PRC projects will develop and test selective and indicated prevention strategies across three domains of vulnerability to major depression in later life: changes in physical health (especially those that entail loss of independence), depletion of psychosocial resources, and increasing cognitive impairments. Each of the three pilot prevention trials has been designed to address multiple areas of vulnerability. The PRC methods development project will utilize data from all three prevention trials to model longitudinal trajectories of risk (clinical, psychosocial, biological) in the service of (1) developing on-target (personalized), on-time risk reduction strategies and (2) better understanding moderators and mediators of depression prevention in older adults. The methods development work in """"""""dynamic"""""""" (that is, longitudinal and updatable) risk assessment will be fed back to the prevention pilot studies as they developing into ROIs, allowing them to test for ways of enhancing the efficiency and impact of risk-reduction strategies in vulnerable older adults. The three prevention trials encompass a range of learning-based interventions that are structured but tailored to be responsive to individual participant needs: enhancing problem solving skills, improving sleep quality, exercise, CBT-based approaches to pain, and conjointly intervening with both care recipient and caregiver. The ensemble of PRC projects address the mandate in the NIMH Strategic Plan (2.3) """"""""to develop and test innovative interventions to reduce risk and positively alter trajectories of illness."""""""" Two of the PRC study Pis qualify for the NIH designation of """"""""Early Stage Investigator"""""""": Karp and Thompson. As noted in the Administrative Unit of the Operations Core (Page 128), the Center will also fund competitive, peer-reviewed seed money and small awards as a further strategy for supporting research career development activity in depression prevention. We will target projects from Early Stage Investigators that propose to test biological mediators and moderators of depression prevention. For example, projects testing depression prophylaxis via exercise in the post-stroke patient and protecting sleep in patients exposed to depressogenic interventions such as interferon alpha, exemplify opportunities to further examine psychobiological mechanisms of depression prophylaxis.

Public Health Relevance

PHR The Principal Research Core will support three depression prevention trials and one methods development project. The prevention trials will enroll a total of 450 older adults with physical, cognitive, and psychosocial vulnerabilities to depression, testing the ability of learning-based interventions to protect from depression;while the methods development project, using data pooled across each of these trials, will develop practical ways to help clinicians apply preventive interventions in an on-target, on-time way to maximize efficiency.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Center Core Grants (P30)
Project #
5P30MH090333-04
Application #
8659207
Study Section
Special Emphasis Panel (ZMH1-ERB-F)
Project Start
Project End
Budget Start
2014-05-01
Budget End
2015-04-30
Support Year
4
Fiscal Year
2014
Total Cost
$284,849
Indirect Cost
$96,829
Name
University of Pittsburgh
Department
Type
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Wei, Wenjing; Karim, Helmet T; Lin, Chemin et al. (2018) Trajectories in Cerebral Blood Flow Following Antidepressant Treatment in Late-Life Depression: Support for the Vascular Depression Hypothesis. J Clin Psychiatry 79:
Karim, Helmet T; Wang, Maxwell; Andreescu, Carmen et al. (2018) Acute trajectories of neural activation predict remission to pharmacotherapy in late-life depression. Neuroimage Clin 19:831-839
Rodakowski, Juleen; Reynolds 3rd, Charles F; Lopez, Oscar L et al. (2018) Developing a Non-Pharmacological Intervention for Individuals With Mild Cognitive Impairment. J Appl Gerontol 37:665-676
Miller, Rachel G; Anderson, Stewart J; Costacou, Tina et al. (2018) Hemoglobin A1c Level and Cardiovascular Disease Incidence in Persons With Type 1 Diabetes: An Application of Joint Modeling of Longitudinal and Time-to-Event Data in the Pittsburgh Epidemiology of Diabetes Complications Study. Am J Epidemiol 187:1520-1529
Gebara, Marie Anne; DiNapoli, Elizabeth A; Kasckow, John et al. (2018) Specific depressive symptoms predict remission to aripiprazole augmentation in late-life treatment resistant depression. Int J Geriatr Psychiatry 33:e330-e335
Okereke, Olivia I; Reynolds 3rd, Charles F; Mischoulon, David et al. (2018) The VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention (VITAL-DEP): Rationale and design of a large-scale ancillary study evaluating vitamin D and marine omega-3 fatty acid supplements for prevention of late-life depression. Contemp Clin Trials 68:133-145
Gebara, Marie Anne; Kasckow, John; Smagula, Stephen F et al. (2018) The role of late life depressive symptoms on the trajectories of insomnia symptoms during antidepressant treatment. J Psychiatr Res 96:162-166
Cohen, Alex; Dias, Amit; Azariah, Fredric et al. (2018) Aging and well-being in Goa, India: a qualitative study. Aging Ment Health 22:168-174
Chen, Jie; Bloodworth, Robin; Novak, Priscilla et al. (2018) Reducing Preventable Hospitalization and Disparity: Association With Local Health Department Mental Health Promotion Activities. Am J Prev Med 54:103-112
Smagula, Stephen F; Lotrich, Francis E; Aizenstein, Howard J et al. (2017) Immunological biomarkers associated with brain structure and executive function in late-life depression: exploratory pilot study. Int J Geriatr Psychiatry 32:692-699

Showing the most recent 10 out of 175 publications