1. Epidemiology of Dementia: the MoVIES Project Alzheimer’s Disease Patient Registry (ADPR ), University of Pittsburgh Initially funded by NIA 1987-1989 under cooperative agreement, U01 AG06782: Population-based Dementia Registry: Subsequently funded by NIA 1989-2002 as project grant R01, AG07562, Epidemiology of Dementia: A Prospective Community Study. Locally called “Monongahela Valley Independent Elders Survey” (MoVIES). Home

2. MoVIES Project Site: mid- Monongahela Valley in Washington and Westmoreland counties, Southwestern Pennsylvania; 23 communities served by the 23 Mon Valley communities served by the Mon Valley Community Health Center, Monessen, PA. Rural area with small towns, former home to coal mines and steel mills until the 1970s. Home

3. MoVIES Cohort Random sample, N=1422 1:13 age-stratified (65-74, 75+ years) random sample drawn from Voter Registration lists for the selected communities. Volunteer sample, N=259 drawn from same area, meeting same entry criteria. Home

4. MoVIES Entry Criteria Age 65+ at time of recruitment; Mon Valley resident; Not in nursing home at time of recruitment; Fluent in English; At least Grade 6 education. Home

5. MoVIES Cohort Characteristics Total sample size of original cohort: –N=1681 (random plus volunteer) Age: Mean (SD) = 72.6 (5.7) yrs (baseline) Sex ratio: F:M=55.5 : 45 Education: % < high school graduate: 43.3% Home

6. MoVIES:Overview Sample recruited 1987-1989 as part of ADPR; prevalent cases identified. Began prospective followup in 1989; Subjects re-assessed approximately every two years; incident cases identified. Followup completed in 2002. Home

7. MoVIES Screening Cognitive Tests MMSE CERAD Word List (10) Learning (3 trials) Delayed Recall Delayed Recognition (originals and foils) Story Immediate Recall Delayed Recall Boston Naming (15) Word Fluency P&S Fruits & Animals CERAD Praxis (4) Clock Drawing Trailmaking A Trailmaking B Temporal Orientation Home

8. MoVIES:Study procedures At each wave: All consenting survivors: cognitive screening and risk factor assessment. Screening identifies those who are –(a) cognitively “impaired;” –(b) cognitively “declined.” Impaired and declined subjects undergo clinical diagnostic evaluation for dementia. Home

9. MoVIES Screening Criteria (1) Cognitive impairment: Actual scores, at any given time, at or below the 10 th %ile of the sample on: MMSE and/or At least one memory test and one other test. Home

10. MoVIES Screening Criteria (2) Cognitive Decline: Decline over time in scores  To “impaired” levels, and/or  By amounts greater than or equal to that experienced by 95 % of the cohort on MMSE and/or At least two other tests. Home

11. MoVIES Clinical Evaluation (1) In-home evaluation; History and general physical exam; Detailed neurological exam; Brief mental status exam; Psychiatric exam; Blood: chemistry/hematology/serology; Home

12. MoVIES Clinical Evaluation (2) Based on Pittsburgh ADRC/CERAD assessment protocols, modified for field use; DSM-III-R criteria for dementia; CDR rating for stage/severity; NINCDS-ADRDA criteria for Probable and Possible AD. Home