The mission of the Research Methods Core (RMC) is to advance the quality and impact of research in "real world settings" by addressing methodological challenges posed by the clinical and service delivery complexities of depressed elders with limited access to good care. Concerns raised by our own communitybased studies, and the field more broadly, guided the development of RMC Initiatives as well as one of our Developmental Studies and three of our Pilot Studies: Initiative 1: Predictors and Moderators of Outcomes in Intervention Development: Development of novel interventions for depressed seniors who may not respond to existing treatment approaches is a complex process. We will rely on exploratory analyses of our rich RCT databases and use predictors of outcomes and moderators of treatment response to sharpen the selection of target populations, improve our interventions, and accelerate the process of moving research into practice. Pilot 3 focuses on the feasibility of web-based training as a way of enhancing the dissemination of community interventions. Pilot 5 studies the cost of care management in home healthcare as a way of evaluating its feasibility. Initiative 2. Reduction of Bias: Interventions focusing on provider behavior as well as patient outcomes often use cluster (setting-based) randomization designs resulting in non-equivalent groups. Building on our study of propensity modeling for patient-RCTs, we will investigate the suitability of propensity modeling in adjusting for group differences in cluster based designs (also addressed in Developmental Project 4). Another source of bias is loss of data through subject attrition, a problem inherent in intervention studies of chronic disorders like geriatric depression. To address this problem, we propose a sequential, multiple imputation procedure that builds on our work in which we evaluated bias reduction using a predictive model based on multiple imputation for the analysis of incomplete, missing not at random (MNAR) data (Pilot 4). Initiative 3. Generalizability of Community-Generated Interventions: To address sampling bias in community-based studies, we propose procedures related to both within-agency generalizability (e.g., reducing the source and impact of sample bias introduced by patient or client recruitment processes) and across-agency variation (e.g., biased introduced in the process of selecting community-based research partners or in implementing interventions).

Public Health Relevance

The RMC relies on a cohesive team with complementary expertise ranging from biostatistics to social systems to develop strategies addressing critical methodological concerns in developing personalized treatments, in reducing bias, and in enhancing generalizability in community-based research of geriatric depression.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Center Core Grants (P30)
Project #
Application #
Study Section
Special Emphasis Panel (ZMH1-ERB-B)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Weill Medical College of Cornell University
New York
United States
Zip Code
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

Showing the most recent 10 out of 42 publications