This application proposes the establishment of a Research Nursing Home Program at the Hebrew Rehabilitation Center for Aged and Harvard Medical School. The consortium which comprises the application includes four principal institutions all of which have substantial experience in clinical geriatrics and gerontological research and which have a proven track record of successful collaboration. The institutions include: 1) The Hebrew Rehabilitation Center for Aged, a long term care facility with a large population of elderly residents exhibiting a broad span of functional disability; 2) The Beth Israel Hospital, a major teaching hospital of Harvard Medical School and the site of a well developed clinical and research program in geriatric medicine and a productive NIH-funded Clinical Research Center; 3) The Harvard Medical School, site of the Division on Aging; and 4) The Boston University School of Nursing, with a well developed program in gerontological nursing. These institutions have a long history of mutual collaboration. The most pivotal consortium link is between the Hebrew Rehabilitation Center and the Beth Israel Hospital which have had a formal collaborative agreement dating back to 1965. The Principal Investigator serves as the Director of the Division on aging at Harvard Medical School and Chief of the Gerontology Program at Beth Israel. Substantial statistical, methodological, and administrative resources have been organized into a program core to facilitate the individual research projects. Experienced investigators will conduct a multi-disciplinary array of research projects focussing on biomedical and psycho-social aspects of the care of institutionalized elderly. The projects include: 1) studies of syncope and altered blood pressure homeostasis in the elderly, 2) studies of bladder function and urinary incontinence in the elderly, 3) studies of vitamin D nutrition and physiology in the elderly, 4) identification of Persons at risk for institutional placement, 5) studies of depression in senile dementia of the Alzheimer's type and, 6) studies of neuroendocrine function in senile dementia of the Alzheimer's type.
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