC Cores to achieve fairness in the representation of underrepresented rural, H/L, and AI communities in AD/ADRD research. Ultimately, knowledge gained from their representation will inform AD/ADRD prevention, detection, and care so that this devastating disease's heavy global and individual burdens can be eased.  
   
   
7. Data Management and Statistics Core (DMSC): DMSC will provide comprehensive, integrated, and continually updated data management for the acquisition, organization, use, and sharing of data from research participants in the NM ADRC. The DSMC will ensure timely and fully compliant transmission of ADRC UDS4 data, brain donor information, brain images, and other data to NACC and SCAN and work with NCRAD to provide coordinated blood sample and DNA sample sharing reports. The DMSC, comprised of a Data Management Program (DMP) and a Statistics Program (SP), will be fully integrated with NM ADRC leaders, Cores, Research Education Component (REC), and other ADRCs. The SP will contribute to the research design, statistical methods, size, and statistical power of their studies, analyze data, interpret findings, contribute to the preparation of grants, abstracts, and manuscripts, and develop their analytical skills. In addition, the SP will continue to develop, implement, test, and support the proper use of new computational, mathematical, statistical, big-data, machine-learning, data-mining, data-harmonization, and image-analysis tools, and new approaches to the use of clinical, imaging, and fluid-based biomarker data, with a focus on inflammation and cerebrovascular impairments.   
   
   
8. Research Education Component (REC): The REC will develop, upscale, deliver, and evaluate research educational activities to meet ADRD biomedical, behavioral, and clinical research needs. It will focus on research education on vascular and inflammatory contributions to Alzheimer's and cerebrovascular diseases in underrepresented groups in New Mexico. The REC’s long-term goal is to increase the capacity of the next generation of leading ADRD scientists to champion disruptive and transformative research that would meet the needs of diverse patients and caregivers nationally and in the Rocky Mountains region. By applying principles of culture-centeredness, we will broaden the scope and impact of ADRD research and prepare a new generation of ADRD researchers who will design and carry out disruptive, translational studies and bring their newly acquired skills to serve diverse patients by collaborating with other NM ADRC cores and with a focus on inflammation and vascular contributions to dementia.