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 #
5P30MH085943-05
Application #
8465906
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
2013-05-01
Budget End
2014-04-30
Support Year
5
Fiscal Year
2013
Total Cost
$1,629,808
Indirect Cost
$463,641
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; Gunning, Faith et al. (2016) "Engage" Therapy: Behavioral Activation and Improvement of Late-Life Major Depression. Am J Geriatr Psychiatry 24:320-6
Gustavson, Kristen A; Alexopoulos, George S; Niu, Grace C et al. (2016) Problem-Solving Therapy Reduces Suicidal Ideation In Depressed Older Adults with Executive Dysfunction. Am J Geriatr Psychiatry 24:11-7
Bogner, Hillary R; Joo, Jin H; Hwang, Seungyoung et al. (2016) Does a Depression Management Program Decrease Mortality in Older Adults with Specific Medical Conditions in Primary Care? An Exploratory Analysis. J Am Geriatr Soc 64:126-31
Yohannes, Abebaw Mengistu; Raue, Patrick J; Kanellopoulos, Dora et al. (2016) Predictors of All-Cause Mortality in Patients With Severe COPD and Major Depression Admitted to a Rehabilitation Hospital. Chest 149:467-73
Mahgoub, Nahla; Alexopoulos, George S (2016) Amyloid Hypothesis: Is There a Role for Antiamyloid Treatment in Late-Life Depression? Am J Geriatr Psychiatry 24:239-47
Alexopoulos, George S; Sirey, Jo Anne; Banerjee, Samprit et al. (2016) Two Behavioral Interventions for Patients with Major Depression and Severe COPD. Am J Geriatr Psychiatry 24:964-974
Gallo, Joseph J; Hwang, Seungyoung; Joo, Jin Hui et al. (2016) Multimorbidity, Depression, and Mortality in Primary Care: Randomized Clinical Trial of an Evidence-Based Depression Care Management Program on Mortality Risk. J Gen Intern Med 31:380-6
Alexopoulos, George S; Raue, Patrick J; McCulloch, Charles et al. (2016) Clinical Case Management versus Case Management with Problem-Solving Therapy in Low-Income, Disabled Elders with Major Depression: A Randomized Clinical Trial. Am J Geriatr Psychiatry 24:50-9
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
Kiosses, Dimitris N; Ravdin, Lisa D; Gross, James J et al. (2015) Problem adaptation therapy for older adults with major depression and cognitive impairment: a randomized clinical trial. JAMA Psychiatry 72:22-30

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