The mission of the proposed ACISR is to produce and disseminate comprehensive interventions that effectively target the complex clinical and social factors contributing to late-life depression, minimize the splintering of health care, and can be implemented under the current health reimbursement system. The rapid increase of older persons (73% increase is anticipated in US by year 2020) and the diseases and disabilities complicating their care make geriatric research a national priority. We focus on late-life depression because it is the leading cause of disability, increases medical morbidity and mortality, causes suffering, family disruption, and increases the cost of care. We propose a challenging program that expands our studies on clinical, psychosocial, and biological predictors of depression treatment outcomes and uses these findings and our clinical experience to develop interventions personalized at the patient and the setting level with the goal to preempt adverse consequences of late-life depression. To maximize our impact we will work both in settings in which most depressed elders receive care (primary care) and in settings serving elders with special clinical (disability) and social needs (poverty). To shorten the road from discovery to practice we plan to do most of this work in the community and together with our community partners. Our community partner will be the Westchester Geriatric Mental Health Coalition, which consists of medical practices, community mental health clinics, home healthcare agencies, rehabilitation hospitals, and government organizations who share our concerns. We propose to use Westchester County as an "incubator" of novel interventions, which we will further test at a national level in order to establish their public health significance. We are confident that we can meet the challenges of this work because of: 1. Our organizational experience in integrating research, methodology, community, and training activities into a cohesive, seamlessly-working system;2. our research structures for ethics, scientific and logistic support, and training of staff;3. our "know-how", history and explicit plans in developing sustained partnerships with community agencies and learning from them;4. our expertise in research methods development;and 5. our record and commitment to fostering the development of new investigators that will continue to invigorate our field. This application proposes a model of research development that can rapidly translate clinical, psychosocial, and biological findings into personalized interventions, shorten the way from discovery to community practice and benefit many depressed seniors, including those with severe pathology and limited resources who are neglected by traditional research.

Public Health Relevance

This application proposes a model of research development that can rapidly translate clinical, psychosocial, and biological findings into personalized interventions, shorten the way from discovery to community practice and benefit many depressed seniors, including those with severe pathology and limited resources who are neglected by traditional research.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Center Core Grants (P30)
Project #
5P30MH085943-04
Application #
8268527
Study Section
Special Emphasis Panel (ZMH1-ERB-B (01))
Program Officer
Niederehe, George T
Project Start
2009-08-26
Project End
2014-04-30
Budget Start
2012-05-01
Budget End
2013-04-30
Support Year
4
Fiscal Year
2012
Total Cost
$1,721,360
Indirect Cost
$489,777
Name
Weill Medical College of Cornell University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
060217502
City
New York
State
NY
Country
United States
Zip Code
10065
Alexopoulos, George S; Raue, Patrick J; Kiosses, Dimitris N et al. (2015) Comparing engage with PST in late-life major depression: a preliminary report. Am J Geriatr Psychiatry 23:506-13
Yuen, Genevieve S; Bhutani, Saumya; Lucas, Bryony J et al. (2015) Apathy in late-life depression: common, persistent, and disabling. Am J Geriatr Psychiatry 23:488-94
Bao, Yuhua; Shao, Huibo; Bruce, Martha L et al. (2015) Antidepressant Medication Management Among Older Patients Receiving Home Health Care. Am J Geriatr Psychiatry 23:999-1006
Avari, Jimmy N; Alexopoulos, George S (2015) Models of care for late-life depression of the medically ill: examples from chronic obstructive pulmonary disease and stroke. Am J Geriatr Psychiatry 23:477-87
Sentürk, Damla; Ghosh, Samiran; Nguyen, Danh V (2014) Exploratory time varying lagged regression: modeling association of cognitive and functional trajectories with expected clinic visits in older adults. Comput Stat Data Anal 73:1-15
Kiosses, Dimitris N; Alexopoulos, George S (2014) Problem-Solving Therapy in the Elderly. Curr Treat Options Psychiatry 1:15-26
Yuen, Genevieve S; Gunning-Dixon, Faith M; Hoptman, Matthew J et al. (2014) The salience network in the apathy of late-life depression. Int J Geriatr Psychiatry 29:1116-24
Raue, Patrick J; Ghesquiere, Angela R; Bruce, Martha L (2014) Suicide risk in primary care: identification and management in older adults. Curr Psychiatry Rep 16:466
Alexopoulos, George S; Kiosses, Dimitris N; Sirey, Jo Anne et al. (2014) Untangling therapeutic ingredients of a personalized intervention for patients with depression and severe COPD. Am J Geriatr Psychiatry 22:1316-24
Yuen, Genevieve S; Gunning, Faith M; Woods, Eric et al. (2014) Neuroanatomical correlates of apathy in late-life depression and antidepressant treatment response. J Affect Disord 166:179-86

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