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.

National Institute of Health (NIH)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Study Section
Special Emphasis Panel (ZAG1)
Program Officer
Salive, Marcel
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Lee, Sei J; Boscardin, W John; Kirby, Katharine A et al. (2014) Individualizing life expectancy estimates for older adults using the Gompertz Law of Human Mortality. PLoS One 9:e108540
Lai, J C; Feng, S; Terrault, N A et al. (2014) Frailty predicts waitlist mortality in liver transplant candidates. Am J Transplant 14:1870-9
Covinsky, Kenneth E; Cenzer, Irena Stijacic; Yaffe, Kristine et al. (2014) Dysphoria and anhedonia as risk factors for disability or death in older persons: implications for the assessment of geriatric depression. Am J Geriatr Psychiatry 22:606-13
Byers, Amy L; Covinsky, Kenneth E; Neylan, Thomas C et al. (2014) Chronicity of posttraumatic stress disorder and risk of disability in older persons. JAMA Psychiatry 71:540-6
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
O'Hare, Ann M; Hotchkiss, John R; Kurella Tamura, Manjula et al. (2014) Interpreting treatment effects from clinical trials in the context of real-world risk information: end-stage renal disease prevention in older adults. JAMA Intern Med 174:391-7
Eubank, Kathryn J; Covinsky, Kenneth E (2014) Delirium severity in the hospitalized patient: time to pay attention. Ann Intern Med 160:574-5
Greysen, S Ryan; Chin Garcia, Carie; Sudore, Rebecca L et al. (2014) Functional impairment and Internet use among older adults: implications for meaningful use of patient portals. JAMA Intern Med 174:1188-90
Kelley, Amy S; Langa, Kenneth M; Smith, Alexander K et al. (2014) Leveraging the health and retirement study to advance palliative care research. J Palliat Med 17:506-11
Greysen, S Ryan; Covinsky, Kenneth E (2014) Functional status--an important but overlooked variable in the readmissions equation. J Hosp Med 9:330-1

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