Challenges and opportunities of clinicopathological investigation in longitudinal studies of Alzheimer's disease.
After organizational involvement in a clinicopathological investigation of Alzheimer's Disease for a decade, the present appears an appropriate time to reflect upon both the major challenges encountered as well as the exciting opportunities presented by such a longitudinal study. Problematic areas have included: brevity of research grant intervals (generally one- or two-year); turnover of support personnel, as a consequence; limited biostatistical and data management expertise dedicated to the Study objectives; limited neuropsychological manpower in this specialized sphere; "distillate" effect of postmortem retrieval, by which only some of the many clinical cases expire during any grant period, only some of those receive autopsy permission, only some of those demonstrate (pure) Alzheimer's Disease neuropathologically, and only some are harvested quickly enough for specialized (e.g. biochemical) analyses; ensuring the scientific optimization of available tissue samples; and paucity of cases dying in the early stages of the illness. Significant achievements include: demonstration of the opportunities for young researchers committed to careers in behavioral neurology, psychogeriatrics or neurodegenerative pathology; development of improved testing protocols for psychometric, electroencephalographic and neuroradiological evaluation of the demented elderly.(ABSTRACT TRUNCATED AT 250 WORDS)
D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology; D003071:Cognition; D005544:Forecasting; D006801:Humans; D007256:Information Systems; D008137:Longitudinal Studies; D011594:Psychometrics / Q000379:methods; D012106:Research; D012108:Research Personnel; D012109:Research Support as Topic; D014015:Tissue Banks