The aims of this K24 renewal are to (1) enable the candidate to further develop his program of outcomes research in older persons, focused on the evaluation of prognostic factors and the development of prognostic stratification tools and (2) Use his research program as a platform to mentor trainees who will develop into future leaders in aging research. The candidate has made excellent use of the support provided in the first cycle of his K24. He has been highly productive, publishing numerous studies on prognostic determinants in older persons, many in the highest impact journals. He has been successful in funding his work, obtaining a new R01 grant focused on outcomes in persons with hip fracture, was PI of the UCSF T32 renewal which received a perfect score of 10, and was PI of the UCSF Pepper Center application which is expected to be funded in mid 2013. He has mentored his first trainees to independence, and new trainees he has mentored with his K24 support have been highly successful in terms of high impact publications and funding, including several with Beeson Scholar Awards. He has been successful in his plan to expand his mentoring beyond Geriatrics trainees, successfully mentoring trainees in diverse fields such as nephrology, gastroenterology, hospital medicine, palliative medicine, and surgery. This renewal will make it possible for the candidate to further develop his research program, and use his research program as a platform for his mentoring. He will leverage his ongoing R01, which uses the HRS to examine the determinants of mortality following hip fracture and examines the supportive and palliative needs of hip fracture patients, as a resource for his mentees. He will also leverage his leadership of the UCSF Pepper Center which focuses on bringing together medical and social determinants of vulnerability to better understand the causes and outcomes of older age disability. Bringing together the career development resources of the Pepper Center with the mentoring resources of the K24 gives the candidate a unique opportunity to develop exceptional mentoring programs. Finally, he will use the K24 to develop a new research direction, using the HRS to examine the psychosocial determinants of prognosis. This project has two aims: (1) To develop psychosocial morbidity indices that risk stratifies older persons into categories at variable risk for mortality and functional decline based on psychosocial measures of risk and (2) To test the hypothesis that the psychosocial morbidity indices improve the accuracy of a widely cited index that did not consider psychosocial factors. The candidate will also continue a formal mentoring program with plans for the recruitment, selection, development, and evaluation of mentees who will become successful leaders in aging research. Each mentee will have a focused career development plan that includes directed didactic and developmental activities and a mentored research project that will lead to first author publications.

Public Health Relevance

This project supports the candidate to further develop a research program that seeks to understand the determinants of health outcomes in older persons and develop a mentoring program that will support trainees doing research in aging. His research program will lead to a better understanding of the determinants of health outcomes such as mortality and disability in older persons. His mentoring program will provide structured training and opportunities for research projects for junior trainees who plan research careers aimed at improving the health of older persons.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AG029812-07
Application #
8738553
Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Salive, Marcel
Project Start
2007-07-01
Project End
2018-04-30
Budget Start
2014-08-01
Budget End
2015-04-30
Support Year
7
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Cenzer, Irena S; Tang, Victoria; Boscardin, W John et al. (2016) One-Year Mortality After Hip Fracture: Development and Validation of a Prognostic Index. J Am Geriatr Soc 64:1863-8
Lai, Jennifer C; Dodge, Jennifer L; Sen, Saunak et al. (2016) Functional decline in patients with cirrhosis awaiting liver transplantation: Results from the functional assessment in liver transplantation (FrAILT) study. Hepatology 63:574-80
Greene, Meredith; Covinsky, Kenneth E; Valcour, Victor et al. (2015) Geriatric Syndromes in Older HIV-Infected Adults. J Acquir Immune Defic Syndr 69:161-7
Lai, Jennifer C; Covinsky, Kenneth E; Hayssen, Hilary et al. (2015) Clinician assessments of health status predict mortality in patients with end-stage liver disease awaiting liver transplantation. Liver Int 35:2167-73
Wang, Connie W; Covinsky, Kenneth E; Feng, Sandy et al. (2015) Functional impairment in older liver transplantation candidates: From the functional assessment in liver transplantation study. Liver Transpl 21:1465-70
Ornstein, Katherine A; Leff, Bruce; Covinsky, Kenneth E et al. (2015) Epidemiology of the Homebound Population in the United States. JAMA Intern Med 175:1180-6
Greysen, S Ryan; Stijacic Cenzer, Irena; Auerbach, Andrew D et al. (2015) Functional impairment and hospital readmission in Medicare seniors. JAMA Intern Med 175:559-65
Hunt, Lauren J; Covinsky, Kenneth E; Yaffe, Kristine et al. (2015) Pain in Community-Dwelling Older Adults with Dementia: Results from the National Health and Aging Trends Study. J Am Geriatr Soc 63:1503-11
Smith, Alexander K; Cenzer, Irena Stijacic; John Boscardin, W et al. (2015) Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc 63:2029-35
Lindquist, Lee A; Covinsky, Kenneth; Langa, Kenneth M et al. (2014) Making general internal medicine research relevant to the older patient with multiple chronic comorbidities. J Gen Intern Med 29:915-9

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