This application requests renewal of the Hebrew Rehabilitation Center for Aged (HRCA)/Harvard Research Nursing Home (RNH) program project. Over the past 15 this program has become a unique, multi-disciplinary collaboration of investigators from 4 academic hospitals and 3 universities in the Boston area that share the common goal of conduct high-quality clinical research focused on prevalent, disabling, previously neglected syndromes that threaten the independence and quality of life of elderly people. During the next five years we plan to move from studies of pathophysiology of clinical syndromes in the nursing home to the development of new diagnostic tools and interventions to prevent disability and improve the well-being of elderly people in all long-term care settings. The participating institutions are HRCA, Brigham and Women's Hospital, Massachusetts General Hospital, Boston University, Harvard Medical School, and the University of Massachusetts School of Nursing. These projects represent the continuation of work by principal investigators who have been in the RNH program since its inception. In addition, we have recruited a new investigator, Dr. James Collins, whose pilot work at HRCA has led to his proposal. The RNH projects include: Aging, Anti-hypertensive Therapy and BP Regulation by Lewis A. Lipsitz, M.D; Pathogenesis of Detrusor Over-activity by Neil M. Resnick, M.D; Interventions to Improve Motor Control in Frail Elderly by James J. Collins; Ph.D. The projects will be supported by Cores to support subject recruitment, data management and analysis; and to assure efficient program operation and promote new research and training. An advisory group of academic leaders in medicine and nursing will review the program annually and help set its future course. The commitment of substantial institutional resources, a successful 15-year collaboration among investigators, a track record of productivity, a consortium of outstanding academic centers, and proven leadership abilities of administrative staff, all assure that this program will achieve its goals.
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