The objective of this revised Academic Career Award, Development, application is to assist Dr. William Apfeldorf in his academic activities in the field of geriatric psychiatry and to develop a clinical research program in late life anxiety disorders at the New York Hospital - Cornell Medical Center. The award will free Dr. Apfeldorf from most of his present clinical responsibilities, allowing him to obtain the training and experience necessary to develop as an academician and scientist. The training plan focuses on forming strong collaborative relationships with experts in the fields of geriatric psychiatry, anxiety disorders, and behavioral neuroscience.
The specific aims of the research plan are: 1) to describe the expression and course of late life panic disorder, and its impact on medical morbidity and functioning in elderly panic disorder patients and elderly normal controls, and 2) to describe the profile of panic symptoms and neuroendocrine responses to pentagastrin panic provocation in elderly panic disorder patients and elderly normal controls. The research plan addresses clinical concerns about the direct and indirect cost of late life panic disorder in term of morbidity, quality of life, and burden for patients and their families. The plan also introduces a biological model for evaluating late life panic symptoms, allowing pathophysiologic mechanisms implicated in late life panic disorder to be investigated. Academic and research activities will take place simultaneously throughout the award period. As a result of this program, hypotheses on the underlying relationships of aging, pathophysiologic mechanisms, and anxiety disorders will be formulated. Upon completion of the award period, Dr. Apfeldorf will function as a faculty scholar, as a principal investigator in late life anxiety disorders for NIMH-supported studies including R01 and First Award applications, and as mentor and resource to medical students, residents, fellows, and colleagues.