This application proposes use of the NIA mid-career award in patient-oriented research to create and sustain a mentoring program for aspiring aging researchers at the Weill Medical College of Cornell University led by Dr. Mark Lachs. Dr. Lachs is a geriatrician and clinical epidemiologist with expertise in the areas of elder mistreatment, protective services, and functional status. He is also Directs the Cornell Center for Aging Research and Clinical Care (CCARCC), an institution wide entity seeded by an NIA Academic Leadership Award and formalized by the Dean in 2000. CCARCC's infrastructure will assist in identifying mentored trainees, provide additional resources to them (e.g., through its pilot grant program), and formally evaluate Dr. Lachs' K24 program through an external advisory committee led by Dr. William Hazzard. Two new patient-oriented research projects are proposed in the area of elder self-neglect (ESN).
The specific aims of these are: (1) to estimate the contribution of executive dysfunction to self-care behaviors that may precede ESN, and (2) to determine if alcohol consumption is an risk factor for ESN. These studies hypothesize that ESN is a continuum of progressively more egregious low self-care states. ESN as chosen as a content area because (a) it is a multi-factorial syndrome likely to attract trainees with interests from diverse fields (e.g., geriatric medicine and psychiatry, neuropsychology, nutrition, alcohol, and medicalethics), (b) it is prevalent but studied despite substantial mortality and indignity, and (c) Cornell has an unusual depth of expertise (and potential mentees) in geriatric psychiatry in the form of the Cornell Geriatric Psychiatry Institute headed by George Alexopoulos. Preliminary data on depression and ESN are provided. Strengths of the candidate include his formal training in research methodology as an RWJ Clinical Scholar at Yale, his history of academic productivity and continuous NIH funding including an active RO1 in the area of crime and health in older people, and an early track record of mentoring junior trainees at all levels. Strengths of the institution include the resources of CCARCC, several aging related Centers at Cornell from which to garner potential mentees, the availability of divisional resources to """"""""protect"""""""" promising trainees in the critical period between fellowship and initial extramural funding, and a divisional co-chief structure that can insulate the candidate from undue administrative and clinical burdens should this application be successful.
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