Core I: Oldest Old Core

PROJECT SUMMARY – OLDEST-OLD CORE (CORE I) The Oldest-Old Core focuses on individuals aged 90 and older, the fastest-growing segment of the population with the highest rates of dementia. This demographic shift presents significant public health challenges as the number of dementia cases among the oldest-old is predicted to exceed the current total across all ages. Despite their increasing prevalence, the oldest-old are underrepresented in aging and cognitive research, partly due to the unique challenges of studying this group. Building on over two decades of pioneering oldest-old research at UCI, the Oldest-Old Core will turn its efforts to guiding the ADRC network in the necessary inclusion of the oldest participants. The Oldest-Old Core will collaborate with the Clinical Core to evaluate the Uniform Data Set (UDS) for deficiencies in assessing the oldest-old. By identifying areas with high rates of missing data and developing a modified, lower-burden UDS battery, we aim to enhance the assessment accuracy and participant retention. Additionally, we will explore the benefits of bi-annual assessments to detect cognitive and functional changes more promptly. Collaborating with the Outreach Recruitment and Engagement Core, we will devise appropriate recruitment strategies to ensure adequate and diverse representation. Quantitative neuropathological measures will also be used to investigate clinicopathological outcomes relevant to the oldest-old such as resilience and resistance to Alzheimer's Disease (AD) and Alzheimer's Disease-Related Dementias (ADRD). Additionally, we will support the education and training of the next generation of AD/ADRD researchers and clinicians, emphasizing the best approaches for studying the oldest-old. Our specific aims align with our center’s principles of collaboration, innovation, and education. Successful completion will position UCI as a leader in accelerating AD/ADRD research by promoting discovery across inadequately represented groups, particularly the oldest-old. We aim to improve recruitment, retention, and assessment practices across the ADRC network, contributing to advances in understanding AD/ADRD in this critical population.