This is a Resubmission Application for a Mentored Patient-Oriented Research Career Development Award for Dr. Rebecca Brown. Dr. Brown's long-term goal is to become a leader in aging research to improve the health and functional status of socioeconomically disadvantaged older adults, including those with early- onset (premature) geriatric syndromes. This award will provide Dr. Brown with the support necessary to continue her progress towards this goal, by obtaining additional training in several key areas and by completing the proposed mentored research project. The proposed career award addresses a critical knowledge gap: the epidemiology and outcomes of geriatric syndromes that develop in adults younger than age 65. Although it is well-recognized that some adults develop aging phenotypes at an age when most adults remain physically robust, very little is known about the epidemiology, outcomes, and potential management strategies of these individuals. Dr. Brown's proposed career development plan will allow her to address this knowledge gap by working with a team of superb mentors who will supervise the following three training goals: (1) to achieve expertise in clinical research methods and content areas which are critical to her future success as an independent clinician investigator (advanced methods for secondary data analysis, methods for the design, conduct, and analysis of clinical trials, social determinants of health, and qualitative research);(2) to create key developmental networks at UCSF and nationally;and (3) to develop grant-writing and research management skills and experience. Dr. Brown will achieve these goals by conducting the proposed research project with the close guidance and support of her mentorship team. In addition, her training will be supported by high-value didactic courses, tutorials, and seminars. The skills and experience she acquires from this training will prepare her to become an independent investigator and to successfully apply for an R01 grant implementing an intervention to identify and manage premature geriatric syndromes. Dr. Brown's research will describe the epidemiology and risk factors for premature geriatric syndromes (Aim 1), and will identify the relationship between premature geriatric syndromes and adverse outcomes, including hospitalization, institutionalization, and mortality (Aim 2). Dr. Brown will accomplish Aims 1 and 2 using longitudinal data from the nationally representative Health and Retirement Study. She will then conduct a qualitative study to better understand patient and clinician perspectives on the clinical needs of patients with premature geriatric syndromes, and to identify models of care that may help to address those needs (Aim 3).

Public Health Relevance

Geriatric syndromes are surprisingly common among adults aged 50-64 years, yet little is known about the epidemiology, outcomes, and potential management strategies of adults who develop aging phenotypes at an age when most adults remain physically robust. This research will provide data necessary to improve medical care for this vulnerable and understudied population.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Neuroscience of Aging Review Committee (NIA)
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Patmios, Georgeanne E
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Brown, Rebecca T; Diaz-Ramirez, L Grisell; Boscardin, W John et al. (2017) Functional Impairment and Decline in Middle Age: A Cohort Study. Ann Intern Med 167:761-768
Brown, Rebecca T; Ahalt, Cyrus; Rivera, Josette et al. (2017) Good Cop, Better Cop: Evaluation of a Geriatrics Training Program for Police. J Am Geriatr Soc 65:1842-1847
Brown, Rebecca T; Goodman, Leah; Guzman, David et al. (2016) Pathways to Homelessness among Older Homeless Adults: Results from the HOPE HOME Study. PLoS One 11:e0155065
Brown, Rebecca T; Miao, Yinghui; Mitchell, Susan L et al. (2015) Health Outcomes of Obtaining Housing Among Older Homeless Adults. Am J Public Health 105:1482-8
Cimino, Theora; Steinman, Michael A; Mitchell, Susan L et al. (2015) The Course of Functional Impairment in Older Homeless Adults: Disabled on the Street. JAMA Intern Med 175:1237-9
Brown, Rebecca T; Ahalt, Cyrus; Steinman, Michael A et al. (2014) Police on the front line of community geriatric health care: challenges and opportunities. J Am Geriatr Soc 62:2191-8
Brown, Rebecca T; Pierluissi, Edgar; Guzman, David et al. (2014) Functional disability in late-middle-aged and older adults admitted to a safety-net hospital. J Am Geriatr Soc 62:2056-63